INTEGRATED HEALTH SERVICES INC
10-Q, 1997-08-14
SKILLED NURSING CARE FACILITIES
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                                  UNITED STATES

                       SECURITIES AND EXCHANGE COMMISSION

                             Washington, D.C. 20549


                                    FORM 10-Q




[ X ]  Quarterly Report Pursuant to Section 13 or 15(d) of the Securities
Exchange Act of 1934

For the period ended             June 30, 1997

                                       or

[   ]  Transition Report Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934

For the transition period from               to

Commission File Number: 1-12306


                     Integrated Health Services, Inc.
             (Exact name of registrant as specified in its charter)


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

          10065 Red Run Boulevard, Owings Mills, MD          21117
         (Address of principal executive offices)          (Zip Code)

                              (410) 998-8400
                  (Registrant's telephone, including area code)


Indicate by check mark whether the registrant (1) has filed all reports required
to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during
the  preceding 12 months (or for such  shorter  period that the  registrant  was
required  to file  such  reports),  and  (2) has  been  subject  to such  filing
requirements for the past 90 days.

                                                          [ X ] Yes     [   ] No

Number of shares of common stock of the registrant outstanding as of
August 6, 1997: 25,513,551 shares.


                                  Page 1 of 27
<PAGE>


                        INTEGRATED HEALTH SERVICES, INC.
                                      INDEX




PART I.  FINANCIAL INFORMATION
                                                                            Page

Item 1.  - Condensed Financial Statements -

         Consolidated Balance Sheets
           June 30, 1997 and December 31, 1996                                3

         Consolidated Statements of Earnings
           for the three and six months ended
           June 30, 1997 and 1996                                             4

         Consolidated Statement of Changes in
           Stockholders' Equity for the six
           months ended June 30, 1997                                         5

         Consolidated Statements of Cash Flows
           for the six months ended June 30, 1997
           and 1996                                                           6

         Notes to Consolidated Financial Statements                           7

Item 2.  Management's Discussion and Analysis of
           Financial Condition and Results of
           Operations                                                         14


PART II:          OTHER INFORMATION

Item 2.  Changes in Securities                                                24

Item 4.  Submission of Matters to a Vote of
           Security Holders                                                   25

Item 6.  Exhibits and Reports on Form 8-K                                     25


                                  Page 2 of 27


<PAGE>
<TABLE>
<CAPTION>
                                          INTEGRATED HEALTH SERVICES, INC. AND SUBSIDIARIES
                                                     CONSOLIDATED BALANCE SHEETS
                                                       (Dollars In Thousands)

                                                                                              June 30,            December 31,
                                                                                                1997                  1996
                                                                                          -----------------    --------------------
<S>                                                                                       <C>                  <C>     
       Assets
Current Assets:
       Cash and cash equivalents                                                       $            43,105                  39,028
       Temporary investments                                                                         2,367                   2,044
       Patient accounts and third-party payor settlements
         receivable, less allowance for doubtful receivables                                       344,144                 326,883
         of $38,881 at June 30, 1997 and $41,527 at December 31, 1996
       Supplies inventories, prepaid expenses
         and other current assets                                                                   28,931                  26,243
       Income tax receivable                                                                        30,617                  20,992
                                                                                          -----------------    --------------------
               Total current assets                                                                449,164                 415,190
                                                                                          -----------------    --------------------

Property, plant and equipment, net                                                                 910,772                 864,335
Intangible assets                                                                                  633,206                 572,159
Investments in and advances to affiliates                                                           74,001                  76,047
Other assets                                                                                        75,504                  65,376
                                                                                          -----------------    --------------------

               Total assets                                                            $         2,142,647               1,993,107
                                                                                          =================    ====================


       Liabilities and Stockholders' Equity
Current Liabilities:
       Current maturities of long-term debt                                            $            13,161                  16,547
       Accounts payable and accrued expenses                                                       276,961                 341,094
                                                                                          -----------------    --------------------
               Total current liabilities                                                           290,122                 357,641
                                                                                          -----------------    --------------------

Long-term Debt:
       Convertible  subordinated debentures                                                        258,750                 258,750
       Other long-term debt, less current maturities                                               946,337                 779,450
                                                                                          -----------------    --------------------
               Total long-term debt                                                              1,205,087               1,038,200
                                                                                          -----------------    --------------------

Other long-term liabilities                                                                         35,315                  33,851
Deferred income taxes                                                                               25,073                  22,283
Deferred gain on sale-leaseback transactions                                                         5,731                   6,267
Stockholders' equity:
       Preferred stock, authorized 15,000,000 shares; no shares
            issued and outstanding                                                                      --                      --
       Common stock, $0.001 par value.  Authorized 150,000,000
         shares;  outstanding  25,387,377  at June 30,  1997 and  23,628,250
         at December 31, 1996 (including 41,900 treasury shares at
         June 30, 1997)                                                                                 25                      24
       Additional paid-in capital                                                                  492,892                 445,667
       Retained earnings                                                                            89,940                  79,814
       Unrealized gain on available for sale securities                                                  0                   9,360
       Treasury stock at cost (41,900 shares at June 30, 1997)                                     (1,538)                       0
                                                                                          -----------------    --------------------
               Net stockholders' equity                                                            581,319                 534,865
                                                                                          -----------------    --------------------

               Total liabilities and stockholders' equity                              $         2,142,647               1,993,107
                                                                                          =================    ====================

                                     See accompanying Notes to Consolidated Financial Statements


                                                            Page 3 of 27


</TABLE>
<PAGE>


<TABLE>
<CAPTION>

                                          INTEGRATED HEALTH SERVICES, INC. AND SUBSIDIARIES
                                                 CONSOLIDATED STATEMENT OF EARNINGS
                                                       (Dollars in Thousands)


                                                          Three Months Ended                        Six Months Ended
                                                            June 30,                                    June 30,
                                              --------------------------------------      --------------------------------------

                                                   1997                  1996                  1997                  1996
                                              ----------------      ----------------      ----------------      ----------------
<S>                                           <C>                   <C>                   <C>                   <C>                 
Net revenues:
  Basic medical services                      $        88,055                98,063               176,810               195,279
  Specialty medical services                          360,113               226,868               722,802               446,393
  Management services and other                         9,805                10,849                19,304                21,381
                                              ----------------      ----------------      ----------------      ----------------
    Total revenues                                    457,973               335,780               918,916               663,053
                                              ----------------      ----------------      ----------------      ----------------

Costs and expenses:
  Operating expenses                                  338,736               254,274               691,148               504,169
  Corporate administrative and general                 18,135                14,854                36,151                29,947
  Depreciation and amortization                        15,814                 8,505                30,844                16,779
  Rent                                                 25,786                17,879                49,795                35,535
  Interest, net                                        23,224                15,888                44,645                30,102
  Non-recurring charges, net                           21,072                     0                20,047                     0
                                              ----------------      ----------------      ----------------      ----------------
    Total costs and expenses                          442,767               311,400               872,630               616,532
                                              ----------------      ----------------      ----------------      ----------------

    Earnings before equity in earnings
    (loss) of affiliates, income taxes
    and extraordinary items                            15,206                24,380                46,286                46,521

Equity in earnings (loss) of affiliates                  (83)                   460                    98                   760
                                              ----------------      ----------------      ----------------      ----------------

    Earnings before income taxes
    and extraordinary items                            15,123                24,840                46,384                47,281

Federal and state income taxes                          5,898                 9,563                18,090                18,203
                                              ----------------      ----------------      ----------------      ----------------

    Earnings before extraordinary items                 9,225                15,277                28,294                29,078

Extraordinary items (Note 6)                           18,168                 1,431                18,168                 1,431
                                              ----------------      ----------------      ----------------      ----------------

    Net earnings (loss)                       $       (8,943)                13,846                10,126                27,647
                                              ================      ================      ================      ================

Per Common Share - primary
    Earnings before extraordinary
    item                                      $          0.31                  0.64                  1.05                  1.26
    Net earnings (loss)                                (0.36)                  0.58                  0.38                  1.20
                                              ================      ================      ================      ================

Per Common Share - fully diluted
    Earnings before extraordinary
    item                                                0.29                  0.56                  0.92                  1.10
    Net earnings (loss)                                (0.22)                  0.51                  0.41                  1.05
                                              ================      ================      ================      ================



                                     See accompanying Notes to Consolidated Financial Statements


                                                            Page 4 of 27
</TABLE>
<PAGE>


<TABLE>
<CAPTION>

                                          INTEGRATED HEALTH SERVICES, INC. AND SUBSIDIARIES
                                      CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY
                                                       (dollars in thousands)
                                                                                            Unrealized
                                                                                             Gain On
                                                            Additional                       Available
                                              Common         Paid-In        Retained         For Sale        Treasury
                                              Stock          Capital        Earnings        Securities         Stock           Total
                                             ---------------------------------------------------------------------------------------

<S>                                            <C>          <C>              <C>               <C>             <C>           <C>
Balance at December 31, 1996               $     24         445,667          79,814            9,360             -           534,865

Issuance of 976,504 shares of common
stock in payment of earn-out in
connection with prior acquisition (Note 3)       1           26,438               -                -              -           26,439

Issuance of 322,472 shares of
common stock in connection with 1997
acquisitions (Note 3)                            -           11,460               -                -              -           11,460

Issuance of 30,248 shares of common
stock in connection with employee
stock purchase plan                              -              647               -                -              -              647

Exercise of employee stock options
for 471,803 shares of common stock               -            8,680               -                -              -            8,680

Repurchase of 41,900 shares of treasury
stock  (Note 7)                                  -                -               -                -         (1,538)         (1,538)

Realized gain on available for sale
securities                                       -                -               -          (9,360)              -          (9,360)

Net earnings                                     -                -          10,126                -              -           10,126
                                              --------------------------------------------------------------------------------------

Balance at June 30, 1997                    $   25         492,892           89,940                0         (1,538)         581,319
                                              ======================================================================================


                                     See accompanying Notes to Consolidated Financial Statements


                                                            Page 5 of 27


</TABLE>
<PAGE>


<TABLE>
<CAPTION>
                                          INTEGRATED HEALTH SERVICES, INC. AND SUBSIDIARIES
                                                CONSOLIDATED STATEMENTS OF CASH FLOWS
                                                       (dollars in thousands)

                                                                                               Six Months Ended
                                                                                                   June 30,
                                                                                     -------------------------------------
                                                                                          1997                 1996
                                                                                     ----------------     ----------------

<S>                                                                                   <C>                  <C>
Cash flows from operating activities:
    Net earnings                                                                   $          10,126               27,647
    Adjustments to reconcile net earnings to net
       cash provided by operating activities:
          Extraordinary item (Note 6)                                                         29,784                2,327
          Non-recurring charges, net                                                          20,047                    0
          Undistributed results of joint ventures                                                328                (390)
          Depreciation and amortization                                                       30,844               16,779
          Deferred income taxes and other non-cash items                                       2,090                2,095
          Amortization of gain on sale-leaseback transactions                                  (536)                (516)
          Increase in patient accounts and third-party
             payor settlements receivable, net                                              (10,109)             (31,399)
          Increase in supplies inventory, prepaid
             expenses and other current assets                                               (2,483)                (986)
          Decrease in accounts payable and accrued expenses                                 (59,439)             (16,716)
          (Increase) decrease in income taxes receivable                                     (9,644)                1,800
                                                                                     ----------------     ----------------

             Net cash provided by operating activities                                        11,008                  641
                                                                                     ----------------     ----------------

Cash flows from financing activities:
    Proceeds from issuance of capital stock, net                                               9,327                1,799
    Proceeds from long-term borrowings                                                     1,083,219              627,675
    Repayment of long-term debt                                                            (919,514)            (490,761)
    Payment of pre-payment premiums and fees of debt
       extinguishment  (Note 6)                                                             (23,598)                    0
    Deferred financing costs                                                                (13,840)              (8,090)
    Dividends paid                                                                             (471)                (435)
    Purchase of treasury stock                                                               (1,538)                    0
                                                                                     ----------------     ----------------

             Net cash provided by financing activities                                       133,585              130,188
                                                                                     ----------------     ----------------

Cash flows from investing activities:
    Sale of temporary investments                                                                119                   97
    Purchase of temporary investments                                                          (442)                    0
    Business acquisitions                                                                   (34,543)             (18,159)
    Payment of termination fees and other costs of terminated merger                        (27,555)                    0
    Purchase of property, plant and equipment                                               (67,588)             (67,355)
    Other assets                                                                            (10,507)             (39,930)
                                                                                     ----------------     ----------------

             Net cash used by investing activities                                         (140,516)            (125,347)
                                                                                     ----------------     ----------------

             Increase in cash and cash equivalents                                             4,077                5,482

Cash and cash equivalents, beginning of period                                                39,028               38,917
                                                                                     ----------------     ----------------

Cash and cash equivalents, end of period                                           $          43,105               44,399
                                                                                     ================     ================


                                     See accompanying Notes to Consolidated Financial Statements


                                                            Page 6 of 27


</TABLE>
<PAGE>


                                      NOTES
                                       TO
                        CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1:          BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

                 The consolidated  financial  statements  included herein do not
                 contain  all  information  and  footnote  disclosures  normally
                 included in financial  statements  prepared in accordance  with
                 generally   accepted   accounting   principles.   For   further
                 information,   such  as  the  significant  accounting  policies
                 followed  by  Integrated   Health  Services,   Inc.  ("IHS"  or
                 "Company"),  refer to the consolidated financial statements and
                 notes thereto  included in the Company's  Annual Report on Form
                 10-K for the year ended  December 31,  1996.  In the opinion of
                 management,  the consolidated  financial statements include all
                 necessary  adjustments  (consisting  of only  normal  recurring
                 accruals) for a fair presentation of the financial position and
                 results of operations for the interim  periods  presented.  The
                 results of operations for the interim periods presented are not
                 necessarily  indicative of the results that may be expected for
                 the full year.

NOTE 2:          EARNINGS PER SHARE

                 Primary  earnings  per share is computed  based on the weighted
                 average   number  of  common  and  common   equivalent   shares
                 outstanding  during  the  periods.   Common  stock  equivalents
                 include options and warrants to purchase common stock,  assumed
                 to be exercised using the treasury stock method.  Fully diluted
                 earnings per share is computed as described above,  except that
                 the  weighted  average  number of common  equivalent  shares is
                 determined assuming the dilution resulting from the issuance of
                 the  aforementioned  options and  warrants at the higher of the
                 end-of-period price per share or the weighted average price for
                 the period,  and the issuance of common shares upon the assumed
                 conversion   of  the   convertible   subordinated   debentures.
                 Additionally, interest expense and amortization of underwriting
                 costs  related to such  debentures  are added,  net of tax,  to
                 income for the purpose of  calculating  fully diluted  earnings
                 per share.  Such  amounts and the  resulting  net  earnings for
                 fully  diluted  earnings per share  purposes are  summarized as
                 follows  for the six  months  ended  June 30,  1997  and  1996,
                 respectively:

                                                               1997       1996
                                                              -----------------
                 Net earnings                                $10,126     27,647

                 Adjustment for interest and underwriting
                 costs on convertible debentures               4,904      4,944
                                                              ---------  -------

                 Net earnings for fully diluted EPS          $15,030     32,591
                                                              =========  =======

                 Weighted average shares-Primary              26,963     23,039
                 Weighted average shares-Fully Diluted        36,233     31,028
                                                              =========  =======


                                  Page 7 of 27


<PAGE>


<TABLE>

NOTE 3:          NEW ACQUISITIONS

                         ACQUISITIONS DURING THE SIX MONTHS ENDED JUNE 30, 1997

                         Acquisitions for the six months ended June 30, 1997 and
                         the manner of payment are summarized as follows:

                                                                  COMMON
                                                      TOTAL       STOCK       ACCRUED           CASH
MONTH            TRANSACTION DESCRIPTION              COST        ISSUED      LIABILITIES       PAID
- -----            -----------------------              -----       ------      -----------       ----
<S>              <C>                                  <C>         <C>        <C>               <C>  
January          Stock of In-Home Health
                         Care, Inc.                   $3,450      $----      $250              $3,200

February         Assets of Professional
                         Health Services, Inc.         350         ----       100               250

February         Assets of Portable X-Ray
                         Labs, Inc.                    6,200       ----       1,300             4,900

March            Assets of Laboratory
                         Corporation of America        35          ----       ----              35

March            Assets of Doctor's Home
                         Health Agency, Inc.           445         ----       95                350

March            Payment of earnout in
                         connection with Achieve-
                         ment Rehab acquisition
                         in December 1993              26,439      26,439     ----              ----

April            Assets of Coastal
                         Rehabilitation, Inc.          1,450       ----       200               1,250

April            Assets of Mobile
                         Diagnostics, Inc.             225         ----       75                150

June             Stock of Health Care
                         Industries, Inc.              2,325       ----       500               1,825

June             Assets of The Nursing
                         Connection                    330         ----       ----              330

June             Assets of Rehab Dynamics,
                         Inc. and Restorative
                         Therapy, Ltd.                 22,163      11,460    2,500              8,203

Various          Cash payments of
                         acquisition costs
                         accrued in 1996               ----        ----      (14,050)           14,050
                                                      ------      ---------  --------           ------

                                                      $63,412     $37,899   $(9,030)           $34,543
                                                      =======     =========  ========          =======


                                                            Page 8 of 27


</TABLE>
<PAGE>


<TABLE>
<CAPTION>
The allocation of the total cost of the 1997 acquisitions to the assets acquired
and liabilities assumed is summarized as follows:

                                PROPERTY,
                   CURRENT      PLANT &         OTHER       INTANGIBLE       CURRENT         LONG-TERM        TOTAL
TRANSACTION        ASSETS       EQUIPMENT       ASSETS      ASSETS           LIABILITIES     LIABILITIES      COSTS
- -----------        -------      ---------       ------      ----------       -----------     -----------      -----
<S>                <C>          <C>             <C>         <C>              <C>             <C>              <C> 
In-Home Health
Care, Inc.         $ 989        $ 229           $ 7         $ 3,856          ($ 797)         ($ 834)          $ 3,450

Professional
Health Services,
Inc.                  --           20             9             321               --               --             350

Portable X-Ray
Labs, Inc.         1,309           --            11           5,653            (297)            (476)           6,200

Laboratory Corp.
of America 
                      --           10            --              25               --               --              35

Doctor's Home
Health Agency,
Inc.                  --            6            --             439               --               --             445

Achievement
Rehab (earnout)       --           --            --          26,439               --               --          26,439

Coastal
Rehabilitation,
Inc.                 257           85            --           1,764            (576)              (80)          1,450

Mobile
Diagnostics,
Inc.                  --           38            --             187               --               --             225

Health Care
Industries,
Inc.                 805          204            41           2,505          (1,080)             (150)          2,325

The Nursing
Connection,
Inc.                  14           62            --             254               --               --             330

Rehab Dynamics,
Inc. & Restorative
Therapy, Ltd.      4,140          954           107          21,478           (3,204)          (1,312)         22,163
                   -----         -----         -----         -------           -------         -------         ------

                  $7,514       $1,608          $175         $62,921          ($5,954)         ($2,852)        $63,412
                  ======       ======          =====        =======          ========         ========        =======


                                                            Page 9 of 27


</TABLE>
<PAGE>


NOTE 4:          9-1/2% SENIOR SUBORDINATED NOTES DUE 2007

                         In May 1997, the Company issued $450 million  aggregate
                         principal  amount  of its  9-1/2%  Senior  Subordinated
                         Notes due 2007 (the  "Senior  Notes").  Interest on the
                         Senior  Notes is payable  semiannually  on March 15 and
                         September 15, commencing September 15, 1997. The Senior
                         Notes are  redeemable  for cash at any time on or after
                         September  15, 2002,  at the option of the Company,  in
                         whole or in part,  initially  at the  redemption  price
                         equal to 104.75% of principal amount, declining to 100%
                         of principal amount on September 15, 2005, plus accrued
                         interest  thereon to the date fixed for redemption.  In
                         addition,  IHS may redeem up to $150,000,000  aggregate
                         principal  amount of Senior  Notes at any time and from
                         time  to  time  prior  to  September   15,  2000  at  a
                         redemption  price  equal to  108.50%  of the  aggregate
                         principal    amount   thereof,  plus  accrued  interest
                         thereon,  out of the net cash  proceeds  of one or more
                         Public  Equity  Offerings  (as defined in the indenture
                         under which the Senior  Notes were issued (the  "Senior
                         Notes Indenture")). In the event of a change in control
                         of IHS (as defined in the Senior Notes Indenture), each
                         holder of Senior  Notes may require  IHS to  repurchase
                         such  holder's  Senior  Notes,  in whole or in part, at
                         101% of the  principal  amount  thereof,  plus  accrued
                         interest  to the  repurchase  date.  The  Senior  Notes
                         Indenture  contains  covenants,   including,   but  not
                         limited to,  covenants  with  respect to the  following
                         matters:  (1)  limitations  on additional  indebtedness
                         unless certain coverage ratios are met; (2) limitations
                         on other  subordinated  debt; (3) limitations on liens;
                         (4)  limitations on the issuance of preferred  stock by
                         the  Company's   subsidiaries;   (5)   limitations   on
                         transactions   with  affiliates;   (6)  limitations  on
                         restricted payments and investments; (7) application of
                         the proceeds of certain asset sales; (8) limitations on
                         restrictions   on   subsidiary   dividends;   and   (9)
                         restrictions   on  mergers,   consolidations   and  the
                         transfer of all or  substantially  all of the assets of
                         the  Company  to  another  person.   The  Company  used
                         approximately  $247.2  million of the net proceeds from
                         the   sale   of  the   Senior   Notes   to   repurchase
                         substantially  all of its  9-5/8%  Senior  Subordinated
                         Notes  due 2002  and its  10-3/4%  Senior  Subordinated
                         Notes due 2004, to pay  pre-payment  premiums,  consent
                         fees and accrued  interest  related to the  repurchase,
                         and used the remaining  approximately $191.0 million to
                         repay a portion of the $436.0 million then  outstanding
                         under its revolving credit facility. In connection with
                         the repurchase,  the Company  recorded an extraordinary
                         loss of  $18.2  million  (net  of  tax).  (See  Note 6:
                         Extraordinary Item)

NOTE 5:          NON-RECURRING CHARGES

                         PHARMACY GAIN:

                         In July 1996, the Company sold its pharmacy division to
                         Capstone  Pharmacy,  Inc.  ("Capstone")  for a purchase
                         price  of  $150  million,  consisting  of  cash of $125
                         million, and shares of Capstone stock having a value of
                         $25  million.  At the date of the  sale  the  Company's
                         investment in the shares of Capstone's common stock was
                         recorded at its carryover cost of $14.7 million,  which
                         represented less than 20% of the total Capstone shares.
                         During the first quarter of 1997, the Company  recorded
                         the remaining gain of $7.6 million on its investment in
                         the  Capstone   shares.   Previously,   such  gain  was
                         accounted  for as an  unrealized  gain on available for
                         sale securities.


                                  Page 10 of 27


<PAGE>


                         SETTLEMENT WITH CORAM:

                         On October 19, 1996,  the Company and Coram  Healthcare
                         Corporation   ("Coram")   entered   into  a  definitive
                         agreement  and plan of merger (the "Merger  Agreement")
                         providing for the merger of a  wholly-owned  subsidiary
                         of IHS into Coram,  with Coram  becoming a wholly-owned
                         subsidiary  of  IHS.  Under  the  terms  of the  Merger
                         Agreement,  holders  of  Coram  common  stock  were  to
                         receive for each share of Coram  common stock 0.2111 of
                         a share of the Company's  common  stock,  and IHS would
                         have    assumed    approximately    $375   million   of
                         indebtedness. On April 4, 1997, IHS notified Coram that
                         it had  exercised  its rights to  terminate  the Merger
                         Agreement.  IHS also  terminated  the  March  30,  1997
                         letter amendment,  setting forth proposed  revisions to
                         the terms of the merger (which  included a reduction in
                         the  exchange  ratio to 0.15 of a share  of IHS  common
                         stock for each share of Coram common  stock),  prior to
                         the  revisions  becoming  effective  at  the  close  of
                         business  on April 4,  1997.  On May 5,  1997,  IHS and
                         Coram entered into a settlement  agreement  pursuant to
                         which  the  Company  paid  Coram  $21  million  in full
                         settlement  of all claims  Coram might have against IHS
                         pursuant  to the Merger  Agreement,  which the  Company
                         recognized  as a  non-recurring  charge  in the  second
                         quarter.  In  addition,  during the first  quarter  the
                         Company incurred a non-recurring charge of $6.6 million
                         relating to  accounting,  legal and other costs related
                         to the merger.

NOTE 6:          EXTRAORDINARY ITEM

                         In the second quarter of 1997,  the Company  recorded a
                         pre-tax  loss  of  $29.8   million   representing   (1)
                         approximately   $23.6  million  of  cash  payments  for
                         pre-payment   premium  and  tender  and  consent   fees
                         relating to the early  extinguishment of debt resulting
                         from the Company's  repurchase  pursuant to cash tender
                         offers of $99,873,000 principal amount of the Company's
                         $100 million of outstanding 10-3/4% Senior Subordinated
                         Notes due 2004 and  $114,975,000  of the Company's $115
                         million of outstanding 9-5/8% Senior Subordinated Notes
                         due 2002 and (2) approximately $6.2 million relating to
                         the write-off of deferred  financing costs.  Such loss,
                         reduced  by the  related  income  tax  effect  of $11.6
                         million,  is presented in the  statement of earnings as
                         an extraordinary loss of $18.2 million.

                         In the second quarter of 1996, the Company replaced its
                         $500 million  revolving  credit  facility and term loan
                         with the $700 million  revolving credit facility.  This
                         event has been  accounted for as an  extinguishment  of
                         debt  and  the   Company   has   recorded   a  loss  on
                         extinguishment  of  debt  of  $2.3  million,   relating
                         primarily  to the  write-off  of deferred  costs.  Such
                         loss,  reduced  by the  related  income  tax  effect of
                         $896,000,  is presented in the statement of earnings as
                         an extraordinary item of $1.4 million.

NOTE 7:          STOCK REPURCHASE 

                         The  Company's  Board of Directors has  authorized  the
                         repurchase  in the open  market of up to $20 million of
                         the  Company's   Common  Stock.   The  purpose  of  the
                         repurchase program is to have available treasury shares
                         of  Common  Stock to (i)  satisfy  contingent  earn-out
                         payments  under prior business  combinations  accounted
                         for by the purchase  method,  (ii) issue in  connection
                         with  acquisition  and  (iii) issue  upon  exercise  of
                         outstanding  options.  The  repurchases  will be funded
                         from the cash from  operations  and drawings  under the
                         Company's revolving credit


                                  Page 11 of 27


<PAGE>


                         facility.  During the six months  ended June 30,  1997,
                         the Company  repurchased  41,900 shares of Common Stock
                         for an aggregate  purchase price of approximately  $1.5
                         million.

NOTE 8:          RECENT ACCOUNTING PRONOUNCEMENTS

                         In February  1997, the Financial  Accounting  Standards
                         Board issued  Statement No. 128,  "Earnings Per Share,"
                         ("SFAS  128"),   which  simplifies  the  standards  for
                         computing  earnings  per  share  ("EPS").  SFAS  128 is
                         effective  for the  Company's  fourth  quarter and year
                         ending  December 31,  1997.  Early  application  is not
                         permitted and prior period EPS data will be restated.

                         Under SFAS 128, primary EPS will be replaced with basic
                         EPS.  Basic EPS excludes the dilutive  effect of common
                         stock equivalents.  Also, under SFAS 128, fully-diluted
                         EPS will be  replaced  by diluted  EPS.  Diluted EPS is
                         calculated  similarly to fully-diluted  EPS pursuant to
                         Accounting Principles Board Opinion 15.

                         The change in  calculation  method is not  expected  to
                         have a material impact on previously  reported earnings
                         per common share data.

NOTE 9:          SUBSEQUENT EVENTS

                         PROPOSED MERGER WITH ROTECH MEDICAL CORPORATION:

                         On  July  6,  1997,  the  Company  and  RoTech  Medical
                         Corporation ("RoTech") entered into a definitive merger
                         agreement  pursuant to which RoTech will merge with the
                         Company.  RoTech provides comprehensive home healthcare
                         and primary care  physician  services,  principally  to
                         patients in non-urban areas.

                         Under  the terms of the  agreement,  the  Company  will
                         issue 0.5806  shares of IHS common stock for each share
                         of RoTech common stock currently outstanding.  When the
                         acquisition    is    consummated,    IHS   will   issue
                         approximately  15.3 million shares of common stock. The
                         equity value of the acquisition is  approximately  $615
                         million,  based on the exchange terms,  and the Company
                         will  reserve  for  issuance  approximately  20 million
                         shares   upon   exercise   of   RoTech    options   and
                         approximately  2.4  million  shares for  issuance  upon
                         conversion  of $110  million  of  RoTech's  convertible
                         Debentures.  Following the merger, IHS may be obligated
                         to repurchase such debentures at face value.  The total
                         value of the  transaction  including the  assumption of
                         RoTech's debt by IHS and other  financial  obligations,
                         will be approximately $915 million.

                         The transaction,  which will be accounted for under the
                         purchase method,  has been unanimously  approved by the
                         Board of Directors of each  company.  Completion of the
                         transaction is subject to various conditions  including
                         approval  by IHS and RoTech  stockholders,  approval by
                         IHS' senior lenders, and certain regulatory  approvals.
                         Each party may  terminate  the agreement if the average
                         trading  price of IHS Common Stock over the ten trading
                         days  ending  on the  fifth  trading  day  prior to the
                         RoTech  stockholders'  meeting to approve the merger is
                         equal to or less than $33.00. The merger agreement also
                         provides  for  payment  of breakup  fees under  certain
                         circumstances.

                         PROPOSED MERGER WITH COMMUNITY CARE OF AMERICA, INC.:

                         On August 1, 1997 the  Company  and  Community  Care of
                         America,  Inc. ("CCA") entered into a definitive merger
                         agreement  for IHS to  acquire  all of the  outstanding
                         shares of CCA for  $4.00  per share in cash.  Community
                         Care  of  America,  Inc.,  based  in  Naples,  Florida,
                         develops and operates  skilled  nursing  facilities  in
                         medically underserved rural communities. CCA's


                                                  Page 12 of 27


<PAGE>


                         operations  include 54 long-term care  facilities,  one
                         physician practice,  and one outpatient  rehabilitation
                         center.  Pursuant  to the  agreement,  IHS on August 7,
                         1997  commenced  a tender  offer of $4.00  per share in
                         cash for all outstanding  shares of CCA's common stock.
                         IHS'  obligation  to purchase  the  tendered  shares is
                         subject  to a number  of  conditions,  including  there
                         being  tendered  at  least  5,329,119   shares  of  CCA
                         (representing  a majority of the outstanding CCA shares
                         on a fully-diluted basis). IHS estimates the total cost
                         for  the  transaction,   including  the  assumption  of
                         approximately    $62   million   of   debt,   will   be
                         approximately $98.2 million.

                         Dr.  Robert N.  Elkins,  Chairman  and Chief  Executive
                         Officer  of the  Company,  is a  director  of CCA,  and
                         beneficially  owns  approximately  21% of CCA's shares;
                         and John  Silverman,  a director  and  employee  of the
                         Company, is Chairman of CCA.

                         OTHER ACQUISITIONS:

                         On  August  8, 1997, the Company  purchased  Healthcare
                         Personell,  Inc.,  a home health services  company, for
                         approximately $675,000.

                         The Company  has reached  agreements  in  principle  to
                         purchase  a  mobile  x-ray  company  for  approximately
                         $300,000, a mobile x-ray company for approximately $1.2
                         million,  a home health company for approximately  $5.1
                         million,  and a home health  company for  approximately
                         $60.0 million.  The Company has also reached definitive
                         agreements  to  purchase  a  home  health  company  for
                         approximately $24.5 million,  and a home health company
                         for approximately $27.9 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.


                                  Page 13 of 27


<PAGE>


                      MANAGEMENT'S DISCUSSION AND ANALYSIS
                             OF FINANCIAL CONDITION
                                       AND
                              RESULTS OF OPERATIONS

                 Statements in this Quarterly Report on Form 10-Q concerning the
Company's   business  outlook  or  future  economic   performance;   anticipated
profitability,  revenues,  expenses or other financial  items;  and product line
growth,  together  with other  statements  that are not  historical  facts,  are
"forward-looking  statements" as that  term is defined under Federal  Securities
Laws.  Forward-looking  statements are subject to risks, uncertainties and other
factors which could cause actual results to differ  materially from those stated
in such statements.  Such risks,  uncertainties and factors include, but are not
limited to, the Company's  substantial  indebtedness,  growth strategy,  managed
care  strategy,   capital  requirements  and  recent  acquisitions  as  well  as
competition,  government  regulation,  general economic conditions and the other
risks  detailed  in the  Company's  filings  with the  Securities  and  Exchange
Commission,  including  the  Company's  Annual  Report on Form 10-K for the year
ended December 31, 1996.


THREE MONTHS ENDED JUNE 30, 1997
COMPARED TO THREE MONTHS ENDED JUNE 30, 1996

                 Net revenues for the three months ended June 30, 1997 increased
$122.2  million,  or 36%, to $458.0 million from the comparable  period in 1996.
Approximately  83%  of the  increase  is  attributable  to  the  acquisition  of
companies   providing   rehabilitation,    home   health,   mobile   x-ray   and
electrocardiogram  services  subsequent to June 30, 1996,  partially offset by a
reduction in revenue resulting from the sale of the Company's  pharmacy division
in July 1996, the sale of a majority  interest in its assisted  living  services
division in October 1996,  and the sale of two  facilities in the second quarter
of 1997.  Revenues in the three months  ended June 30, 1996 include  revenues of
$25.0  million for the  pharmacy  division and revenues of $5.7 million from its
assisted living services  division.  The remaining increase was due primarily to
facilities and ancillary  companies  acquired  during the second quarter of 1996
and increased  revenues  from  facilities  and ancillary  companies in operation
during  both  periods.  The  Company  derived  approximately  49% and 17% of its
patient revenues from Medicare and Medicaid,  respectively,  in the three months
ended June 30, 1997,  compared to 33% and 24%,  respectively,  in the comparable
period in 1996.

                 Basic medical services revenue decreased 10% from $98.1 million
to $88.1 million.  This decrease  primarily  resulted from the conversion by the
Company of certain  skilled  nursing beds to Medical  Specialty  Unit (MSU) beds
after June 30,  1996,  the sale of a majority  interest in its  assisted  living
services  division in October 1996, and the sale of two facilities in the second
quarter of 1997.

                 Specialty  medical services  revenue  increased 59% from $226.9
million to $360.1 million.  Of the $133.2 million increase,  $101.1 million,  or
76%, was attributable to revenue from acquisitions  subsequent to June 30, 1996,
partially  offset by a reduction  in  specialty  medical  services  revenue as a
result  of the  sale  of the  Company's  pharmacy  division  in July  1996.  The
remaining  increase was due to increased  revenue from  facilities and ancillary
companies in operation in both


                                  Page 14 of 27


<PAGE>


periods, ancillary companies acquired during the second quarter of 1996, as well
as skilled nursing beds being converted to MSU beds after June 30, 1996.

                 Management services and other revenues decreased 10% from $10.8
million to $9.8 million.

                 Total  expenses for the period  increased 42% to $442.8 million
from $311.4  million in the  comparable  period of 1996.  Of the $131.4  million
increase,  $84.5  million,  or 64%,  resulted  from  an  increase  in  operating
expenses. A substantial portion of the increase in operating expenses was due to
acquisitions  consummated  subsequent to June 30, 1996,  partially offset by the
sale of the  Company's  pharmacy  division in July 1996,  the sale of a majority
interest in its assisted living services  division in October 1996, and the sale
of two facilities in the second quarter of 1997.

                 Corporate  administrative  and general  expenses  for the three
months  ended  June  30,  1997  increased  by $3.3  million,  or 22%,  over  the
comparable  period  in  1996.  This  increase  primarily  represents  additional
operations,  information  systems,  accounting,  finance and other  personnel to
support the growth  resulting  from the  acquisition  of  ancillary  businesses.
Depreciation and amortization increased to $15.8 million during the three months
ended June 30,  1997, an 86%  increase as  compared to $8.5  million in the same
period in 1996, primarily as a result of increases in goodwill amortization,  as
well as  depreciation  related to  ancillary  company  acquisitions  consummated
during 1996 and 1997. Rent expense  increased by $7.9 million,  or 44%, over the
comparable  period in 1996,  primarily as a result of  increases  in  contingent
rentals, which are based on gross revenues of certain leased facilities and rent
at ancillary companies acquired subsequent to June 30, 1996, partially offset by
a reduction  resulting from the sale of the pharmacy  division and the sale of a
majority  interest in its assisted living services  division.  Interest expense,
net, increased $7.3 million, or 46%, during the three months ended June 30, 1997
to $23.2 million. The increase in interest expense was primarily a result of the
Company's $450 million principal amount of 9-1/2% Senior


                                  Page 15 of 27


<PAGE>


Subordinated  Notes issued in May 1997,  the  Company's  $150 million  principal
amount of 10-1/4%  Senior  Subordinated  Notes issued in May 1996, and increased
borrowings under its current $700 million credit facility, partially offset by a
reduction in interest  resulting from the repurchase of substantially all of the
Company's 9-5/8% and 10-3/4% Senior Subordinated Notes.

                 Earnings before equity in earnings (loss) of affiliates, income
taxes and  extraordinary  items  decreased by 38% to $15.2 million for the three
months  ended June 30,  1997,  as compared to $24.4  million for the  comparable
period in the prior year. This decrease  resulted  primarily from  non-recurring
charges incurred during the three months ended June 30, 1997. The  non-recurring
charge in the three months ended June 30, 1997  represents  the  settlement  and
other  costs  of the  terminated  merger  with  Coram  Health  Care  Corporation
("Coram") of $27.6 million,  less the gain on the sale of the pharmacy  division
of $7.6  million.  Such gain had  previously  been  deferred  and reported as an
unrealized  gain on available for sale  securities,  as discussed  more fully in
Note 5. Excluding the  non-recurring  charges,  net,  earnings  before equity in
earnings (loss) of affiliates,  income taxes and extraordinary  items would have
increased $11.9 million, or 49% over the comparable prior period.

                 Earnings before income taxes and extraordinary  items decreased
by 39% to $15.1 million for the three months ended June 30, 1997, as compared to
$24.8  million  for the  comparable  period in the  prior  year.  This  decrease
resulted  primarily from the  non-recurring  charges  incurred  during the three
months ended June 30, 1997. (See Note 5:  Non-Recurring  Charges)  Excluding the
non-recurring  charges,  net,  earnings  before  income taxes and  extraordinary
items,  would have  increased  $11.4  million or 46% over the  comparable  prior
period.  The  provision  for federal and state income taxes was $5.9 million for
the three months  ended June 30,  1997,  and $9.6 million for the same period in
the prior year. Net loss and  fully-diluted  loss per share for the quarter were
$8.9  million in 1997,  or 22 cents per share,  as compared to net  earnings and
fully diluted  earnings per share of $13.8 million or 51 cents per share for the
same period in 1996.  During the three months ended June 30, 1997 and 1996,  the
Company incurred  extraordinary  losses on the  extinguishments of debt of $18.2
million (net of tax),  or 51 cents per share  (fully-diluted)  representing  the
payment of premium  and consent  fees and the  write-off  of deferred  financing
costs in connection with the repurchase of substantially  all of the Company's 9
5/8% and 10 3/4% Senior  Subordinated Notes (see Note 6:  Extraordinary  Item.),
and $1.4 million (net of tax), or 5 cents per share (fully-diluted) representing
the write-off of deferred  fees related to  replacement  of the  Company's  $500
million  revolving credit and term loan facility with the $700 million revolving
credit facility. (See Note 6: Extraordinary Item.), respectively.


                                  Page 16 of 27


<PAGE>


SIX MONTHS ENDED JUNE 30, 1997
COMPARED TO SIX MONTHS ENDED JUNE 30, 1996

                 Net revenues  for the six months ended June 30, 1997  increased
$255.9  million,  or 39%, to $918.9 million from the comparable  period in 1996.
Approximately  84%  of the  increase  is  attributable  to  the  acquisition  of
companies   providing   rehabilitation,    home   health,   mobile   x-ray   and
electrocardiogram  services  subsequent to June 30, 1996,  partially offset by a
reduction in revenue resulting from the sale of the Company's  pharmacy division
in July 1996, the sale of a majority  interest in its assisted  living  services
division in October 1996,  and the sale of two  facilities in the second quarter
of 1997.  Revenues  in the six months  ended June 30, 1996  include  revenues of
$47.4  million for the pharmacy  division and revenues of $11.3 million from its
assisted living services  division.  The remaining increase was due primarily to
facilities and ancillary  companies  acquired  during the first half of 1996 and
increased  revenues from facilities and ancillary  companies in operation during
both  periods.  The  Company  derived  approximately  49% and 17% of its patient
revenues from Medicare and Medicaid,  respectively, in the six months ended June
30, 1997, compared to 33% and 24%, respectively, in the comparable prior period.

                 Basic medical services revenue decreased 9% from $195.3 million
to $176.8 million.  This decrease  primarily resulted from the conversion by the
Company of certain  skilled  nursing beds to Medical  Specialty  Unit (MSU) beds
after June 30,  1996,  the sale of a majority  interest in its  assisted  living
services  division in October 1996, and the sale of two facilities in the second
quarter of 1997.

                 Specialty  medical services  revenue  increased 62% from $446.4
million to $722.8 million.  Of the $276.4 million increase,  $214.0 million,  or
77%, was attributable to revenue from  acquisitions  subsequent to June 30, 1996
partially  offset by a reduction in   specialty  medical  services  revenue as a
result  of the  sale  of the  Company's  pharmacy  division  in July  1996.  The
remaining  increase was due to increased revenue from facilities in operation in
both periods,  ancillary  companies  acquired  during the first half of 1996, as
well as skilled nursing beds being converted to MSU beds after June 30, 1996.


                                  Page 17 of 27


<PAGE>


                 Management services and other revenues decreased 10% from $21.4
million to $19.3 million.

                 Total expenses for the period  increased 42%  to $872.6 million
from $616.5 million, an increase of 42%. Of the $256.1 million increase,  $187.0
million,  or 73%, was due to an increase in operating  expenses.  A  substantial
portion  of  the  increase  in  operating   expenses  was  due  to  acquisitions
consummated  subsequent  to June 30, 1996,  partially  offset by the sale of the
Company's pharmacy division in July 1996, the sale of a majority interest in its
assisted  living  services  division  in  October  1996,  and  the  sale  of two
facilities in the second quarter of 1997.

                 Corporate  administrative  and  general  expenses  for  the six
months  ended  June  30,  1997  increased  by $6.2  million,  or 21%,  over  the
comparable  period  in  1996.  This  increase  primarily  represents  additional
operations,  information  systems,  accounting,  finance and other  personnel to
support the growth  resulting  from the  acquisition  of  ancillary  businesses.
Depreciation  and  amortization  increased 84% to $30.8  million  during the six
months ended June 30, 1997 as compared to $16.8 million for the six months ended
June 30,  1996.  This  increase is primarily  the result of  increased  goodwill
amortization,  as well as depreciation related to ancillary company acquisitions
consummated  subsequent to the second quarter of 1996. Rent expense increased by
$14.3  million,  or 40%,  over the  comparable  period  in 1996,  as a result of
increases in contingent  rentals,  which are based on gross  revenues of certain
leased facilities and rent at ancillary  companies  acquired  subsequent to June
30, 1996, partially offset by a reduction in rent resulting from the sale of the
pharmacy division and the sale of a majority interest in the Company's  assisted
living services division. Interest expense, net increased $14.5 million, or 48%,
during the six months  ended June 30, 1997 to $44.6  million.  This  increase in
interest expense was primarily


                                  Page 18 of 27


<PAGE>


a result of the Company's 9-1/2% Senior  Subordinated  Notes issued in May 1997,
10-1/4% Senior  Subordinated Notes issued in May 1996, and increased  borrowings
under its $700  million  credit  facility,  partially  offset by a reduction  in
interest  resulting  from the repurchase of  substantially  all of the Company's
9-5/8% and 10-3/4% Senior Subordinated Notes.

                 Earnings before equity in earnings of affiliates,  income taxes
and  extraordinary  items  decreased  by 1% to $46.3  million for the six months
ended June 30, 1997, as compared to $46.5 million for the  comparable  period in
the prior year.  This  decrease  is  primarily  the result of the  non-recurring
charges  which were incurred  during the three months ended June 30, 1997.  (See
Note  5:  Non-Recurring  Charges)  Excluding  the  non-recurring  charges,  net,
earnings before equity in earnings of affiliates, income taxes and extraordinary
items  would  have  increased  $19.8  million or 43% over the  comparable  prior
period.

                 Earnings before income taxes and extraordinary  items decreased
by 2% to $46.4  million for the six months ended June 30,  1997,  as compared to
$47.3  million for the  comparable  period in the prior year.  This  decrease is
primarily  the  result  of  the  non-recurring  charge,  net,  discussed  above.
Excluding  the  non-recurring  charges,  net, earnings  before  income taxes and
extraordinary  items  would  have  increased  $19.2  million  or  41%  over  the
comparable  prior  period.  The provision for federal and state income taxes was
$18.1 million for the six months ended June 30, 1997,  and $18.2 million for the
same period in the prior year. Net earnings and fully diluted earnings per share
for the six  months  were  $10.1  million  in 1997,  or 41 cents per  share,  as
compared to $27.6 million or $1.05 per share for the same period in 1996. During
the six months ended June 30, 1997 and 1996, the Company incurred  extraordinary
losses on the extinguishments of debt of $18.2 million (net of tax), or 51 cents
per share  (fully-diluted)  and $1.4 million (net of tax),  or 5 cents per share
(fully-diluted), respectively. Weighted average shares (fully-diluted) increased
by 17%, from 31,028,000 at June 30, 1996 to 36,233,000 at June 30, 1997.


                                  Page 19 of 27


<PAGE>


LIQUIDITY AND CAPITAL RESOURCES

                 At June 30,  1997,  the Company  had working  capital of $159.0
million,  as compared with $57.5  million at December 31, 1996.  The increase in
working  capital was primarily due to an increase in patient  accounts and third
party payor  settlements  receivable  and other current assets and a decrease in
accounts payable and accrued  expenses.  There were no material  commitments for
capital  expenditures as of June 30, 1997. Net patient  accounts and third-party
payor settlements  receivable  increased $17.3 million to $344.1 million at June
30,  1997,  as compared to $326.9  million at December  31,  1996.  Of the $17.3
million  increase in accounts  receivable,  $7.1  million  was  attributable  to
related service  businesses  acquired  subsequent to December 31, 1996 and $10.2
million was due to increased accounts  receivable at facilities in operation and
related  service  businesses  owned at both December 31, 1996 and June 30, 1997.
Gross  patient  accounts  receivable  were $364.1  million at June 30, 1997,  as
compared  to  $340.8  million  at  December  31,  1996.  Net  third-party  payor
settlements  receivable from federal and state governments  (i.e.,  Medicare and
Medicaid  cost reports) was $18.9 million at June 30, 1997, as compared to $27.6
million at  December  31,  1996.  Approximately  $10.8  million,  or 57%, of the
third-party payor  settlements  receivable from federal and state governments at
June 30, 1997  represent  the costs for its MSU patients  which exceed  regional
reimbursement limits established under Medicare.

                 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
reimbursement   for  those  costs   which   exceed  the   Medicare   established
reimbursement limits by obtaining waivers of these cost limitations. The Company
has submitted  waiver  requests for 225 cost  reports,  covering all cost report
periods through  December 31, 1996. To date,  final action has been taken by the
Health Care Financing  Administration  ("HCFA") on 221 waiver requests  covering
cost report  periods  through  December 31, 1996.  The Company's  final rates as
approved by HCFA represent approximately 95% of the requested rates as submitted
in the waiver requests. There can be no assurance, however, that the


                                  Page 20 of 27


<PAGE>


Company will be able to recover its excess costs under any waiver requests which
may be submitted in the future.  The Company's failure to recover  substantially
all these  excess costs would  adversely  affect its results of  operations  and
could adversely affect its MSU strategy.

                 As  discussed in Note 4, in May 1997,  the Company  issued $450
million  principal  amount Senior  Subordinated  Notes. The Company used the net
proceeds to repurchase substantially all of its 9-5/8% Senior Subordinated Notes
due 2002 and its 10-3/4% Senior  Subordinated Notes due 2004, to pay pre-payment
premiums,  consent fees and accrued interest related to the repurchase,  as well
as to repay a portion of the $436.0 million then outstanding under its revolving
credit  facility.  In connection  with the repurchase,  the Company  recorded an
extraordinary loss of $18.2 million (net of tax).

                 The  other   asset  and   liability   increases   were  due  to
acquisitions  and normal  growth in  operations  which was  consistent  with the
growth in revenues of such operations in 1997.

                 Net cash  provided by operating  activities  for the six months
ended  June 30,  1997,  was  $11.0  million  as  compared  to  $600,000  for the
comparable period in 1996.

                 Net cash provided by financing  activities  was $133.6  million
for  the six  month  period  in  1997 as  compared  to  $130.2  million  for the
comparable  period in 1996. In both periods,  the Company  received net proceeds
from long-term borrowings and made repayments on certain debt.

                 Net cash used by investing  activities  was $140.5  million for
the six month period  ended June 30, 1997 as compared to $125.3  million for the
six  month  period  ended  June  30,  1996.  Cash  used for the  acquisition  of
facilities  and  ancillary  company  acquisitions  was $34.5  million in 1997 as
compared to $18.2  million  for 1996.  Cash used for the  purchase of  property,
plant and equipment was $67.6 million in 1997 and $67.4 million in 1996.


                                  Page 21 of 27


<PAGE>


                 The Company's contingent liabilities (other than liabilities in
respect  of  litigation  and the  contingent  payments  in  respect of the First
American  acquisition)  aggregated  approximately  $77.3  million as of June 30,
1997. The Company is obligated to purchase its Greenbriar facility upon a change
in  control  of  the  Company.  The  net  purchase  price  of  the  facility  is
approximately  $4.0  million.  The Company  has  guaranteed  approximately  $6.6
million of the  lessor's  indebtedness.  The Company is  required,  upon certain
defaults  under the lease,  to purchase its Orange Hills  facility at a purchase
price equal to the greater of $7.1 million or the facility's  fair market value.
The Company  entered into a guaranty  agreement  whereby the Company  guaranteed
approximately  $4.0  million  owed by the Tutera  Group,  Inc.  and Sunset Plaza
Limited  Partnership,  a partnership  affiliated with a partnership in which the
Company  has a 49%  interest,  to Finova  Capital  Corporation.  The Company has
guaranteed  approximately  $8.9  million  owed by  Litchfield  Asset  Management
Corporation  to National  Health  Investors,  Inc.  The Company has  established
several  irrevocable  letters of credit  with the Bank of Nova  Scotia  totaling
$15.7  million  at June 30,  1997 to secure  certain of the  Company's  workers'
compensation,  health benefits and other obligations. The Company has guaranteed
a maximum of  $539,062  owed by Dunns Creek to National  Health  Investors.  The
Company has  guaranteed  approximately  $4.8 million  owed by Community  Care of
America,  Inc.  ("CCA"),  a related party company to which IHS provides  certain
management services, to Daiwa Healthco-II,  LLC. The Company has also guaranteed
approximately  $10.0  million  owed by CCA to Health and  Retirement  Properties
Trust  under  a loan  and  lease  financing  agreement.  The  Company  has  also
established three  Irrevocable  Standby Letters of Credit in the total amount of
$10.7 million.  In addition,  the Company has obligations under operating leases
aggregating  approximately  $212.1  million at June 30,  1997.  The Company owns
warrants to purchase  approximately 14.9% of CCA, and the Company's Chairman and
Chief  Executive  Officer   beneficially  owns  approximately   21.0%  of  CCA's
outstanding  common stock. The Company has made available to CCA a $10.0 million
revolving  credit facility.  At June 30, 1997 $5.0 million was outstanding.  The
Company currently has outstanding a cash tender offer for all outstanding shares
of CCA. In addition, with respect to certain acquired businesses, the Company is
obligated to make certain contingent payments.


                                  Page 22 of 27


<PAGE>


if earnings of the acquired  business  increase or earnings targets are met. The
Company  is also  obligated  under  certain  circumstances  to  make  contingent
payments of up to $155 million in respect of its acquisition of First American.

                 The  liquidity  of the Company will depend in large part on the
timing of payments by private,  third-party and governmental  payors,  including
payments in excess of regional cost reimbursement  limitations established under
Medicare.  Costs in excess of the regional reimbursement limits relate primarily
to the delivery of services and patient care to the Company's MSU patients.

                 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,  margins,  particularly in its
skilled nursing and subacute  facilities.  Aspects of certain  healthcare reform
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 IHS. 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 health care pending  implementation  of a
prospective  payment system 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.  The Company 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 the Company's
business.

                 The  Company  anticipates  that cashflow  from  operations  and
borrowings  under  revolving  credit  facilities  will be  adequate to cover its
scheduled debt payments and future anticipated capital expenditure  requirements
throughout  1997. The Company  expects to continue to be growth oriented in 1997
through  the  expansion  of  its  existing  operations,  by the  acquisition  of
additional  facilities and ancillary  companies and the entry into agreements to
manage additional facilities.


                                  Page 23 of 27


<PAGE>


Part II:                 Other Information

              Item 2    Changes in Securities

                     (c) On March 27, 1997, the Company issued 976,504 shares of
                         Common Stock, having a value of $26.4 million (based on
                         the average  closing  price of IHS Common Stock for the
                         sixty day trading  period  ending March 19,  1997),  in
                         payment of an  earnout  related  to the  December  1993
                         acquisition  of  Associated   Therapists   Corporation,
                         d/b/a/  Achievement Rehab, a provider of rehabilitation
                         therapy  services.  The  earnout  was paid based on the
                         increase in  Achievement  Rehab's  earnings over a base
                         amount in 1996.  The  issuance of stock was exempt from
                         registration pursuant to Section 4(2) of the Securities
                         Act of 1933, as amended (the "Securities Act"). Each of
                         the investors  made  representations  (the  "Investment
                         Representations")  to the  effect  that:  (i)  that the
                         shares were being  acquired for its own account and not
                         with a view to,  or for sale in  connection  with,  any
                         distribution;  (ii)  acknowledging that the shares were
                         restricted securities under Rule 144; (iii) that it had
                         knowledge  and  experience  in  business  matters,  was
                         capable  of  evaluating  the  merits  and  risks of the
                         investment,  and was able to bear the risk of loss; and
                         (iv)  had  the  opportunity  to make  inquiries  of and
                         obtain information from IHS.

                         On  May  30,  1997,   the  Company  sold  $450  million
                         aggregate   principal  amount  of  its  9  1/2%  Senior
                         Subordinated  Notes  due  2007 to  Smith  Barney  Inc.,
                         Donaldson,  Lufkin & Jenrette  Securities  Corporation,
                         Morgan Stanley & Co.  Incorporated and Salomon Brothers
                         Inc as Initial  Purchasers  pursuant to Section 4(2) of
                         the Securities Act. The Initial  Purchasers  resold the
                         notes to  qualified  institutional  buyers  pursuant to
                         Rule  144A  under  the  Securities   Act.  The  Company
                         received net proceeds (after underwriting discounts and
                         commissions) of $438,187,500.

                         On June 20, 1997,  the Company  acquired  substantially
                         all the assets,  and assumed  certain  liabilities,  of
                         Rehab Dynamics,  Inc. and  Restorative  Therapy Limited
                         (which  has  since  changed  its name to  Synergy  Two,
                         Inc.), which provide contract rehabilitation  services,
                         including speech and language  pathology,  occupational
                         therapy and physical therapy services, to patients in a
                         variety  of  settings.  The  purchase  price  was $31.4
                         million,  of which $8.2 million was paid in cash at the
                         closing, $11.5 million was paid through the issuance of
                         322,472 shares of the Company's  Common Stock (based on
                         the average  closing price of IHS' common stock for the
                         thirty  day  trading  period  ending  two days prior to
                         closing  date)  and the  remainder  is to be paid after
                         determination  of any purchase price  adjustment due to
                         earnings  relating to the  purchased assets in the year
                         following the closing. The issuance of stock was exempt
                         from  registration  pursuant  to  Section  4(2)  of the
                         Securities   Act.  The  sellers  made  the   Investment
                         Representations.   These   shares   were   subsequently
                         registered  for  resale   pursuant  to  a  Registration
                         Statement on Form S-3 (No. 333-31121).


                                  Page 24 of 27
<PAGE>

                Item 4:  Submission of Matters to a Vote of Security Holders    
                                                                                
                         (a) The Annual  Meeting of  Stockholders  of Integrated
                         Health Services, Inc. was held on June 20, 1997.       
                                                                                
                         (c)(i) The  following  persons,  comprising  the entire
                         Board of Directors,  were elected at the Annual Meeting
                         pursuant to the following vote tabulations:            
                         
                                                               Votes  
                                                Votes For      Withheld
                                                ---------      --------
                         Robert N. Elkins       19,839,582     693,460
                         Lawrence P. Cirka      19,737,006     796,036
                         Edwin M. Crawford      19,825,899     707,143
                         Kenneth M. Mazik       19,889,406     643,636
                         Robert A. Mitchell     19,889,357     643,685
                         Charles W. Newhall     19,826,006     707,036
                         Timothy F. Nicholson   19,889,372     643,670
                         John L. Silverman      19,825,972     707,070
                         George H. Strong       19,889,396     643,646


                Item 6:  EXHIBITS  AND  REPORTS ON FORM 8-K     
                                 

                 A.      EXHIBITS

                         4.1  Second    Amended   and   Restated    Supplemental
                              Indenture,  dated  as of  May  15,  1997,  between
                              Integrated  Health  Services Inc. and Signet Trust
                              Company, as Trustee,  relating to the  Company's 9
                              5/8% Senior Subordinated Notes due 2002.

                         4.2  Amended and Restated Supplemental Indenture, dated
                              as of May  15,  1997,  between  Integrated  Health
                              Services,   Inc.  and  Signet  Trust  Company,  as
                              Trustee,  relating to the Company's 10 3/4% Senior
                              Subordinated Notes due 2004.

                         4.3  Indenture,  dated  as of  May  30,  1997,  between
                              Integrated Health Services,  Inc., and First Union
                              National Bank of Virginia, as Trustee, relating to
                              the Company's 9 1/2% Senior Subordinated Notes due
                              2007.

                         10.1 Credit  Agreement,  dated as of May 15,  1996,  as
                              amended,  by and among Integrated Health Services,
                              the lenders named therein, and Citibank,  N.A., as
                              administrative agent.

                         10.2 Purchase  Agreement,  dated May 22, 1997,  between
                              Integrated Health Services,  Inc. and Smith Barney
                              Inc.,  Donaldson,  Lufkin  &  Jenrette  Securities
                              Corporation, Morgan Stanley & Co. Incorporated and
                              Salomon  Brothers Inc,  relating to  the Company's
                              9 1/2% Senior Subordinated Notes due 2007.

                         10.3 Registration Rights Agreement, dated May 22, 1997,
                              between  Integrated  Health  Services,  Inc.,  and
                              Smith  Barney Inc.,  Donaldson,  Lufkin & Jenrette
                              Securities  Corporation,   Morgan  Stanley  &  Co.
                              Incorporated and Salomon  Brothers Inc,   relating
                              to the Company's 9 1/2% Senior  Subordinated Notes
                              due 2007.

                         10.4 Agreement and Plan of Merger,  dated as of July 6,
                              1997,  by and among  Integrated  Health  Services,
                              Inc.,  IHS  Acquisition   XXIV,  Inc.  and  RoTech
                              Medical  Corporation  (incorporated  by  reference
                              from  the  Company's  Current  Report  on Form 8-K
                              dated July 6, 1997).

                         10.5 Agreement  and Plan of Merger,  dated as of August
                              1, 1997, by and among Integrated  Health Services,
                              Inc.,  IHS  Acquisition  XXVI,  Inc. and Community
                              Care of America, Inc.   (incorporated by reference
                              from the Company's  Schedule 14D-1 filed August 7,
                              1997).

                                  Page 25 of 27

<PAGE>


                 B.      REPORTS ON FORM 8-K

                         The Company filed a Current Report on Form 8-K dated as
                         of May 23, 1997  relating  to the  private  issuance of
                         $450,000,000  aggregate  principal amount 9-1/2% Senior
                         Subordinated Notes due 2007.

                         The Company filed a Current Report on Form 8-K dated as
                         of May 30, 1997,  relating to the  completion of tender
                         offer for its 9-5/8% and  10-3/4%  Senior  Subordinated
                         Notes and completion of financing.

                         The Company filed a Current Report on Form 8-K dated as
                         of October 19, 1996 as amended by Form 8/KA filed April
                         11, 1997 relating to the Company's  termination  of its
                         agreement to acquire Coram Healthcare Corporation.

                         The  Company  filed a Current  Report on Form 8-K dated
                         October 17, 1996  reporting  the  acquisition  of First
                         American  Healthcare  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.

                         The  Company  filed a 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")
                         relating  to  the  Company's  proposed  acquisition  of
                         RoTech.


                                  Page 26 of 27


<PAGE>


                                 - SIGNATURES -


Pursuant  to the  requirements  of the  Securities  Exchange  Act of  1934,  the
registrant  has duly  caused  this  report  to be  signed  on its  behalf by the
undersigned thereunto duly authorized.



                                           INTEGRATED HEALTH SERVICES, INC.



                                           By: /s/ Robert N. Elkins
                                               --------------------
                                                   Robert N. Elkins
                                                    Chief Executive Officer



                                          By: /s/ W. Bradley Bennett
                                              ----------------------
                                                  W. Bradley Bennett
                                                   Senior Vice President and
                                                   Chief Accounting Officer



                                          By: /s/ Eleanor C. Harding
                                              ----------------------
                                                  Eleanor C. Harding
                                                   Senior Vice President Finance








Dated: August 13, 1997
      -------------------------


                                  Page 27 of 27





================================================================================

                        INTEGRATED HEALTH SERVICES, INC.,

                             A DELAWARE CORPORATION,

                                    AS ISSUER


                                       TO

                              SIGNET TRUST COMPANY,

                                   AS TRUSTEE


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


               SECOND AMENDED AND RESTATED SUPPLEMENTAL INDENTURE


                            Dated as of May 15, 1997


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



                                  $115,000,000


                    9 5/8% Senior Subordinated Notes due 2002
               9 5/8% Senior Subordinated Notes due 2002, Series A

================================================================================




<PAGE>



                             CROSS REFERENCE TABLE*

Trust Indenture
Act Section                                                    Indenture Section
- ---------------                                                -----------------
310(a)(1)               .....................................                7.9
   (a)(2)               .....................................                7.9
   (a)(3)               .....................................     Not Applicable
   (a)(4)               .....................................     Not Applicable
   (a)(5)               .....................................                7.9
   (b)                  .....................................                7.9
   (c)                  .....................................     Not Applicable
311(a)                  .....................................                 **
   (b)                  .....................................                 **
   (c)                  .....................................     Not Applicable
312                     .....................................                 **
313(a)                  .....................................                 **
   (b)(1)               .....................................     Not Applicable
   (b)(2)               .....................................                 **
   (c)                  .....................................                 **
   (d)                  .....................................                 **
314(a)                  .....................................            4.3,4.4
   (b)                  .....................................     Not Applicable
   (c)(1)               .....................................               11.3
   (c)(3)               .....................................     Not Applicable
   (d)                  .....................................     Not Applicable
   (e)                  .....................................               11.4
   (f)                  .....................................     Not Applicable
315(a)                  .....................................             7.1(2)
   (b)                  .....................................           7.5,11.2
   (c)                  .....................................             7.1(1)
   (d)                  .....................................             7.1(3)
   (e)                  .....................................               6.11
316(a)(last sentence)   .....................................                2.8
   (a)(1)(A)            .....................................               .6.5
   (a)(1)(B)            .....................................               .6.4
   (a)(2)               .....................................     Not Applicable
   (b)                  .....................................                6.7
   (c)                  .....................................                9.4
317(a)(1)               .....................................                6.8
   (a)(2)               .....................................                6.9
   (b)                  .....................................                2.4
318(a)                  .....................................               11.1
- --------
*    This Cross-Reference Table is not part of the Indenture.

**   Included pursuant to Section 318(c) of the Trust Indenture Act of 1939.


<PAGE>



                                TABLE OF CONTENTS

<TABLE>
<CAPTION>
                                                                                            Page

                                   ARTICLE 1.

                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE
<S>     <C>                                                                                   <C>
Section 1.1     Definitions.................................................................  1
Section 1.2     Other Definition............................................................  9
Section 1.3     Incorporation by Reference of Trust Indenture Act...........................  9
Section 1.4     Rules of Construction.......................................................  9

                                   ARTICLE 2.

                                 THE SECURITIES
Section 2.1     Form and Dating............................................................. 10
Section 2.2     Execution and Authentication................................................ 10
Section 2.3     Registrar and Paying Agent.................................................. 11
Section 2.4     Paying Agent to Hold Money in Trust......................................... 11
Section 2.5     Registration of Transfer and Exchange....................................... 11
Section 2.6     Replacement Securities...................................................... 15
Section 2.7     Outstanding Securities...................................................... 15
Section 2.8     Treasury Securities......................................................... 15
Section 2.9     Temporary Securities........................................................ 16
Section 2.10    Cancellation................................................................ 16
Section 2.11    Defaulted Interest.......................................................... 16
Section 2.12    Securities Issuable in the Form of a Global Security........................ 16

                                   ARTICLE 3.

                                    COVENANTS
Section 3.1     Payment of Securities....................................................... 17
Section 3.2     Maintenance of Office or Agency............................................. 18
Section 3.3     SEC Reports................................................................. 18
Section 3.4     Compliance Certificate...................................................... 18
Section 3.5     Corporate Existence, Taxes, etc............................................. 19
Section 3.6     Stay, Extension and Usury Laws.............................................. 19
Section 3.7     Change in Control........................................................... 19
Section 3.8     Limitations on Asset Sales.................................................. 20

                                   ARTICLE 4.

                                   SUCCESSORS
Section 4.1     Limitations on Mergers and Consolidations................................... 21
Section 4.2     Successor Corporation Substituted........................................... 21

                                   ARTICLE 5.

                              DEFAULTS AND REMEDIES
Section 5.1     Events of Default........................................................... 21
Section 5.2     Acceleration................................................................ 23
Section 5.3     Other Remedies.............................................................. 23
Section 5.4     Waiver of Past Defaults..................................................... 23
Section 5.5     Control by Majority......................................................... 23
Section 5.6     Limitations on Suits........................................................ 24
Section 5.7     Rights of Holders to Receive Payment........................................ 24

                                        i



<PAGE>


<CAPTION>
                                                                                           Page

Section 5.8     Collection Suit by Trustee................................................. 24
Section 5.9     Trustee May File Proofs of Claim........................................... 24
Section 5.10    Priorities................................................................. 25
Section 5.11    Undertaking for Costs...................................................... 25

                                    ARTICLE 6.

                                      TRUSTEE
Section 6.1     Duties of Trustee.......................................................... 25
Section 6.2     Rights of Trustee.......................................................... 26
Section 6.3     Individual Rights of Trustee............................................... 27
Section 6.4     Trustee's Disclaimer....................................................... 27
Section 6.5     Notice of Defaults......................................................... 27
Section 6.6     Compensation and Indemnity................................................. 27
Section 6.7     Replacement of Trustee..................................................... 28
Section 6.8     Successor Trustee by Merger, etc........................................... 28
Section 6.9     Eligibility; Disqualification.............................................. 28

                                    ARTICLE 7.

                              DISCHARGE OF INDENTURE
Section 7.1     Termination of Company's Obligations....................................... 29
Section 7.2     Application of Trust Money................................................. 31
Section 7.3     Repayment to the Company................................................... 31
Section 7.4     Reinstatement.............................................................. 31

                                    ARTICLE 8.

                                    AMENDMENTS
Section 8.1     Without Consent of Holders................................................. 32
Section 8.2     With Consent of Holders.................................................... 32
Section 8.3     Compliance with Trust Indenture Act........................................ 33
Section 8.4     Revocation and Effect of Consents.......................................... 33
Section 8.5     Notation on or Exchange of Securities...................................... 34
Section 8.6     Trustee to Sign Amendments, etc............................................ 34


                                    ARTICLE 9.

                                   SUBORDINATION
Section 9.1     Securities Subordinated to Senior Indebtedness............................. 34
Section 9.2     Payment Over of Proceeds Upon Dissolution, Etc............................. 34
Section 9.3     Prior Payment to Senior Indebtedness Upon Acceleration of Securities
                 .......................................................................... 35
Section 9.4     No Payment Upon Certain Defaults with Respect to Senior Indebtedness
                 .......................................................................... 36
Section 9.5     Payment Permitted If No Default............................................ 37
Section 9.6     Subrogation to Rights of Holders of Senior Indebtedness.................... 37
Section 9.7     Provisions Solely to Define Relative Rights................................ 37
Section 9.8     Application by Trustee of Monies Deposited With It......................... 38
Section 9.9     Trustee to Effectuate Subordination........................................ 38
Section 9.10    No Waiver of Subordination Provisions...................................... 38
Section 9.11    Notice to Trustee.......................................................... 39
Section 9.12    Reliance on Judicial Order or Certificate of Liquidating Agent............. 40
Section 9.13    Trustee Not Fiduciary for Holders of Senior Indebtedness................... 40

                                       ii



<PAGE>


                                                                                           Page
<CAPTION>

Section 9.14    Rights of Trustee as Holder of Senior Indebtedness; Preservation of
                Trustee's Rights........................................................... 40


                                       iii



<PAGE>


                                                                                           Page

                                       ARTICLE 10.

                                      MISCELLANEOUS
Section 10.1    Trust Indenture Act Controls............................................... 41
Section 10.2    Notices.................................................................... 41
Section 10.3    Certificate and Opinion as to Conditions Precedent......................... 42
Section 10.4    Statements Required in Certificate or Opinion.............................. 42
Section 10.5    Rules by Trustee and Agents................................................ 42
Section 10.6    Legal Holidays............................................................. 42
Section 10.7    No Recourse Against Others................................................. 42
Section 10.8    Governing Law.............................................................. 43
Section 10.9    No Adverse Interpretation of Other Agreements.............................. 43
Section 10.10   Successors................................................................. 43
Section 10.11   Severability............................................................... 43
Section 10.12   Counterpart Originals...................................................... 43
Section 10.13   Trustee as Paying Agent and Registrar...................................... 43
Section 10.14   Table of Contents, Headings, etc........................................... 43
Section 10.15   Effective Date............................................................. 43
SIGNATURES................................................................................. 44
</TABLE>

EXHIBIT A     FORM OF RULE 144A NOTE
EXHIBIT B     FORM OF SERIES A NOTE
EXHIBIT C     TRANSFER CERTIFICATION



                                       iv


<PAGE>


     SECOND  AMENDED AND  RESTATED  SUPPLEMENTAL  INDENTURE  dated as of May 15,
1997,  between  INTEGRATED  HEALTH SERVICES,  INC., a Delaware  corporation (the
"Company"),  and SIGNET TRUST COMPANY, a Virginia  corporation,  as Trustee (the
"Trustee").


                             RECITALS OF THE COMPANY

     The Company  duly  authorized  the issue of its 9 5/8% Senior  Subordinated
Notes due 2002 (the "Rule  144A  Notes") in the  aggregate  principal  amount of
$115,000,000,  and to provide the terms and conditions  upon which the Rule 144A
Notes were  authenticated,  issued and  delivered  the  Company  and the Trustee
entered into an Indenture  dated as of May 15, 1995 with regard to the Rule 144A
Notes.

     The Company and the Trustee subsequently amended, restated and supplemented
said Indenture (the "Amended and Restated Supplemental Indenture") to permit the
issuance of the Company's 9 5/8% Senior  Subordinated  Notes due 2002,  Series A
(the  "Series  A  Notes"  and  collectively   with  the  Rule  144A  Notes,  the
"Securities"),  having  the same terms as the Rule 144A  Notes  except  that the
Series A Notes are registered under the Securities Act (as hereinafter defined),
in  exchange  for the  Rule  144A  Notes  pursuant  to the  Exchange  Offer  (as
hereinafter defined).

     On June 13, 1996, the Company, with the consent of Holders of not less than
a  majority  in  principal  amount  of the  Outstanding  Securities  executed  a
Supplemental  Indenture amending the Amended and Restated Supplemental Indenture
(such Indenture, as amended,  restated and supplemented through the date hereof,
the "Original Indenture").

     The Company by Board Resolution has authorized, and the Holders of not less
than a majority in principal amount of the Company's Outstanding Securities have
by consents delivered to the Trustee consented to, the execution and delivery of
this Second Amended and Restated  Supplemental  Indenture amending and restating
the Original Indenture.

     Each party  agrees as follows for the benefit of the other  parties and for
the equal and ratable benefit of the Holders of the Securities:


                                   ARTICLE 1.

                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

SECTION 1.1 DEFINITIONS

     "Affiliate"  of any  specified  Person means any other  Person  directly or
indirectly controlling, controlled by or under direct or indirect common control
with such specified Person. For purposes of this definition, "control" when used
with respect to any  specified  Person means the power to direct the  management
and  policies  of such  Person,  directly  or  indirectly,  whether  through the
ownership  of  voting  securities,  by  contract  or  otherwise,  and the  terms
"controlling" and "controlled" have meanings correlative to the foregoing.

     "Agent" means any Registrar or Paying Agent.

     "Allowed and Disallowed  Post-Commencement Interest and Expenses" means all
interest,  at  the  rate  provided  in  the  applicable  document  or  documents
(including  any rate  applicable  upon any default or event of  default,  to the
extent lawful), and all reimbursements,  costs, expenses and indemnities, to the
extent provided in the applicable document or documents,  accruing or claimed at
any time after commencement of any insolvency or bankruptcy case or




<PAGE>



proceeding,  or  any  receivership,  liquidation,  reorganization,  dissolution,
winding up,  assignment for the benefit of creditors,  marshalling of assets and
liabilities or other similar case or  proceeding,  whether or not such interest,
reimbursement,  cost or expense  is an allowed  claim  enforceable  against  the
Company in a case or proceeding  under  Bankruptcy Law or in any other such case
or proceeding.

     "Asset  Sale" for any Person  means the sale,  lease,  conveyance  or other
disposition  (including,  without  limitation,  by merger or consolidation,  and
whether  by  operation  of law or  otherwise)  of any of  that  Person's  assets
(including,  without limitation,  the sale or other disposition of Capital Stock
of any Subsidiary of such Person, whether by such Person or by such Subsidiary),
whether owned on the date hereof or hereafter acquired,  in one transaction or a
series of related  transactions,  in which such Person  and/or its  Subsidiaries
sell, lease,  convey or otherwise dispose of (i) all or substantially all of the
Capital Stock of any of such Person's Subsidiaries, (ii) assets which constitute
substantially  all of an operating unit or business of such Person or any of its
Subsidiaries,  or (iii) any health care facility;  provided,  however,  that the
following  shall not  constitute  Asset Sales:  (a) a  transaction  or series of
related  transactions  that results in a Change in Control,  or (b) transactions
between  the  Company  and any of its Wholly  Owned  Subsidiaries  or among such
Wholly  Owned  Subsidiaries  or (c)  transactions  in which  either (x) the fair
market value of the asset  disposed of does not exceed 2.5% of the  Consolidated
Tangible  Assets of the  Company or (y) the  Consolidated  EBITDA of the company
associated  with the asset disposed of does not exceed 2.5% of the  Consolidated
EBITDA of the Company.

     "Attributable  Indebtedness,"  when  used  with  respect  to any  Sale  and
Leaseback  Transaction  or an  operating  lease with  respect  to a health  care
facility means, as at the time of  determination,  the present value (discounted
at a rate equivalent to the interest rate implicit in the lease, compounded on a
semi-annual  basis) of the total  obligations of the lessee for rental payments,
after  excluding all amounts  required to be paid on account of maintenance  and
repairs,  insurance,  taxes, utilities and other similar expenses payable by the
lessee  pursuant  to the terms of the lease,  during the  remaining  term of the
lease  included in any such Sale and  Leaseback  Transaction  or such  operating
lease or until the earliest  date on which the lessee may  terminate  such lease
without  penalty or upon payment of a penalty (in which case the rental payments
shall include such penalty);  provided, that the Attributable  Indebtedness with
respect  to a Sale and  Leaseback  Transaction  shall  be no less  than the fair
market value of the property subject to such Sale and Leaseback Transaction.

     "Bank Agent" means  Citicorp  USA,  Inc., as  Administrative  Agent for the
Lenders, or any successor under the Credit Agreement.

     "Bank Debt" means all obligations of the Company and its Subsidiaries,  now
or  hereafter  existing  under the  Credit  Agreement,  whether  for  principal,
interest, reimbursement of amounts drawn under letters of credit issued pursuant
thereto, guarantees in respect thereof, fees, expenses, premiums, indemnities or
otherwise,   including  such   obligations   incurred  by  the  Company  or  its
Subsidiaries  in  connection  with  any  extension,  refunding,  refinancing  or
replacement of, or successor to, the Credit Agreement.

     "Bankruptcy  Law" means Title 11, U.S. Code or any similar federal or state
law for the relief of debtors.

     "Board of  Directors"  means the Board of  Directors  of the Company or any
authorized committee of the Board of Directors of the Company.

     "Business Day" means any day other than a Legal Holiday.

     "Capital Stock" of any Person means any and all shares, rights to purchase,
warrants or options  (whether or not currently  exercisable),  participation  or
other equivalents of or interests in (however designated) the equity (including,
without  limitation,  common stock,  preferred  stock and  partnership and joint
venture  interests)  of such  Person  (excluding  any debt  securities  that are
convertible into, or exchangeable for, such equity).


                                       -2-



<PAGE>




     "Capitalized Lease Obligations" of any Person means the obligations of such
Person  to pay  rent or  other  amounts  under a lease  that is  required  to be
capitalized  for financial  reporting  purposes in accordance with GAAP, and the
amount of such obligation shall be the capitalized  amount thereof determined in
accordance with GAAP.

     "Change  in  Control"  means any of the  following:  (i) the  sale,  lease,
conveyance or other  disposition  of all or  substantially  all of the Company's
assets as an entirety or  substantially  as an entirety to any Person or "group"
(within the meaning of Section  13(d)(3) of the  Exchange  Act) (other than to a
Permitted  Holder) in one or a series of transactions;  (ii) stockholders of the
Company shall approve any plan or proposal for the liquidation or dissolution of
the Company;  (iii)  consummation of any  consolidation or merger of the Company
(a) in which the Company is not the continuing or surviving  corporation  (other
than a consolidation  or merger with a Wholly Owned Subsidiary of the Company in
which  all  shares  of  Common  Stock  outstanding   immediately  prior  to  the
effectiveness  thereof are changed into or exchanged for the same consideration)
or (b)  pursuant  to which  the  Common  Stock  would be  converted  into  cash,
securities or other property,  in each case other than a consolidation or merger
of the Company in which the holders of the Common Stock immediately prior to the
consolidation or merger have, directly or indirectly, at least a majority of the
common stock of the continuing or surviving  corporation  immediately after such
consolidation or merger; or (iv) any transaction or series of transactions (as a
result of a tender offer,  merger,  consolidation  or otherwise) that results in
any Person  (other than a  Permitted  Holder),  including a "group"  (within the
meaning of Section  13(d)(3) of the  Exchange  Act) that  includes  such Person,
acquiring  "beneficial  ownership"  (as defined in Rule 13d-3 under the Exchange
Act),  directly or indirectly,  of 50% or more of the aggregate  voting power of
all classes of capital  stock of the Company  entitled to vote  generally in the
election of directors of the Company.

     "Common  Equity" of any Person means all Capital  Stock of such Person that
is generally entitled to (i) vote in the election of directors of such Person or
(ii) if such Person is not a corporation,  vote or otherwise  participate in the
selection of the governing body, partners,  managers or others that will control
the management and policies of such Person.

     "Company"  means  (i)  Integrated   Health   Services,   Inc.,  a  Delaware
corporation, and (ii) any successor of Integrated Health Services, Inc.

     "Consolidated  Amortization Expense" of any Person for any period means the
amortization expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated  Depreciation Expense" of any Person for any period means the
depreciation expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated   EBITDA"  of  any  Person   means,   with   respect  to  any
determination  date,  Consolidated  Net Income before  extraordinary  losses and
losses realized in connection with Asset Sales, plus (i) Consolidated Income Tax
Expense,  plus (ii) Consolidated  Depreciation  Expense, plus (iii) Consolidated
Amortization  Expense,  plus (iv) Consolidated  Interest  Expense,  plus (v) all
other  non-cash items  reducing  Consolidated  Net Income of such Person and its
Subsidiaries,  determined on a consolidated  basis in accordance  with GAAP, and
less all non-cash items  increasing  Consolidated  Net Income of such Person and
its Subsidiaries, determined on a consolidated basis in accordance with GAAP, in
each case, for such Person's prior four full fiscal quarters for which financial
results have been reported immediately preceding the determination date.

     "Consolidated  Income Tax  Expense" of any Person for any period  means the
provision  for  taxes  based  on  income  and  profits  of such  Person  and its
Subsidiaries  to the extent such income or profits  were  included in  computing
Consolidated Net Income of such Person for such period.



                                       -3-



<PAGE>



     "Consolidated  Interest  Expense"  of any Person  for any period  means the
Interest Expense of such Person and its Subsidiaries for such period, determined
on a consolidated  basis in accordance with GAAP, plus any dividends accrued for
such period on any Preferred  Stock of any Subsidiary not held by the Company or
any Wholly Owned Subsidiary.

     "Consolidated Net Income" of any Person for any period means the net income
(or loss) of such Person and its  Subsidiaries  for such period  determined on a
consolidated  basis in accordance with GAAP,  without giving effect to dividends
on any series of preferred  stock of any  Subsidiary of such Person,  whether or
not in cash,  to the extent such  consolidated  net income was reduced  thereby;
provided  that  there  shall be  excluded  from such net  income  (to the extent
otherwise included therein),  without duplication:  (i) the net income (or loss)
of any Person  (other than a  Subsidiary  of the  referent  Person) in which any
Person other than the referent Person has an ownership  interest,  except to the
extent that any such income has actually been received by the referent Person or
any of its  Wholly  Owned  Subsidiaries  in the  form of  dividends  or  similar
distributions  during such period;  (ii) except to the extent  includible in the
consolidated  net income of the referent Person pursuant to the foregoing clause
(i), the net income (or loss) of any Person that accrued  prior to the date that
(a) such Person becomes a Subsidiary of the referent Person or is merged into or
consolidated  with the  referent  Person or any of its  Subsidiaries  or (b) the
assets  of  such  Person  are  acquired  by the  referent  Person  or any of its
Subsidiaries;  (iii) the net income of any  Subsidiary  of the  referent  Person
(other than a Wholly Owned  Subsidiary)  to the extent that the  declaration  or
payment of dividends or similar  distributions by such Subsidiary of that income
is not  permitted  by  operation  of the terms of its charter or any  agreement,
instrument,  judgment,  decree, order, statute, rule or governmental  regulation
applicable to that Subsidiary during such period;  (iv) any gain (but not loss),
together with any related provisions for taxes on any such gain, realized during
such  period  by the  referent  Person or any of its  Subsidiaries  upon (a) the
acquisition of any securities, or the extinguishment of any Indebtedness, of the
referent Person or any of its Subsidiaries or (b) any Asset Sale by the referent
Person  or any  of  its  Subsidiaries;  (v)  any  extraordinary  gain  (but  not
extraordinary  loss),  together with any related provision for taxes on any such
extraordinary  gain,  realized by the referent Person or any of its Subsidiaries
during  such  period;  and (vi) in the case of a  successor  to such  Person  by
consolidation,  merger or transfer of its assets,  any earnings of the successor
prior to such merger, consolidation or transfer of assets.

     "Consolidated Tangible Assets" of any Person as of any date means the total
assets of such Person and its  Subsidiaries  (excluding any assets that would be
classified as "intangible  assets" under GAAP) on a  consolidated  basis at such
date,  as determined in  accordance  with GAAP,  less all write-ups  (other than
write-ups  in  connection  with  acquisitions)  subsequent  to the  date of this
Indenture  in the book value of any asset  (except any such  intangible  assets)
owned by such Person or any of its Subsidiaries.

     "Corporate  Trust  Office of the  Trustee"  shall be at the  address of the
Trustee  specified in Section 10.2 or such other address as the Trustee may give
notice to the Company.

     "Credit  Agreement"  means the  Revolving  Credit and Term Loan  Agreement,
dated as of April 20,  1995,  among the Company,  the Bank Agent,  and the other
financial  institutions  signatory thereto,  together with the related documents
thereto, including,  without limitation, any security documents and all exhibits
and  schedules  thereto,  and  any  agreement  or  agreements  relating  to  any
extension, refunding, refinancing, successor or replacement facility, whether or
not with the same lenders,  and whether or not the principal amount or amount of
letters of credit outstanding thereunder or the interest rate payable in respect
thereof shall be thereby  increased,  in each case as amended and in effect from
time to time.

     "Default" means any event, act or condition that is, or after notice or the
passage of time or both would be, an Event of Default.

     "Definitive Securities" means any Securities other than a Global Security.



                                       -4-



<PAGE>



     "Depositary"  means, with respect to Securities issuable or issued in whole
or in part in global form hereunder,  unless otherwise  specified by the Company
pursuant to Section 2.12, The Depository  Trust Company,  New York, New York, or
any successor thereto  registered as a clearing agency under the Exchange Act or
other applicable statute or regulation.

     "Exchange Act" means the Securities Exchange Act of 1934, as amended.

     "Exchange  Offer"  means the offer the  Company is to make  pursuant to the
Registration Rights Agreement to exchange Rule 144A Notes for Series A Notes.

     "GAAP" means  generally  accepted  accounting  principles  set forth in the
opinions and  pronouncements of the Accounting  Principles Board of the American
Institute of Certified Public  Accountants and statements and  pronouncements of
the Financial  Accounting  Standards  Board or in such other  statements by such
other  entity as may be  approved  by a  significant  segment of the  accounting
profession of the United States, as in effect from time to time.

     "Global  Security"  means a Security  which is  executed by the Company and
authenticated  and delivered by the Trustee to the Depositary or pursuant to the
Depositary's instruction,  all in accordance with this Indenture and pursuant to
a written  order of the Company,  which shall be  registered  in the name of the
Depositary or its nominee and which shall represent, and shall be denominated in
an amount equal to the aggregate  principal  amount of, all of the Securities or
any  portion  thereof,  but not  including  any  Securities  that are no  longer
outstanding,  and having the same terms, including, without limitation, the same
original  issue  date,  date or  dates on which  principal  is due,  and rate of
interest.

     "Guarantee" by any Person means any obligation, contingent or otherwise, of
such Person  directly  or  indirectly  guaranteeing  any  Indebtedness  or other
obligation  of any other  Person and,  without  limiting the  generality  of the
foregoing, any obligation,  direct or indirect, contingent or otherwise, of such
Person (i) to purchase or pay (or  advance or supply  funds for the  purchase or
payment of) such  Indebtedness or other obligation of such other Person (whether
arising by virtue of  partnership  arrangements,  by agreement  to keepwell,  to
purchase assets, goods,  securities or services, to take-or-pay,  or to maintain
financial  statement  conditions  or  otherwise)  or (ii)  entered  into for the
purpose of assuring  in any other  manner the  obligee of such  Indebtedness  or
other  obligation of the payment thereof or to protect such obligee against loss
in respect thereof (in whole or in part); provided that the term Guarantee shall
not include  endorsements  for  collection or deposit in the ordinary  course of
business. The term "Guarantee" used as a verb has a corresponding meaning.

     "Hedging  Obligations"  of any Person means the  obligations of such Person
pursuant  to  any  interest  rate  swap  agreement,  foreign  currency  exchange
agreement,  interest rate collar agreement,  option or futures contract or other
similar agreement or arrangement  relating to interest rates or foreign exchange
rates.

     "Holder" means a Person in whose name a Security is registered.

     "Indebtedness" of any Person at any date means,  without  duplication:  (i)
all Bank Debt;  (ii) all other  Indebtedness  of such Person for borrowed  money
(whether or not the recourse of the lender is to the whole of the assets of such
Person  or only to a portion  thereof);  (iii) all  obligations  of such  Person
evidenced by bonds,  debentures,  notes or other similar  instruments;  (iv) all
obligations  of such  Person in respect  of  letters of credit or other  similar
instruments  (or  reimbursement  obligations  with  respect  thereto);  (v)  all
obligations of such Person with respect to Hedging Obligations (other than those
that fix the interest rate on variable rate indebtedness  otherwise permitted by
this  Indenture  or that  protect the Company  and/or its  Subsidiaries  against
changes in foreign exchange  rates);  (vi) all obligations of such Person to pay
the deferred  and unpaid  purchase  price of property or services,  except trade
payables and accrued expenses incurred in the ordinary course of business; (vii)
all Capitalized  Lease  Obligations of such Person;  (viii) all  Indebtedness of
others  secured  by a Lien on any  asset  of such  Person,  whether  or not such
Indebtedness  is  assumed  by such  Person;  (ix)  all  Indebtedness  of  others
guaranteed by such Person to the extent of such guarantee; and (x) all


                                       -5-



<PAGE>



Attributable Indebtedness.  The amount of Indebtedness of any Person at any date
shall be the outstanding  balance at such date of all unconditional  obligations
as  described  above;  and in the case of  clauses  (iv) and (ix),  the  maximum
liability of such Person for any such  contingent  obligations at such date and,
in the case of clause (viii), the amount of the Indebtedness secured.

     "Indenture" means this Second Amended and Restated Supplemental  Indenture,
as amended from time to time.

                  "Interest  Expense"  of any Person  for any  period  means the
aggregate  amount of  interest  which,  in  accordance  with GAAP,  would be set
opposite  the  caption  "interest  expense"  or any like  caption  on an  income
statement for such Person (including, without limitation or duplication, imputed
interest included in Capitalized Lease Obligations,  all commissions,  discounts
and other fees and charges  owed with  respect to letters of credit and bankers'
acceptance  financing,  the  net  costs  associated  with  Hedging  Obligations,
amortization  of  financing  fees and  expenses,  the  interest  portion  of any
deferred  payment  obligation,  amortization  of discount and all other non-cash
interest expense).

     "Interest Payment Date" shall have the meaning assigned to such term in the
Securities.

     "Lien"  means,  with  respect to any asset,  any  mortgage,  lien,  pledge,
charge, security interest or other similar encumbrance of any kind in respect of
such  asset,  whether  or not  filed,  recorded  or  otherwise  perfected  under
applicable law (including,  without  limitation,  any conditional  sale or other
title retention  agreement,  and any financing lease in the nature thereof,  any
agreement  to sell,  and any  filing of, or  agreement  to give,  any  financing
statement  (other than notice filings not perfecting a security  interest) under
the Uniform Commercial Code (or equivalent statutes) of any jurisdiction).

     "Net  Proceeds"  with  respect  to any Asset  Sale  means (i) cash (in U.S.
dollars or freely  convertible into U.S. dollars) received by the Company or any
of its Subsidiaries from such Asset Sale (including,  without  limitation,  cash
received as  consideration  for the  assumption  or  incurrence  of  liabilities
incurred in connection with or in  anticipation  of such Asset Sale),  after (a)
provision for all income or other taxes measured by or resulting from such Asset
Sale or the transfer of the proceeds of such Asset Sale to the Company or any of
its Subsidiaries,  (b) payment of all brokerage commissions and the underwriting
and other fees and  expenses  related to such  Asset Sale and (c)  deduction  of
appropriate  amounts to be provided by the Company or any of its Subsidiaries as
a reserve, in accordance with GAAP, against any liabilities  associated with the
assets  sold or  otherwise  disposed  of in such Asset Sale and  retained by the
Company or any of its  Subsidiaries  after such Asset Sale  (including,  without
limitation,   pension  and  other   post-employment   benefit   liabilities  and
liabilities  related to  environmental  matters) or against any  indemnification
obligations  associated with the sale or other disposition of the assets sold or
otherwise  disposed  of in such Asset Sale and (ii) all  non-cash  consideration
received by the Company or any of its Subsidiaries from such Asset Sale upon the
liquidation or conversion of such consideration into cash.

     "Officer" means the Chief Executive  Officer,  the Chief Financial Officer,
the  Treasurer,  any  Assistant  Treasurer,  Controller,  Secretary  or any Vice
President of the Company.

     "Officers'  Certificate" means a certificate signed by two Officers, one of
whom must be the Company's Chief Executive Officer or Chief Financial Officer.

     "Opinion of Counsel"  means an opinion from legal counsel who is acceptable
to the  Trustee in its sole  discretion.  The  counsel  may be an employee of or
counsel to the Company or the Trustee.

     "Payment or Distribution in Respect of the Securities"  means, for purposes
of Article 9 hereof,  any  payment  or  distribution  of any kind or  character,
whether in cash,  property  or  securities,  on  account  of the  payment of the
principal  of and  premium,  if  any,  and  interest  on any of the  Securities,
including,  without limitation,  any redemption or repurchase price paid for any
optional or mandatory redemption, Asset Sale Offer, Change in Control Repurchase


                                       -6-



<PAGE>



or other  repurchase  or  retirement  of the  Securities or any other payment on
account of the Securities  (including payments with respect to claims related to
the issuance of the Securities);  provided,  however,  that the exchange of Rule
144A Notes for a like amount of Series A Notes shall not constitute a Payment or
Distribution in Respect of the Securities.  For purposes of this definition, the
words "cash,  property or securities" shall not be deemed to include  securities
of the Company as reorganized or readjusted, or securities of the Company or any
other corporation provided for by a plan of reorganization or readjustment which
are  subordinated  in right of payment to all Senior  Indebtedness  which may be
outstanding  to  substantially  the same extent as, or to a greater extent than,
the Securities are so subordinated as provided in Article 9 and which securities
are not subject to maturity or mandatory prepayment prior to the maturity of any
Senior Indebtedness then outstanding.

     "Permitted Holder" means Robert N. Elkins and any group (within the meaning
of Section  13(d)(3) of the Exchange  Act) of which Mr.  Elkins is a member;  so
long as, with respect to any group,  Mr.  Elkins owns more than 20% of the total
voting power of all classes of Capital Stock of the acquiring entity entitled to
vote generally in the election of directors of the acquiring entity.

     "Person" means any  individual,  corporation,  partnership,  joint venture,
incorporated  or  unincorporated   association,   joint-stock  company,   trust,
unincorporated   organization   or  government  or  other  agency  or  political
subdivision thereof or other entity of any kind.

     "Preferred  Stock"  means with  respect to any Person all Capital  Stock of
such Person which has a preference in liquidation  or a preference  with respect
to the payment of dividends.

     "Registration  Rights  Agreement" means the  Registration  Rights Agreement
dated as of May 11, 1995 by and  between  Smith  Barney Inc.  and the Company as
such agreement may be amended, modified or supplemented from time to time.

     "Rule 144A Notes" means the Company's 9 5/8% Senior  Subordinated Notes due
2002, issued under this Indenture.

     "Sale and  Leaseback  Transaction"  means with  respect to any  Person,  an
arrangement with any bank,  insurance  company or other lender or investor or to
which such  lender or  investor  is a party,  providing  for the leasing by such
Person or any of its Subsidiaries of any property or asset of such Person or any
of its  Subsidiaries  which  has been or is being  sold or  transferred  by such
Person or such  Subsidiary  to such  lender or investor or to any Person to whom
funds have been or are to be advanced by such lender or investor on the security
of such property or asset.

     "SEC" means the Securities and Exchange Commission.

     "Securities" means the Rule 144A Notes and Series A Notes issued under this
Indenture.

     "Securities Act" means the Securities Act of 1933, as amended.

     "Senior  Indebtedness"  means the  principal  of and  premium,  if any, and
interest on and other amounts due on or in connection  with any  Indebtedness of
the  Company  (including,   without  limitation,   all  Allowed  and  Disallowed
Post-Commencement Interest and Expenses in respect of such Indebtedness) and any
amounts  with  respect  to Hedging  Obligations  that fix the  interest  rate on
variable rate indebtedness otherwise permitted by this Indenture, other than the
Securities,  the  Company's  10 3/4%  Senior  Subordinated  Notes due 2004,  the
Company's 5 3/4%  Convertible  Senior  Subordinated  Debentures due 2001 and the
Company's 6% Convertible  Subordinated  Debentures due 2003, whether outstanding
on the  date of the  Original  Indenture  or  thereafter  created,  incurred  or
assumed,  unless,  in the case of any  particular  Indebtedness,  the instrument
creating or  evidencing  the same or  pursuant to which the same is  outstanding
expressly  provides  that  such  Indebtedness  shall  not be  senior in right of
payment to the Securities;  provided that Senior  Indebtedness  will not include
(i) any Indebtedness, liability or obligation of the Company to (a) any of its


                                       -7-



<PAGE>



Subsidiaries,  (b) trade  creditors or (c) any person arising out of any lawsuit
against the Company or any of its Subsidiaries or any settlement  thereof (other
than any lawsuit or settlement thereof respecting amounts payable with regard to
Senior Indebtedness),  (ii) any redemption or other payments on Preferred Stock,
(iii) any Indebtedness  incurred in violation of the provisions of the Indenture
or (iv) amounts owing under leases (other than Capitalized Lease Obligations).

     "Series A Notes" means the Company's 9 5/8% Senior  Subordinated  Notes due
2002, Series A, issued under this Indenture.

     "Shelf  Registration  Statement"  means  the  Registration  Statement  with
respect to the Securities  which the Company is required to file pursuant to the
Registration Rights Agreement.

     "Significant  Subsidiary" has the meaning ascribed to it under Regulation C
promulgated under the Securities Act of 1933, as amended.

     "Stated  Maturity"  means,  when used with  respect to any  security or any
installment  of interest  thereon,  that date  specified in such security as the
fixed  date on which the  principal  of such  security  or such  installment  of
interest is due and payable.

     "Subsidiary" of any Person means (i) any corporation of which Common Equity
having  ordinary  voting  power to elect a  majority  of the  directors  of such
corporation  is owned by such  Person  directly  or  through  one or more  other
Subsidiaries  of such Person,  and (ii) any entity other than a  corporation  in
which such  Person,  directly  or  indirectly,  owns at least a majority  of the
Common Equity of such entity.

     "TIA" means the Trust  Indenture Act of 1939, as amended (15 U.S.C.  ss.ss.
77aaa-77bbbb),  as in effect on the date hereof (unless  otherwise  specifically
provided herein).

     "Transfer Restricted Securities" means Securities that bear or are required
to bear the legend set forth in Section 2.5 hereof.

     "Trustee" means the party named as such above until a successor replaces it
in accordance  with the  applicable  provisions of this Indenture and thereafter
means the successor serving hereunder.

     "Trust  Officer"  means any  officer or  assistant  officer of the  Trustee
assigned by the Trustee to administer its corporate trust matters.

     "U.S. Government Obligations" means direct obligations of the United States
of  America  for the  payment  of which the full  faith and credit of the United
States of America is pledged.

     "Wholly  Owned  Subsidiary"  of any Person means (i) a Subsidiary  of which
100% of the Common Equity  (except for directors'  qualifying  shares or certain
minority  interests owned by other Persons solely due to local law  requirements
that there be more than one stockholder,  but which interest is not in excess of
what is required for such  purpose) is owned  directly by such Person or through
one or more other Wholly Owned  Subsidiaries  of such Person and (ii) any entity
other than a corporation in which such Person, directly or indirectly,  owns all
of the Common Equity of such entity.



                                       -8-



<PAGE>



SECTION 1.2 OTHER DEFINITIONS

                                                                       Defined
        Term                                                          in Section

        "Asset Sale Offer".........................................     3.8
        "Custodian"................................................     5.1
        "Change in Control Repurchase".............................     3.7
        "Event of Default".........................................     5.1
        "Legal Holiday"............................................    10.6
        "Payment Blockage Period"..................................     9.4
        "Paying Agent".............................................     2.3
        "Registrar"................................................     2.3
        "Repurchase Date"..........................................     3.7
        "Successor"................................................     4.1


SECTION 1.3 INCORPORATION BY REFERENCE OF TRUST INDENTURE ACT

     Whenever this Indenture  refers to a provision of the TIA, the provision is
incorporated by reference in and made a part of this Indenture.

     All terms used in this  Indenture  that are defined by the TIA,  defined by
TIA  reference to another  statute or defined by SEC rule under the TIA have the
meanings so assigned to them.

SECTION 1.4 RULES OF CONSTRUCTION

     Unless the context otherwise requires:

     (1)  a term has the meaning assigned to it;

     (2)  an accounting term not otherwise  defined has the meaning  assigned to
          it in accordance with GAAP;

     (3)  "or" is not exclusive;

     (4)  words in the singular  include the plural,  and in the plural  include
          the singular;

     (5)  provisions apply to successive events and transactions;

     (6)  any amount may be negative; and

     (7)  "herein",  "hereof"  and other words of similar  import  refer to this
          Indenture  as a whole and not to any  particular  Article,  Section or
          Subdivision.




                                       -9-



<PAGE>



                                   ARTICLE 2.

                                 THE SECURITIES

SECTION 2.1 FORM AND DATING

     The Rule 144A Notes and the Trustee's  certificate of authentication  shall
be substantially in the form of Exhibit A. Subject to Section 2.6, the Rule 144A
Notes shall be in an aggregate  principal  amount no greater than  $115,000,000;
provided,  that if Series A Notes are issued hereunder  pursuant to the Exchange
Offer,  the  aggregate  maximum  principal  amount of Rule 144A  Notes  shall be
reduced by the principal amount of Series A Notes so issued. The Series A Notes,
when and if issued,  and the Trustee's  certificate of  authentication  shall be
substantially  in the form of Exhibit B.  Subject to Section  2.6,  the Series A
Notes shall be in an aggregate  principal  amount no greater  than  $115,000,000
less the  principal  amount of Rule 144A  Notes not  exchanged  for the Series A
Notes in the Exchange  Offer.  The  Securities  may have  notations,  legends or
endorsements  required by law, stock exchange rule or usage. Each Security shall
be  dated  the  date  of  its   authentication.   The  Securities  shall  be  in
denominations of $1,000 and integral multiples thereof.

     The  Securities  may be  initially  issued  either  in the form of a Global
Security or Securities or in the form of Definitive Securities or both. A Global
Security  shall  represent  such  of the  outstanding  Securities  as  shall  be
specified therein and shall provide that it shall represent the aggregate amount
of  outstanding  Securities  from  time to time  endorsed  thereon  and that the
aggregate amount of outstanding  Securities represented thereby may from time to
time  be  reduced  or  increased,  as  appropriate,  to  reflect  exchanges  and
redemptions.  Any  endorsement of a Global Security to reflect the amount of any
increase or decrease in the amount of outstanding Securities represented thereby
shall  be made by the  Trustee  or an agent  thereof,  at the  direction  of the
Trustee, in accordance with instructions given by the Holder thereof. Definitive
Securities  shall be  printed,  lithographed  or  engraved  or  produced  by any
combination of these methods on steel engraved borders or may be produced in any
other  manner  permitted  by the rules of any  securities  exchange on which the
Securities  may be listed,  all as  determined  by the officers  executing  such
Securities, as evidenced by their execution of such Securities.

     The terms and provisions contained in the Securities shall constitute,  and
are  hereby  expressly  made,  a part  of  this  Indenture  and  to  the  extent
applicable, the Company and the Trustee, by their execution and delivery of this
Indenture, expressly agree to such terms and provisions and to be bound thereby.

SECTION 2.2 EXECUTION AND AUTHENTICATION

     Two  Officers  shall  sign the  Securities  for the  Company  by  manual or
facsimile  signature.  The Company's  seal shall be reproduced on the Securities
and may be in facsimile form.

     If an Officer whose  signature is on a Security no longer holds that office
at the time the Security is authenticated,  the Security  nevertheless  shall be
valid.

     A Security shall not be valid until  authenticated  by the manual signature
of the Trustee. The signature shall be conclusive evidence that the Security has
been authenticated under this Indenture.

     The Trustee  shall  authenticate  Securities  for original  issue up to the
aggregate  principal  amount  stated in  paragraph 4 of the  Securities,  upon a
written  order of the Company  signed by two Officers.  The aggregate  principal
amount of Securities  outstanding  at any time may not exceed such amount except
as provided in Section 2.6.

     The Trustee may appoint an  authenticating  agent acceptable to the Company
to authenticate Securities.  An authenticating agent may authenticate Securities
whenever the Trustee may do so. Each reference in this Indenture


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<PAGE>



to  authentication  by the Trustee  includes  authentication  by such agent.  An
authenticating agent has the same rights as an Agent to deal with the Company or
an Affiliate.

SECTION 2.3 REGISTRAR AND PAYING AGENT

     The Company shall maintain or cause to be maintained through the Trustee or
such  other  Person as may be  appointed  hereunder  an  office or agency  where
Securities  may be  presented  for  registration  of  transfer  or for  exchange
("Registrar")  and an office or agency where  Securities  may be  presented  for
payment ("Paying Agent").  The Registrar shall keep a register of the Securities
and of  their  transfer  and  exchange.  The  Company  may  appoint  one or more
co-registrars  and one or more additional  paying agents.  The term  "Registrar"
includes any  co-registrar  and the term "Paying Agent"  includes any additional
paying  agent.  The Company  may change any Paying  Agent or  Registrar  without
notice to any  Holder.  The  Company  shall  notify the  Trustee of the name and
address  of any Agent not a party to this  Indenture.  If the  Company  fails to
appoint or maintain  another  entity as Registrar or Paying  Agent,  the Trustee
shall act as such.  The  Company  or any of its  Subsidiaries  may act as Paying
Agent or Registrar.

SECTION 2.4 PAYING AGENT TO HOLD MONEY IN TRUST

     The Company shall require each Paying Agent other than the Trustee to agree
in  writing  that the  Paying  Agent  will hold in trust for the  benefit of the
Holders or the  Trustee  all money held by the Paying  Agent for the  payment of
principal of or premium, if any, or interest on the Securities,  and will notify
the Trustee of any default by the Company in making any such payment.  While any
such default continues,  the Trustee may require a Paying Agent to pay all money
held by it to the Trustee. The Company at any time may require a Paying Agent to
pay all money held by it to the Trustee.  Upon payment over to the Trustee,  the
Paying Agent (if other than the Company or a  Subsidiary)  shall have no further
liability for the money. If the Company or a Subsidiary acts as Paying Agent, it
shall segregate and hold in a separate trust fund for the benefit of the Holders
all money held by it as Paying Agent.

SECTION 2.5 REGISTRATION OF TRANSFER AND EXCHANGE

     (a) With respect to the transfer  and  exchange of  Definitive  Securities:
when Definitive  Securities are presented to the Trustee with the request (x) to
register  the  transfer of the  Definitive  Securities  or (y) to exchange  such
Definitive  Securities for an equal principal amount of Definitive Securities of
other authorized denominations,  the Trustee shall register the transfer or make
the exchange as requested if its  requirements  for such  transactions  are met;
provided,  however,  that the Definitive Securities presented or surrendered for
register of transfer or exchange:

          (i) shall be duly endorsed or accompanied by a written  instruction of
     transfer in form  satisfactory  to the Trustee duly  executed by the Holder
     thereof or by its attorney, duly authorized in writing; and

          (ii) shall,  in the case of Transfer  Restricted  Securities  that are
     Definitive  Securities,  except  if  exchanged  for a  Series A Note in the
     Exchange Offer, be accompanied by the following additional  information and
     documents, as applicable

               (A) if such Transfer  Restricted  Security is being  delivered to
          the Registrar by a Holder for registration in the name of such Holder,
          without transfer,  a certification from such Holder to that effect (in
          substantially the form of Exhibit C hereto); or

               (B) if such Transfer  Restricted Security is being transferred to
          a "qualified  institutional  buyer" (as defined in Rule 144A under the
          Securities  Act) in reliance on Rule 144A under the  Securities Act or
          pursuant to an exemption from registration in accordance with Rule 144
          or Regulation S under the Securities Act or pursuant to an effective


                                      -11-



<PAGE>



          registration  statement under the Securities  Act, a certification  to
          that effect (in substantially the form of Exhibit C hereto); or

               (C) if such Transfer  Restricted Security is being transferred in
          reliance on another  exemption from the  registration  requirements of
          the Securities Act, a certification  to that effect (in  substantially
          the form of Exhibit C hereto)  and an  Opinion  of counsel  reasonably
          acceptable to the Company and to the Registrar to the effect that such
          transfer is in compliance with the Securities Act.

     (b) The  following  restrictions  apply  to any  transfer  of a  Definitive
Security for a beneficial  interest in a Global Security.  A Definitive Security
may not be exchanged for a beneficial interest in a Global Security except until
and upon  satisfaction of the requirements set forth below.  Upon receipt by the
Trustee of a Definitive  Security,  duly endorsed or  accompanied by appropriate
instruments of transfer, in form satisfactory to the Trustee, together with:

          (i) if such Definitive  Security is a Transfer Restricted Security and
     such  transfer is not being made in  connection  with the  Exchange  Offer,
     certification,  substantially  in the form of  Exhibit C hereto,  that such
     Definitive  Security is being  transferred  to a  "qualified  institutional
     buyer" (as  defined in Rule 144A under the  Securities  Act) in  accordance
     with Rule 144A under the Securities Act; and

          (ii) whether or not such Definitive  Security is a Transfer Restricted
     Security, written instructions directing the Trustee to make an endorsement
     on the Global  Security to reflect an increase in the  aggregate  principal
     amount of the Securities represented by the Global Security,

then the Trustee shall cancel such Definitive  Security and cause, in accordance
with the  standing  instructions  and  procedures  existing  between  it and the
Depositary,  the aggregate  principal  amount of Securities  represented  by the
Global Security to be increased  accordingly.  If no Global  Securities are then
outstanding,   the  Company   shall  issue  and,   upon  receipt  of  a  written
authentication order in the form of an Officers' Certificate,  the Trustee shall
authenticate a new Global Security in the appropriate principal amount.

     (c) The transfer and exchange of Global Securities or beneficial  interests
therein  shall be  effected  through the  Depositary,  in  accordance  with this
Indenture  (including  the  restrictions  on transfer set forth  herein) and the
procedures of the Depositary therefor.

     (d) With  respect to the  transfer  of a  beneficial  interest  in a Global
Security for a Definitive Security:

          (i) Any person having a beneficial  interest in a Global  Security may
     upon request exchange such beneficial  interest for a Definitive  Security.
     Upon receipt by the Trustee of written  instructions  or such other form of
     instructions as is customary for the Depositary or its nominee on behalf of
     any person having a beneficial interest in a Global Security constituting a
     Transfer  Restricted Security only, except if exchanged for a Series A Note
     in the Exchange Offer, the following  additional  information and documents
     (all of which may be submitted by facsimile):

               (A) if such  beneficial  interest  is  being  transferred  to the
          person  designated by the Depositary as being the beneficial  owner, a
          certification  from such person to that effect (in  substantially  the
          form of Exhibit C hereto); or

               (B)  if  such  beneficial  interest  is  being  transferred  to a
          "qualified  institutional  buyer"  (as  defined in Rule 144A under the
          Securities Act) in accordance with Rule 144A


                                      -12-



<PAGE>



          under the Securities Act or pursuant to an exemption from registration
          in accordance  with Rule 144 or Regulation S under the  Securities Act
          or  pursuant  to  an  effective   registration   statement  under  the
          Securities Act, a certification to that effect from the transferor (in
          substantially the form of Exhibit C hereto); or

               (C) if such beneficial  interest is being transferred in reliance
          on  another  exemption  from  the  registration  requirements  of  the
          Securities Act, a certification  to that effect from the transferee or
          transferor  (in  substantially  the form of  Exhibit C hereto)  and an
          Opinion  of  counsel  from the  transferee  or  transferor  reasonably
          acceptable to the Company and to the Security  Registrar to the effect
          that such transfer is in compliance with the Securities Act,

then the Trustee will cause,  in accordance with the standing  instructions  and
procedures  existing  between it and the  Depositary,  the  aggregate  principal
amount of the Global Security to be reduced and,  following such reduction,  the
Company will execute and, upon receipt of a written  authentication order in the
form of an Officers'  Certificate the Trustee will  authenticate  and deliver to
the transferee a Definitive Security.

          (ii)  Definitive  Securities  issued  in  exchange  for  a  beneficial
     interest  in a  Global  Security  pursuant  to this  Section  2.5  shall be
     registered  in such  names  and in  such  authorized  denominations  as the
     Depositary,   pursuant  to   instructions   from  its  direct  or  indirect
     participants  or otherwise,  shall instruct the Trustee.  The Trustee shall
     deliver  such  Definitive  Securities  to the  persons  in whose  name such
     Securities are so registered.

     (e)  Notwithstanding any other provisions of this Indenture (other than the
provisions set forth in subsection  (f) of this Section 2.5), a Global  Security
may not be  transferred  as a whole except by the Depositary to a nominee of the
Depositary  or by a nominee  of the  Depositary  to the  Depositary  or  another
nominee  of  the  Depositary  or by the  Depositary  or any  such  nominee  to a
successor Depositary or a nominee of such successor Depositary.

     (f) The following relates to the authentication of Definitive Securities in
absence of the Depositary. If at any time: (i) the Depositary for the Securities
notifies the Company that the  Depositary  is unwilling or unable to continue as
Depositary for the Global  Securities and a successor  Depositary for the Global
Securities is not appointed by the Company within 90 days after delivery of such
notice;  or (ii) the Company,  at its sole  discretion,  notifies the Trustee in
writing that it elects to cause the issuance of Definitive Securities under this
Indenture,  then the Company will  execute,  and the Trustee,  upon receipt of a
written  order  in  the  form  of  an  Officers'   Certificate   requesting  the
authentication  and delivery of Definitive  Securities,  will  authenticate  and
deliver Definitive  Securities,  in an aggregate a principal amount equal to the
principal  amount  of  the  Global  Securities,  in  exchange  for  such  Global
Securities.

     (g) (i) Except as permitted by the following paragraph (ii), each Rule 144A
Note certificate  evidencing the Global Securities and the Definitive Securities
(and all  Securities  other than Series A Notes  issued in exchange  therefor or
substitution thereof) shall bear a legend in substantially the following form:

   THIS SECURITY HAS NOT BEEN  REGISTERED  UNDER THE  SECURITIES ACT OF 1933, AS
   AMENDED (THE SECURITIES  ACT"), OR ANY STATE  SECURITIES  LAWS.  NEITHER THIS
   SECURITY NOR ANY INTEREST OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
   ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED OR OTHERWISE DISPOSED OF IN THE
   ABSENCE OF SUCH  REGISTRATION  OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR
   NOT SUBJECT TO, REGISTRATION.

   THE HOLDER OF THIS  SECURITY BY ITS  ACCEPTANCE  HERETO  AGREES NOT TO OFFER,
   SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY,  PRIOR TO THE DATE (THE "RESALE
   RESTRICTION TERMINATION DATE") WHICH IS THREE YEARS AFTER THE LATER OF THE


                                      -13-



<PAGE>



   ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST DATE ON WHICH THE  COMPANY OR ANY
   AFFILIATED  PERSON  OF THE  COMPANY  WAS THE OWNER OF THIS  SECURITY  (OR ANY
   PREDECESSOR  OF SUCH SECURITY)  UNLESS SUCH OFFER,  SALE OR OTHER TRANSFER IS
   (A) TO THE COMPANY,  (B) PURSUANT TO A REGISTRATION  STATEMENT WHICH HAS BEEN
   DECLARED  EFFECTIVE  UNDER  THE  SECURITIES  ACT,  (C)  FOR  SO  LONG  AS THE
   SECURITIES  ARE  ELIGIBLE FOR RESALE  PURSUANT TO RULE 144A,  TO A PERSON THE
   HOLDER REASONABLY BELIEVES IS A "QUALIFIED INSTITUTIONAL BUYER" AS DEFINED IN
   RULE 144A UNDER THE  SECURITIES ACT THAT PURCHASES FOR ITS OWN ACCOUNT OR FOR
   THE ACCOUNT OF A QUALIFIED  INSTITUTIONAL  BUYER TO WHOM NOTICE IS GIVEN THAT
   THE  TRANSFER IS BEING MADE IN RELIANCE ON RULE 144A,  (D) PURSUANT TO OFFERS
   AND SALES  THAT  OCCUR  OUTSIDE  THE  UNITED  STATES  WITHIN  THE  MEANING OF
   REGULATION S UNDER THE SECURITIES  ACT, (E) TO AN  INSTITUTIONAL  "ACCREDITED
   INVESTOR" WITHIN THE MEANING OF SUBPARAGRAPH (A)(1), (A)(2), (A)(3) OR (A)(7)
   OF RULE 501 UNDER THE  SECURITIES  ACT THAT IS ACQUIRING THE SECURITY FOR ITS
   OWN  ACCOUNT,  OR FOR  THE  ACCOUNT  OF  SUCH  AN  INSTITUTIONAL  "ACCREDITED
   INVESTOR,"  FOR  INVESTMENT  PURPOSES AND NOT WITH A VIEW TO, OR FOR OFFER OR
   SALE IN CONNECTION WITH, ANY DISTRIBUTION IN VIOLATION OF THE SECURITIES ACT,
   OR  (F)  PURSUANT  TO  ANOTHER  AVAILABLE  EXEMPTION  FROM  THE  REGISTRATION
   REQUIREMENTS  OF THE  SECURITIES  ACT,  SUBJECT  TO  THE  COMPANY'S  AND  THE
   TRUSTEE'S RIGHT PRIOR TO ANY SUCH OFFER, SALE OR TRANSFER PURSUANT TO CLAUSES
   (D),  (E)  or  (F)  TO  REQUIRE  THE  DELIVERY  OF  AN  OPINION  OF  COUNSEL,
   CERTIFICATION  AND/OR OTHER INFORMATION  SATISFACTORY TO EACH OF THEM, AND IN
   EACH OF THE FOREGOING  CASES, A CERTIFICATE OF TRANSFER IN THE FORM APPEARING
   ON THIS SECURITY IS COMPLETED AND DELIVERED BY THE TRANSFEROR TO THE TRUSTEE.
   THIS  LEGEND  WILL BE REMOVED  UPON THE  REQUEST  OF THE THEN  HOLDER OF THIS
   SECURITY AFTER THE RESALE RESTRICTION TERMINATION DATE.

          (ii)  Upon any sale or  transfer  of a  Transfer  Restricted  Security
     (including  any  Transfer  Restricted  Security  represented  by  a  Global
     Security)  pursuant to Rule 144 under the  Securities  Act or an  effective
     registration  statement  under  the  Securities  Act  (including  the Shelf
     Registration Statement):

               (A) in the case of any  Transfer  Restricted  Security  that is a
          Definitive Security,  the Registrar shall permit the Holder thereof to
          exchange such Transfer  Restricted  Security for a Definitive Security
          that  does not  bear the  legend  set  forth  above  and  rescind  any
          restriction on the transfer of such Transfer Restricted Security; and

               (B) any such Transfer Restricted Security represented by a Global
          Security shall not be subject to the provisions set forth in (i) above
          (such sales or  transfers  being  subject  only to the  provisions  of
          Section 305(c) hereof);  provided,  however,  that with respect to any
          request  for an  exchange of a Transfer  Restricted  Security  that is
          represented by a Global  Security for a Definitive  Security that does
          not bear a legend,  which request is made in reliance upon Rule 144 or
          an effective registration statement,  the Holder thereof shall certify
          in writing to the  Registrar  that such request is being made pursuant
          to Rule 144 or an effective registration statement (such certification
          to be substantially in the form of Exhibit C hereto.)

     (h) At such time as all  beneficial  interests  in a Global  Security  have
either been  exchanged  for  Definitive  Securities,  redeemed,  repurchased  or
cancelled,  such Global  Security shall be returned to or retained and cancelled
by the  Trustee.  At any time  prior  to such  cancellation,  if any  beneficial
interest in a Global Security is exchanged for Definitive Securities,  redeemed,
repurchased or cancelled, the principal amount of Securities represented


                                      -14-



<PAGE>



by such Global  Security  shall be reduced and an  endorsement  shall be made on
such  Global  Security,  by the  Trustee  or the  Securities  Custodian,  at the
direction of the Trustee, to reflect such reduction.

     (i) All  Definitive  Securities  and  Global  Securities  issued  upon  any
registration  of  transfer  or  exchange  of  Definitive  Securities  or  Global
Securities  shall be the valid  obligations of the Company,  evidencing the same
debt, and entitled to the same benefits under this Indenture,  as the Definitive
Securities or Global  Securities  surrendered upon such registration of transfer
or exchange.

     No  service  charge  shall  be made to a  Holder  for any  registration  of
transfer or exchange (except as otherwise expressly  permitted herein),  but the
Company may require  payment of a sum  sufficient  to cover any  transfer tax or
similar  governmental  charge payable and any other expenses (including the fees
and expenses of the Trustee) in connection  therewith  (other than such transfer
tax or similar  governmental  charge payable upon exchanges  pursuant to Section
2.6 or 8.5).

SECTION 2.6 REPLACEMENT SECURITIES

     If any mutilated Security is surrendered to the Trustee, or the Company and
the Trustee receive evidence to their  satisfaction of the destruction,  loss or
theft of any Security, the Company shall issue and the Trustee, upon the written
order of the Company  signed by two Officers,  shall  authenticate a replacement
Security if the  Trustee's  requirements  are met. If required by the Trustee or
the Company, an indemnity bond must be supplied by the Holder that is sufficient
in the  judgment of the Trustee  and the  Company to protect  the  Company,  the
Trustee,  the Agent or any authenticating  agent from any loss which any of them
may suffer if a Security is replaced. The Company may charge for its expenses in
replacing a Security.

     Every replacement Security is an additional obligation of the Company.

SECTION 2.7 OUTSTANDING SECURITIES

     The Securities outstanding at any time are all the Securities authenticated
by the  Trustee  except for those  canceled  by it,  those  delivered  to it for
cancellation and those described in this Section 2.7 as not outstanding.

     If a  Security  is  replaced  pursuant  to  Section  2.6,  it  ceases to be
outstanding  unless  the  Trustee  receives  proof  satisfactory  to it that the
replaced Security is held by a bona fide purchaser.

     If the principal  amount of any Security is  considered  paid under Section
3.1, it ceases to be  outstanding  and interest on it ceases to accrue as of the
date it is deemed paid. Upon a "legal defeasance"  pursuant to Section 7.1(b) or
a "covenant  defeasance"  pursuant to Section  7.1(c),  the Securities  shall be
deemed to be  outstanding  or not  outstanding  as  provided  in the  applicable
Section 7.1(b) or 7.1(c).

     Except  as set  forth in  Section  2.8,  a  Security  does not  cease to be
outstanding because the Company or an Affiliate holds the Security.

SECTION 2.8 TREASURY SECURITIES

     In  determining  whether the Holders of the  required  principal  amount of
Securities have concurred in any direction,  waiver or consent, Securities owned
by the Company or by any Person directly or indirectly controlling or controlled
by or  under  direct  or  indirect  common  control  with the  Company  shall be
considered  as  though  not  outstanding,   except  that  for  the  purposes  of
determining  whether  the  Trustee  shall be  protected  in  relying on any such
direction,  waiver or consent,  only  Securities  which the Trustee knows are so
owned shall be so disregarded.



                                      -15-



<PAGE>



SECTION 2.9 TEMPORARY SECURITIES

     Until definitive Securities are ready for delivery, the Company may prepare
and the Trustee shall authenticate  temporary  Securities.  Temporary Securities
shall  be  substantially  in the  form of  definitive  Securities  but may  have
variations  that the Company  considers  appropriate  for temporary  Securities.
Without  unreasonable  delay,  the Company  shall  prepare and the Trustee shall
authenticate definitive Securities in exchange for temporary Securities.

SECTION 2.10 CANCELLATION

     The  Company  at  any  time  may  deliver  Securities  to the  Trustee  for
cancellation.  The  Registrar  and Paying Agent shall forward to the Trustee any
Securities  surrendered  to them  for  registration  of  transfer,  exchange  or
payment. The Trustee shall cancel all Securities surrendered for registration of
transfer, exchange, payment,  replacement or cancellation,  and, upon request of
the  Company,  certification  of their  destruction  shall be  delivered  to the
Company  unless,  by a written order signed by two  Officers,  the Company shall
direct that canceled Securities be returned to it. The Company may not issue new
Securities to replace Securities that it has paid or that have been delivered to
the Trustee for cancellation.

SECTION 2.11 DEFAULTED INTEREST

     If the Company  defaults in a payment of  interest  on the  Securities,  it
shall pay the  defaulted  interest  in any  lawful  manner  plus,  to the extent
lawful,  interest  payable on the  defaulted  interest,  to the  Persons who are
Holders on a subsequent  special  record date, in each case at the rate provided
in the Securities.  The Company, with the consent of the Trustee, shall fix each
such special  record date and payment  date. At least 15 days before the special
record date, the Company (or, upon request of the Company,  the Trustee,  in the
name of and at the expense of the  Company)  shall mail to Holders a notice that
states the special record date, the related  payment date and the amount of such
interest to be paid.

SECTION 2.12 SECURITIES ISSUABLE IN THE FORM OF A GLOBAL SECURITY

     (a) If the Company shall  establish that the Securities are to be issued in
whole or in part in the form of one or more Global Securities,  then the Company
shall execute and the Trustee or an agent  thereof  shall,  in  accordance  with
Section 2.2 and the written order of the Company delivered to the Trustee or its
agent  thereunder,  authenticate and deliver such Global Security or Securities,
which (i) shall  represent,  and shall be  denominated in an amount equal to the
aggregate  principal amount of, the outstanding  Securities to be represented by
such Global Security or Securities, or such portion thereof as the Company shall
specify in a written order of the Company signed by two Officers,  (ii) shall be
registered in the name of the Depositary for such Global  Security or Securities
or its  nominee,  (iii)  shall be  delivered  by the Trustee or its agent to the
Depositary  or pursuant to the  Depositary's  instruction  and (iv) shall bear a
legend substantially to the following effect:  "Unless and until it is exchanged
in whole or in part for securities in definitive  form, this security may not be
transferred  except as a whole by the  Depositary to a nominee of the Depositary
or by a nominee of the  Depositary to the  Depositary or another  nominee of the
Depositary or by the Depositary or any such nominee to a successor Depositary or
a nominee of such successor Depositary.  Unless this certificate is presented by
an authorized  representative  of the Depositary to the Company or its agent for
registration of transfer,  exchange,  or payment,  and any certificate issued is
registered in the name of the nominee of the Depositary or in such other name as
is requested by an authorized  representative of the Depositary (and any payment
is made to the nominee of the Depositary or to such other entity as is requested
by an authorized  representative  of the Depositary),  ANY TRANSFER,  PLEDGE, OR
OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch
as the registered owner hereof,  the nominee of the Depositary,  has an interest
herein."

     (b)  Notwithstanding any other provision of this Section 2.12 or of Section
2.5, and subject to the provisions of paragraph (c) below, a Global Security may
be transferred, in whole but not in part and in the manner


                                      -16-



<PAGE>



provided in Section  2.5,  only to a nominee of the  Depositary  for such Global
Security,  or to the  Depositary,  or a  successor  Depositary  for such  Global
Security selected or approved by the Company,  or to a nominee of such successor
Depositary.

     (c) (i) If at any time the  Depositary for a Global  Security  notifies the
Company that it is unwilling or unable to continue as Depositary for such Global
Security or if at any time the Depositary for the Securities  shall no longer be
eligible or in good  standing  under the  Exchange  Act or any other  applicable
statute or  regulation,  the Company shall appoint a successor  Depositary  with
respect to such  Global  Security.  If a  successor  Depositary  for such Global
Security  is not  appointed  by the  Company  within 90 days  after the  Company
receives  such notice or becomes aware of such  ineligibility,  the Company will
execute, and the Trustee or an agent thereof, upon receipt of a written order of
the  Company  signed by two  Officers  for the  authentication  and  delivery of
individual  Definitive  Securities  in exchange for such Global  Security,  will
authenticate  and deliver,  individual  Definitive  Securities of like tenor and
terms in an  aggregate  principal  amount equal to the  principal  amount of the
Global Security in exchange for such Global Security.

     (ii) The Company may at any time and in its sole discretion  determine that
the  Securities  issued in the form of one or more  Global  Securities  shall no
longer be represented by such Global  Security or Securities.  In such event the
Company will  execute,  and the Trustee,  upon receipt of a written order of the
Company signed by two Officers for the authentication and delivery of individual
Definitive  Securities in exchange in whole or in part for such Global Security,
will authenticate and deliver individual Definitive Securities of like tenor and
terms in an aggregate  principal  amount equal to the  principal  amount of such
Global   Security  or  Securities  in  exchange  for  such  Global  Security  or
Securities.

     (iii) If  specified  by the  Company  pursuant  to a  written  order of the
Company  signed  by two  Officers,  the  Depositary  for a Global  Security  may
surrender  such Global  Security in exchange in whole or in part for  individual
Definitive Securities of like tenor and terms on such terms as are acceptable to
the Company and such  Depositary.  Thereupon the Company shall execute,  and the
Trustee or an agent  thereof,  upon a written order of the Company signed by two
Officers,  shall  authenticate and deliver,  without service charge, (1) to each
Person  specified by such Depositary a new Definitive  Security or Securities of
like tenor and terms and of any  authorized  denomination  as  requested by such
Person  in an  aggregate  principal  amount  equal to and in  exchange  for such
Person's  beneficial  interest as  specified  by such  Depositary  in the Global
Security;  and (2) to such  Depositary  a new Global  Security of like tenor and
terms and in an authorized denomination equal to the difference, if any, between
the  principal  amount of the  surrendered  Global  Security  and the  aggregate
principal amount of Definitive Securities delivered to Holders thereof.

     (iv) In any exchange  provided for in (i), (ii) or (iii) of this  paragraph
(c),  the  Company  will  execute  and the  Trustee  or an  agent  thereof  will
authenticate and deliver individual  Definitive Securities in registered form in
authorized denominations.  Upon the exchange of the entire principal amount of a
Global Security for individual  Definitive  Securities,  such Global  Securities
shall be  cancelled  by the Trustee or an agent  thereof.  Except as provided in
(iii) above,  Definitive  Securities  issued in exchange  for a Global  Security
pursuant  to  this  Section  shall  be  registered  in  such  names  and in such
authorized denominations as the Depositary for such Global Security, pursuant to
instructions  from its  direct or  indirect  participants  or  otherwise,  shall
instruct  either the Trustee or the  Registrar.  Such  Trustee or the  Registrar
shall  deliver  such  Definitive  Securities  to the Persons in whose names such
Securities are so registered.

                                   ARTICLE 3

                                    COVENANTS

SECTION 3.1 PAYMENT OF SECURITIES

     The Company shall pay the principal of and premium, if any, and interest on
the  Securities  on the  dates and in the  manner  provided  in the  Securities.
Principal, premium, if any, and interest shall be considered paid on the


                                      -17-



<PAGE>



date due if the Paying  Agent,  other than the  Company or a  Subsidiary  of the
Company,  holds on that date money  deposited by the Company  designated for and
sufficient to pay all principal, premium, if any, and interest then due.

     The Company  shall pay interest  (including  post-petition  interest in any
proceeding  under any Bankruptcy Law) on overdue  principal at the rate equal to
the interest rate on the Securities to the extent lawful;  it shall pay interest
on overdue  payments of premium,  if any, or installments  of interest  (without
regard to any applicable grace period) at the same rate to the extent lawful.

SECTION 3.2  MAINTENANCE OF OFFICE OR AGENCY

     The Company  will  maintain  an office or agency  where  Securities  may be
surrendered  for  registration  of transfer or  exchange  and where  notices and
demands to or upon the Company with respect of the Securities and this Indenture
may be served  pursuant  to Section  2.3.  The  Company  hereby  designates  the
Corporate Trust Office of the Trustee as such office or agency of the Company.

     The Company also from time to time may  designate one or more other offices
or agencies where the Securities may be presented or surrendered  for any or all
such purposes and from time to time may rescind such  designations.  The Company
will give  prompt  written  notice to the  Trustee  of any such  designation  or
rescission and of any change in the location of any such other office or agency.

SECTION 3.3 SEC REPORTS

     (a) The Company  shall  remain  subject to the  reporting  requirements  of
Section 13 or Section 15(d) of the Exchange Act and shall  continue to file with
the SEC such annual  reports and such  information,  documents and other reports
which are specified in Sections 13 and 15(d) of the Exchange Act.

     (b) The Company shall file with the Trustee and cause to be provided to the
Holders,  within 15 days  after it files  the same  with the SEC,  copies of its
annual reports and of the information, documents and other reports (or copies of
such  portions of any of the  foregoing as the SEC may by rules and  regulations
prescribe)  which the  Company or any  subsidiary  of the Company is required to
file with the SEC  pursuant  to Section  13 or 15(d) of the  Exchange  Act.  The
Company shall cause any annual report  furnished to its  stockholders  generally
and any quarterly or other financial reports furnished by it to its stockholders
generally  to be filed  with the  Trustee  and  mailed to the  Holders  at their
addresses appearing in the register of Securities maintained by the Registrar.

SECTION 3.4 COMPLIANCE CERTIFICATE

     (a) The Company shall deliver to the Trustee, within 120 days after the end
of each fiscal year of the  Company,  an  Officers'  Certificate  stating that a
review  of the  activities  of the  Company  and  its  Subsidiaries  during  the
preceding  fiscal  year has been  made  under  the  supervision  of the  signing
Officers  with a view to  determining  whether the  Company has kept,  observed,
performed  and  fulfilled  its  obligations  under this  Indenture,  and further
stating,  as to each such Officer signing such certificate,  that to the best of
his knowledge  the Company has kept,  observed,  performed  and  fulfilled  each
covenant contained in this Indenture and is not in default in the performance or
observance  of any of the terms,  provisions  and  conditions  hereof  (or, if a
Default or Event of Default shall have occurred, describing all such Defaults or
Events of Default of which he may have  knowledge and what action the Company is
taking or proposes  to take with  respect  thereto)  and that to the best of his
knowledge  no event has  occurred  and remains in  existence  by reason of which
payments on account of the principal of or premium, if any, or interest, if any,
on the Securities  are prohibited or, if such event has occurred,  a description
of the event and what  action  the  Company is taking or  proposes  to take with
respect thereto.

     (b) So long as (i) not contrary to the then current  recommendations of the
American  Institute  of  Certified  Public  Accountants  or (ii)  the  Company's
independent public accountants do not have in effect a policy, of


                                      -18-



<PAGE>



general  applicability with respect to their clients, that such accountants will
not prepare  statements on the subjects  specified below, the year-end financial
statements  delivered  pursuant to Section 4.3 shall be accompanied by a written
statement of the Company's  independent  public accountants (who shall be a firm
of established national reputation) that in making the examination necessary for
certification of such financial  statements  nothing has come to their attention
that would lead them to believe that the Company has violated any  provisions of
Article 3 or 4 or, if any such violation has occurred, specifying the nature and
period of existence thereof, it being understood that such accountants shall not
be liable  directly  or  indirectly  to any  Person  for any  failure  to obtain
knowledge of any such violation.

     (c) The Company,  so long as any of the  Securities are  outstanding,  will
deliver to the Trustee, forthwith upon any Officer becoming aware of any Default
or Event of Default under this Indenture,  an Officers'  Certificate  specifying
such  Default  or Event of  Default  and what  action  the  Company is taking or
proposes to take with respect thereto.

SECTION 3.5 CORPORATE EXISTENCE, TAXES, ETC.

     Subject to the  provisions of Section 4.1, the Company shall do or cause to
be done all things  necessary  to preserve and keep in full force and effect its
rights (charter and statutory), licenses and franchises; provided, however, that
the Company shall not be required to preserve any such right or franchise if the
Board of Directors  shall determine that the  preservation  thereof is no longer
desirable  in the conduct of the business of the Company and the loss thereof is
not disadvantageous in any material respect to the Holders.

SECTION 3.6 STAY, EXTENSION AND USURY LAWS

     The Company  covenants  (to the extent that it may  lawfully do so) that it
will not at any time insist  upon,  plead or in any manner  whatsoever  claim or
take the  benefit or  advantage  of any stay,  extension  or usury law  wherever
enacted,  now or at any time  hereafter in force,  that may affect the Company's
obligation  to pay the  Securities;  and the  Company (to the extent that it may
lawfully do so) hereby expressly waives all benefit or advantage of any such law
insofar as such law applies to the  Securities,  and covenants that it will not,
by resort to any such law,  hinder,  delay or impede the execution of any power,
right or remedy  herein  granted to the Trustee,  but will suffer and permit the
execution  of every such  power,  right or remedy as though no such law has been
enacted.

SECTION 3.7 CHANGE IN CONTROL

     (a)  Following the  occurrence  of any Change in Control,  each Holder will
have the right, at such Holder's option, to require that the Company purchase (a
"Change  in Control  Repurchase"),  and upon the  exercise  of such  right,  the
Company shall, subject to the provisions of Section 9.3 hereof, purchase, all or
any part of such Holder's  Securities on a date (the "Repurchase  Date") that is
no  earlier  than 30 days nor  later  than 60 days  after  the date on which the
Company  gives  notice  of a Change in  Control  as  provided  in (b) below at a
purchase  price  equal  to  101%  of  the  aggregate  principal  amount  of  the
Securities,  plus accrued and unpaid interest thereon, if any, to the Repurchase
Date.

     (b) Within 30 days after any Change in Control, the Company (with notice to
the Trustee),  or the Trustee at the Company's request, will mail or cause to be
mailed  to all  Holders  on the date of the  Change  in  Control a notice of the
occurrence  of such Change in Control and of the  Holders'  rights  arising as a
result  thereof.  Such  notice,  which  shall  govern the terms of the Change in
Control Repurchase, shall state:

          (1) that a Change in Control has occurred and that such Holder has the
     right to require the Company to repurchase such Holder's Notes in cash;

          (2) the  Repurchase  Date (which  will be no earlier  than 30 days nor
     later than 60 days from the date such notice is mailed);



                                      -19-



<PAGE>



          (3) the purchase price for the repurchase;

          (4) the date by which the repurchase right must be exercised; and

          (5) the instructions  determined by the Company,  consistent with this
     Section  3.7,  that a Holder  must  follow in order to have its  Securities
     repurchased.

     (c) To exercise a repurchase  right,  a Holder shall deliver to the Company
(or a depositary  or Paying Agent  designated by the Company for such purpose in
the notice referred to in (b) above),  on or before the close of business on the
Repurchase Date, the Security or Securities with respect to which the repurchase
right is being  exercised,  duly endorsed for transfer to the Company,  with the
form  entitled  "Option  of Holder to Elect  Purchase"  on the  reverse  of each
Security so delivered  completed.  Holders  shall be entitled to withdraw  their
election if the Company (or the  depositary  or Paying Agent  designated  by the
Company for the purpose of receiving  such  election)  receives,  not later than
five Business Days prior to the Repurchase  Date, a telegram,  telex,  facsimile
transmission  or letter  setting  forth the name of the  Holder,  the  principal
amount of the Security or  Securities  the Holder  delivered  for purchase and a
statement that such Holder is withdrawing  its election to the have the Security
or Securities purchased.

     (d) In the event a repurchase  right shall be exercised in accordance  with
the terms  hereof,  subject  to  Article  9, the  Company  shall on or  promptly
following  the  Repurchase  Date pay or  cause to be paid in cash to the  Holder
thereof  the  repurchase  price of the  Security or  Securities  as to which the
repurchase  right has been exercised.  In the event that the repurchase right is
exercised with respect to less than the entire principal amount of a surrendered
Security,  the Company  shall execute and deliver to the Trustee and the Trustee
shall  authenticate  for  issuance  in the name of the Holder a new  Security or
Securities in the aggregate  principal  amount of the  unrepurchased  portion of
such surrendered security.

     (e) If the Repurchase Date is on or before an Interest  Payment Date and on
or after the  related  record  date,  any  interest  accrued  and  unpaid to the
Repurchase  Date  will be paid to the  Person  in  whose  name the  Security  is
registered  at the close of  business  on such record  date,  and no  additional
interest will be payable to Holders who exercise their repurchase right pursuant
to this Section 3.7.

     (f) Any Change in Control  Repurchase shall be conducted in compliance with
applicable  tender offer rules,  including Section 14(e) of the Exchange Act and
Rule 14(e)(1)  thereunder.  The Change in Control Repurchase may not be modified
or conditioned by the Company in any manner.

SECTION 3.8 LIMITATIONS ON ASSET SALES

     The Company  shall not,  and shall not permit any of its  Subsidiaries  to,
consummate  any Asset Sale  unless (i) the Company or its  Subsidiaries  receive
consideration  at the time of such Asset Sale at least  equal to the fair market
value of the assets or Capital Stock  included in such Asset Sale (as determined
in good faith by the Board of Directors, whose determination shall be conclusive
and  evidenced  by a board  resolution)  and  (ii)  not  less  than  50% of such
consideration  is in the form of cash.  The Net  Proceeds of Asset Sales  shall,
within 360 days,  (a) be  reinvested  in the lines of business of the Company or
any of its Subsidiaries immediately prior to such investment;  (b) be applied to
the payment of the principal of, and interest on,  Senior  Indebtedness;  (c) be
utilized  to make any  Investment  in any  other  Person  permitted  under  this
Indenture;  or (d) be applied to an offer (an "Asset  Sale  Offer") to  purchase
outstanding Securities. In any such Asset Sale Offer, the Company shall offer to
purchase Securities,  as selected by lot (with such adjustments as may be deemed
appropriate by the Company so that only Securities in denominations of $1,000 or
integral  multiples  thereof shall be  purchased),  at a purchase price equal to
100% of the  aggregate  principal  amount of the  Securities,  plus  accrued and
unpaid  interest  to the  date of  purchase,  in the  manner  set  forth in this
Indenture.  Any Asset Sale Offer will be conducted in compliance with applicable
tender offer rules,  including  Section 14(e) of the Exchange Act and Rule 14e-1
thereunder.  Any Net Proceeds remaining  immediately after the completion of any
Asset


                                      -20-



<PAGE>



Sale Offer may be used by the  Company or its  Subsidiaries  for any purpose not
inconsistent with the other provisions of this Indenture.


                                    ARTICLE 4

                                   SUCCESSORS

SECTION 4.1 LIMITATIONS ON MERGERS AND CONSOLIDATIONS

     The Company shall not  consolidate  or merge with or into, or sell,  lease,
convey or otherwise dispose of all or substantially all of its assets, or assign
any of its obligations hereunder or under the Securities, to any Person unless:

          (i) the Person formed by or surviving such consolidation or merger (if
     other than the  Company),  or to which  sale,  lease,  conveyance  or other
     disposition or assignment shall be made (collectively, the "Successor"), is
     a corporation organized and existing under the laws of the United States or
     any State thereof or the District of Columbia, and the Successor assumes by
     supplemental  indenture  in a form  satisfactory  to the Trustee all of the
     obligations of the Company hereunder and under the Securities; and

          (ii) immediately after giving effect to such  transaction,  no Default
     or Event of Default shall have occurred and be continuing.

     The Company shall deliver to the Trustee prior to the  consummation  of the
proposed  transaction an Officers'  Certificate  to the foregoing  effect and an
Opinion of Counsel stating that the proposed  transaction and such  supplemental
indenture comply with this Indenture.

SECTION 4.2 SUCCESSOR CORPORATION SUBSTITUTED

     Upon any consolidation or merger,  or any sale, lease,  conveyance or other
disposition  of all or  substantially  all of the  assets of the  Company or any
assignment  of  its  obligations  under  this  Indenture  or the  Securities  in
accordance with Section 4.1, the Successor formed by such  consolidation or into
or with which the Company is merged or to which such sale, lease,  conveyance or
other  disposition  or assignment  is made shall succeed to, and be  substituted
for, and may exercise every right and power of, the Company under this Indenture
with the same effect as if such  Successor has been named as the Company  herein
and the predecessor  Company, in the case of a sale, lease,  conveyance or other
disposition or  assignment,  shall be released from all  obligations  under this
Indenture and the Securities.


                                   ARTICLE 5

                              DEFAULTS AND REMEDIES

SECTION 5.1 EVENTS OF DEFAULT

     An "Event of Default" occurs if:

          (1) the Company  defaults in the payment of the  principal  of, or any
     premium on, any Security when the same becomes due and payable,  whether at
     Stated Maturity, upon redemption, upon acceleration or otherwise;



                                      -21-



<PAGE>



          (2) the Company  defaults  in the payment of interest on any  Security
     when the same  becomes  due and payable  and the  Default  continues  for a
     period of 30 days (even if such payment is prohibited by Article 9 hereof);

          (3)  the  Company  fails  to  comply  with  any of its  agreements  or
     covenants in, or provisions  of, the  Securities or this Indenture and such
     failure continues for the period and after the notice specified below;

          (4) any acceleration of the maturity of Indebtedness of the Company or
     its Subsidiaries  having an outstanding  principal amount of at least $50.0
     million  or a failure  to pay such  Indebtedness  at its  Stated  Maturity;
     provided  that such  acceleration  or failure to pay is not cured within 10
     days after such acceleration or failure to pay;

          (5) the Company or any of its Significant  Subsidiaries pursuant to or
     within the meaning of any Bankruptcy Law:

               (a) commences a voluntary case,

               (b) consents to the entry of an order for relief against it in an
          involuntary case,

               (c) consents to the  appointment  of a Custodian of it or for all
          or substantially all of its property, or

               (d) makes a general  assignment for the benefit of its creditors;
          or

          (6) a court of competent  jurisdiction enters an order or decree under
     any Bankruptcy Law that:

               (a) is for relief  against the Company or any of its  Significant
          Subsidiaries as debtor in an involuntary case,

               (b) appoints a Custodian of the Company or any of its Significant
          Subsidiaries  or a  Custodian  for  all  or  substantially  all of the
          property of the Company or any of its Significant Subsidiaries, or

               (c)  orders  the  liquidation  of  the  Company  or  any  of  its
          Significant Subsidiaries,

     and the order or decree remains unstayed and in effect for 60 days.

     The term "Custodian" means any receiver,  trustee, assignee,  liquidator or
similar official under any Bankruptcy Law.

     The Trustee  shall not be deemed to know of a Default  unless it has actual
knowledge  of such  Default or  receives  written  notice of such  Default  with
specific reference to such Default.

     A Default  under  clause (3) is not an Event of Default  until the  Trustee
notifies  the  Company,  or the Holders of at least 25% in  aggregate  principal
amount of the then outstanding Securities notify the Company and the Trustee, of
the  Default  and the  Company  does not cure the  Default  within 45 days after
receipt of the notice.  The notice must specify the  Default,  demand that it be
remedied and state that the notice is a "Notice of Default."



                                      -22-



<PAGE>



SECTION 5.2 ACCELERATION

     If an Event of Default  (other than an Event of Default with respect to the
Company specified in clause (6) or (7) of Section 5.1) occurs and is continuing,
the Trustee by written notice to the Company,  or the Holders of at least 25% in
aggregate principal amount of the then outstanding  Securities by written notice
to the Company and the Trustee, may declare all Securities to be due and payable
immediately.   Upon  such  declaration  the  amounts  due  and  payable  on  the
Securities,  as determined in the next  succeeding  paragraph,  shall be due and
payable  immediately.  If an  Event  of  Default  with  respect  to the  Company
specified in clause (6) or (7) of Section 5.1 occurs,  such an amount shall ipso
facto become and be immediately due and payable without any declaration,  notice
or other act on the part of the Trustee or any Holder. The Holders of a majority
in aggregate  principal  amount of the then  outstanding  Securities  by written
notice to the Trustee may rescind an  acceleration  and its  consequences if the
rescission  would not  conflict  with any judgment or decree and if all existing
Events of Default  (except  nonpayment of principal  of, or premium,  if any, or
interest  on the  Securities  or that  resulted  from a failure  to comply  with
Section 3.7) have been cured or waived.

     In the event that the maturity of the Securities is accelerated pursuant to
this Section 5.2,  100% of the  principal  amount  thereof and premium,  if any,
shall become due and payable  plus accrued  interest to the date of payment plus
interest on defaulted interest to the extent provided herein.

SECTION 5.3 OTHER REMEDIES

     If an Event of Default occurs and is continuing, the Trustee may pursue any
available remedy to collect the payment of principal of, or premium,  if any, or
interest on the Securities or to enforce the performance of any provision of the
Securities or this Indenture.

     The Trustee may  maintain a  proceeding  even if it does not possess any of
the  Securities  or does not produce any of them in the  proceeding.  A delay or
omission by the Trustee or any Holder in exercising any right or remedy accruing
upon an Event of Default  shall not impair the right or remedy or  constitute  a
waiver of or acquiescence  in the Event of Default.  All remedies are cumulative
to the extent permitted by law.

SECTION 5.4 WAIVER OF PAST DEFAULTS

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding Securities by notice to the Trustee may waive an existing Default or
Event of Default and its consequences,  except a continuing  Default or Event of
Default in the payment of the principal  of, or premium,  if any, or interest on
any Security or in respect of a provision  under this Indenture  which cannot be
modified  or amended  without the  consent of the Holder of each  Security  then
outstanding.  Upon any such waiver,  such Default shall cease to exist,  and any
Event of Default arising  therefrom shall be deemed to have been cured for every
purpose of this Indenture;  but no such waiver shall extend to any subsequent or
other  Default  or Event of  Default  or impair  any right or remedy  consequent
thereon.

SECTION 5.5 CONTROL BY MAJORITY

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding  Securities may direct the time,  method and place of conducting any
proceeding  for any remedy  available to the Trustee or exercising  any trust or
power conferred on it.  However,  the Trustee may refuse to follow any direction
that conflicts with law or this  Indenture,  that the Trustee  determines may be
unduly  prejudicial  to the rights of other  Holders,  or that may  involve  the
Trustee in personal liability, in each case as determined by the Trustee.



                                      -23-



<PAGE>



SECTION 5.6 LIMITATIONS ON SUITS

     A  Holder  may  pursue a  remedy  with  respect  to this  Indenture  or the
Securities only if:

          (1) the Holder  gives to the Trustee  written  notice of a  continuing
     Event of Default;

          (2) the Holders of at least 25% in aggregate  principal  amount of the
     then outstanding Securities make a written request to the Trustee to pursue
     the remedy;

          (3) such Holder or Holders offer to the Trustee indemnity satisfactory
     to the  Trustee  in its sole  discretion  against  any loss,  liability  or
     expense;

          (4) the Trustee does not comply with the request  within 60 days after
     receipt of the request and the offer of indemnity; and

          (5) during such 60-day  period the Holders of a majority in  aggregate
     principal amount of the then outstanding Securities do not give the Trustee
     a direction inconsistent with the request.

A Holder may not use this Indenture to prejudice the rights of another Holder or
to obtain a preference or priority over another Holder.

SECTION 5.7 RIGHTS OF HOLDERS TO RECEIVE PAYMENT

     Notwithstanding  any other  provision of this  Indenture,  the right of any
Holder of a Security to receive  payment and  interest  on the  Security,  on or
after the respective due dates  expressed in the Security,  or to bring suit for
the enforcement of any such payment on or after such respective dates, shall not
be impaired or affected without the consent of the Holder.

SECTION 5.8 COLLECTION SUIT BY TRUSTEE

     If an Event of Default  specified  in  Section  5.1(1) or (2) occurs and is
continuing, the Trustee is authorized to recover judgment in its own name and as
trustee of an express  trust  against the  Company for the amount of  principal,
premium, if any, and interest remaining unpaid on the Securities,  determined in
accordance with Section 5.2, and interest on overdue  principal and premium,  if
any, and, to the extent lawful,  interest on overdue  installments  of interest,
and such further  amount as shall be  sufficient to cover the costs and expenses
of collection,  including the reasonable compensation,  expenses,  disbursements
and advances of the Trustee, its agents and counsel.

SECTION 5.9  TRUSTEE MAY FILE PROOFS OF CLAIM

     The Trustee is  authorized to file such proofs of claim and other papers or
documents  as may be  necessary  or advisable in order to have the claims of the
Trustee  (including  any  claim  for  the  reasonable  compensation,   expenses,
disbursements  and  advances of the  Trustee,  its agents and  counsel)  and the
Holders  allowed  in any  judicial  proceedings  relative  to the  Company,  its
creditors  or its  property  and shall be  entitled  and  empowered  to collect,
receive and distribute any money or other property payable or deliverable on any
such  claims  and any  Custodian  in any  such  judicial  proceeding  is  hereby
authorized by each Holder to make such payments to the Trustee, and in the event
that the Trustee shall  consent to the making of such  payments  directly to the
Holders,  to  pay to the  Trustee  any  amount  due  to it  for  the  reasonable
compensation,  expenses,  disbursements and advances of the Trustee,  its agents
and counsel,  and any other  amounts due the Trustee  under  Section 6.6. To the
extent that the payment of any such  compensation,  expenses,  disbursements and
advances of the Trustee,  its agents and counsel,  and any other amounts due the
Trustee  under  Section 6.6 out of the estate in any such  proceeding,  shall be
denied  for any  reason,  payment of the same shall be secured by a Lien on, and
shall be paid out of, any and all distributions,  dividends,  money,  securities
and other


                                      -24-



<PAGE>



properties  which the  Holders of the  Securities  may be entitled to receive in
such proceeding  whether in liquidation or under any plan of  reorganization  or
arrangement or otherwise.  Nothing herein contained shall be deemed to authorize
the  Trustee  to  authorize  or  consent  to or accept or adopt on behalf of any
Holder  any  plan of  reorganization,  arrangement,  adjustment  or  composition
affecting the  Securities or the rights of any Holder  thereof,  or to authorize
the  Trustee  to  vote  in  respect  of the  claim  of any  Holder  in any  such
proceeding;  provided,  however, that the Trustee may, on behalf of the Holders,
vote for the election of a trustee (or similar  official) in bankruptcy  and may
be a member of the creditors' committee.

SECTION 5.10 PRIORITIES

     If the Trustee  collects any money pursuant to this Article 5, it shall pay
out the money in the following order:

          First: to the Trustee for amounts due under Section 6.6;

          Second:  to Holders for amounts due and unpaid on the  Securities  for
     principal,  premium, if any, and interest,  ratably,  without preference or
     priority  of any kind,  according  to the  amounts  due and  payable on the
     Securities for principal, premium, if any, and interest, respectively; and

          Third: to the Company.

     The  Trustee  may fix a record  date and  payment  date for any  payment to
Holders pursuant to this Article.

SECTION 5.11 UNDERTAKING FOR COSTS

     In any suit for the enforcement of any right or remedy under this Indenture
or in any suit  against the  Trustee for any action  taken or omitted by it as a
Trustee,  a court in its discretion may require the filing by any party litigant
in the suit of an undertaking to pay the costs of the suit, and the court in its
discretion may assess reasonable costs,  including  reasonable  attorneys' fees,
against any party litigant in the suit, having due regard to the merits and good
faith of the claims or defenses  made by the party  litigant.  This Section 5.11
does not apply to a suit by the Trustee,  a suit by a Holder pursuant to Section
5.7 or a suit by  Holders  of more  than  10% in  principal  amount  of the then
outstanding Securities.


                                    ARTICLE 6

                                     TRUSTEE

SECTION 6.1 DUTIES OF TRUSTEE

     (1) If an Event of Default  has  occurred  and is  continuing,  the Trustee
shall exercise such of the rights and powers vested in it by this Indenture, and
use the same degree of care and skill in such  exercise,  as a prudent man would
exercise or use under the circumstances in the conduct of his own affairs.

     (2) Except during the continuance of an Event of Default:

          (a) the Trustee need  perform only those duties that are  specifically
     set forth in this  Indenture  and no others,  and no implied  covenants  or
     obligations shall be read into this Indenture against the Trustee; and



                                      -25-



<PAGE>



          (b)  in the  absence  of  bad  faith  on its  part,  the  Trustee  may
     conclusively rely, as to the truth of the statements and the correctness of
     the opinions expressed therein,  upon certificates or opinions furnished to
     the Trustee and conforming to the requirements of this Indenture;  however,
     the  Trustee  shall  examine the  certificates  and  opinions to  determine
     whether or not, on their face,  they appear to conform to the  requirements
     of this Indenture.

     (3) The Trustee may not be relieved from  liabilities for its own negligent
action, its own negligent failure to act, or its own willful misconduct,  except
that:

          (a) this  paragraph does not limit the effect of paragraph (2) of this
     Section;

          (b) the Trustee  shall not be liable for any error of judgment made in
     good faith by a Trust  Officer,  unless it is proved  that the  Trustee was
     negligent in ascertaining the pertinent facts; and

          (c) the  Trustee  shall not be liable  with  respect  to any action it
     takes  or  omits  to take in good  faith  in  accordance  with a  direction
     received by it pursuant to Section 6.5.

     (4) Whether or not therein  expressly so provided,  every provision of this
Indenture  that in any way relates to the Trustee is subject to paragraphs  (1),
(2), (3) and (5) of this Section 6.1.

     (5) No provision of this  Indenture  shall require the Trustee to expend or
risk its own funds or incur any liability. The Trustee may refuse to perform any
duty or exercise any right or power unless it receives indemnity satisfactory to
it against any loss, liability or expense.

     (6) The Trustee  shall not be liable for interest on any money  received by
it except as the Trustee may agree in writing  with the  Company.  Money held in
trust by the  Trustee  need not be  segregated  from other  funds  except to the
extent required by law.

SECTION 6.2 RIGHTS OF TRUSTEE

     (1) Subject to Section 6.1,  the Trustee may rely on any document  believed
by it to be genuine and to have been signed or presented  by the proper  Person,
and the Trustee need not investigate any fact or matter stated in the document.

     (2) Before the Trustee  acts or  refrains  from  acting,  it may require an
Officers' Certificate or an Opinion of Counsel or both. The Trustee shall not be
liable  for any action it takes or omits to take in good  faith in  reliance  on
such Officers'  Certificate or Opinion of Counsel.  The Trustee may consult with
counsel and the written  advice of such counsel or any Opinion of Counsel  shall
be full and  complete  authorization  and  protection  in  respect of any action
taken,  suffered  or  omitted  by it  hereunder  in good  faith and in  reliance
thereon.

     (3) The Trustee may act through agents and shall not be responsible for the
misconduct or negligence of any agent appointed with due care.

     (4) The  Trustee  shall not be liable  for any  action it takes or omits to
take in good faith which it believes  to be  authorized  or within its rights or
powers conferred upon it by this Indenture.

     (5) Unless otherwise  specifically provided in this Indenture,  any demand,
request,  direction or notice from the Company  shall be sufficient if signed by
an Officer of the Company.



                                      -26-



<PAGE>



SECTION 6.3 INDIVIDUAL RIGHTS OF TRUSTEE

     The Trustee in its individual or any other capacity may become the owner or
pledgee of  Securities  and may  otherwise  deal with the  Company or any of its
Affiliates with the same rights it would have if it were not Trustee.  Any Agent
may do the same with like rights.

SECTION 6.4 TRUSTEE'S DISCLAIMER

     The Trustee makes no  representation as to the validity or adequacy of this
Indenture or the Securities or as to the Company's ability to pay the Securities
when and as due or  perform  its other  obligations  hereunder.  It shall not be
accountable  for the Company's  use of the proceeds  from the  Securities or any
money paid to the Company or upon the  Company's  direction  under any provision
hereof.  It shall not be  responsible  for the use or  application  of any money
received by any Paying Agent other than the Trustee. It shall not be responsible
for any  statement or recital  herein or any statement in the  Securities  other
than its certificate of authentication.

SECTION 6.5 NOTICE OF DEFAULTS

     If a Default or Event of  Default  occurs  and is  continuing  and if it is
known to the Trustee,  the Trustee shall mail to Holders a notice of the Default
or Event of  Default  within 90 days  after it  occurs.  Except in the case of a
Default or Event of Default in payment of principal  of, or premium,  if any, or
interest  on any  Security  or that  resulted  from a failure by the  Company to
comply with Section 3.7, the Trustee may withhold the notice if it in good faith
determines that withholding the notice is in the interests of Holders.

SECTION 6.6 COMPENSATION AND INDEMNITY

     The  Company  shall  pay  to the  Trustee  from  time  to  time  reasonable
compensation  for its acceptance of this Indenture and services  hereunder.  The
Trustee's  compensation  shall not be  limited by any law on  compensation  of a
trustee of an express  trust.  The Company  shall  reimburse  the  Trustee  upon
request for all reasonable disbursements,  advances and expenses incurred by it.
Such  expenses  shall include the  reasonable  compensation,  disbursements  and
expenses of the Trustee's agents and counsel.

     The Company shall indemnify the Trustee, its employees, officers, directors
and agents and any predecessor Trustee hereunder against any loss,  liability or
expense  incurred by it arising out of or in connection  with the  acceptance or
administration  of  its  duties  under  this  Indenture  or in  connection  with
enforcing  this  indemnification  provision,  except  as set  forth  in the next
paragraph.  The Trustee promptly shall notify the Company of any claim for which
it may seek indemnity.  The Company shall defend the claim and the Trustee shall
cooperate in the defense.  The Trustee may have separate counsel and the Company
shall pay the reasonable fees and expenses of such counsel. The Company need not
pay for any  settlement  made without its consent,  which  consent  shall not be
unreasonably withheld.

     The Company need not reimburse any expense or indemnify against any loss or
liability incurred by the Trustee through negligence or bad faith.

     To secure the  Company's  payment  obligations  in this  Section  6.6,  the
Trustee shall have a Lien prior to the  Securities on all money or property held
or  collected  by the Trustee,  except that held in trust to pay  principal  of,
premium, if any, and interest on particular Securities.  Such Lien shall survive
the satisfaction and discharge of this Indenture.

     When the  Trustee  incurs  expenses or renders  services  after an Event of
Default  specified  in  Section  5.1(6)  or (7)  occurs,  the  expenses  and the
compensation   for  the  services  are  intended  to   constitute   expenses  of
administration under any Bankruptcy Law.



                                      -27-



<PAGE>



SECTION 6.7 REPLACEMENT OF TRUSTEE

     A  resignation  or removal of the  Trustee and  appointment  of a successor
Trustee shall become effective only upon the successor  Trustee's  acceptance of
appointment as provided in this Section.

     The Trustee may resign and be discharged  from the trust hereby  created by
so notifying the Company.  The Holders of a majority in principal  amount of the
then  outstanding  Securities may remove the Trustee by so notifying the Trustee
and the Company. The Company may remove the Trustee if:

     (1)  the Trustee fails to comply with Section 310(b) of the TIA;

     (2)  the  Trustee is adjudged a bankrupt  or an  insolvent  or an order for
          relief is entered  with  respect to the Trustee  under any  Bankruptcy
          Law;

     (3)  a  Custodian  or public  officer  takes  charge of the  Trustee or its
          property; or

     (4)  the Trustee becomes incapable of acting.

     If the Trustee  resigns or is removed or if a vacancy  exists in the office
of Trustee  for any  reason,  the  Company  shall  promptly  appoint a successor
Trustee.

     If a  successor  Trustee  does not take  office  within  60 days  after the
retiring Trustee resigns or is removed, the retiring Trustee, the Company or the
Holders of at least 10% in principal amount of the then  outstanding  Securities
may  petition  any court of  competent  jurisdiction  for the  appointment  of a
successor Trustee.

     If the Trustee  fails to comply with Section 310 of the TIA, any Holder may
petition any court of competent  jurisdiction for the removal of the Trustee and
the appointment of a successor Trustee.

     A successor  Trustee shall deliver a written  acceptance of its appointment
to the retiring Trustee and to the Company. Thereupon the resignation or removal
of the retiring Trustee shall become effective,  and the successor Trustee shall
have all the rights, powers and duties of the Trustee under this Indenture.  The
successor Trustee shall mail a notice of its succession to Holders. The retiring
Trustee  shall  promptly  transfer  all  property  held by it as  Trustee to the
successor   Trustee,   subject  to  the  Lien   provided  for  in  Section  6.6.
Notwithstanding  replacement  of the Trustee  pursuant to this  Section 6.7, the
Company's  obligations  under Section 6.6 shall  continue for the benefit of the
retiring Trustee.

SECTION 6.8 SUCCESSOR TRUSTEE BY MERGER, ETC.

     Subject to Section  6.9,  if the Trustee  consolidates,  merges or converts
into, or transfers all or substantially  all of its corporate trust business to,
another corporation,  the successor corporation without any further act shall be
the successor Trustee.

SECTION 6.9 ELIGIBILITY; DISQUALIFICATION

     There  shall at all times be a Trustee  hereunder  which shall be a bank or
corporation  organized and doing business under the laws of the United States of
America,  any state  thereof or the District of Columbia  authorized  under such
laws to exercise  corporate  trustee  power,  shall be subject to supervision or
examination  by Federal or state (or the  District of  Columbia)  authority  and
shall have a combined  capital  and surplus of at least $50 million as set forth
in its most recent published annual report of condition.



                                      -28-



<PAGE>



     This Indenture  shall always have a Trustee who satisfies the  requirements
of TIA ss. 310(a)(1) and 310(a)(2). The Trustee is subject to TIA ss. 310(b). If
at any time the  Trustee  shall  cease to be  eligible  in  accordance  with the
provisions of this Section,  it shall resign  immediately in the manner and with
the effect specified in Section 6.7.


                                   ARTICLE 7

                             DISCHARGE OF INDENTURE

SECTION 7.1 TERMINATION OF COMPANY'S OBLIGATIONS

     (a) This  Indenture  shall cease to be of further  effect  (except that the
Company's  obligations  under Section 6.6 and the  Trustee's and Paying  Agent's
obligations  under Section 7.3 shall  survive) when all  outstanding  Securities
theretofore  authenticated and issued have been delivered (other than destroyed,
lost or stolen  Securities  that have been  replaced or paid) to the Trustee for
cancellation and the Company has paid all sums payable  hereunder.  In addition,
the Company may elect to have either  paragraph  (b) or  paragraph  (c) below be
applied to the  outstanding  Securities  upon compliance with the conditions set
forth in paragraph (d).

     (b)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable  to this  paragraph  (b),  the  Company  shall be deemed to have been
released and discharged  from its  obligations  with respect to the  outstanding
Securities   on  the  date  the   conditions   set  forth  below  are  satisfied
(hereinafter, "legal defeasance"). For this purpose, such legal defeasance means
that the  Company  shall  be  deemed  to have  paid and  discharged  the  entire
indebtedness  represented by the outstanding Securities,  which shall thereafter
be deemed to be  "outstanding"  only for the  purposes  of the  Sections  of and
matters  under this  Indenture  referred to in (i) and (ii)  below,  and to have
satisfied all its other  obligations  under such  Securities  and this Indenture
insofar as such Securities are concerned (and the Trustee, at the expense of the
Company,  shall execute proper instruments  acknowledging the same),  except for
the  following  which shall  survive  until  otherwise  terminated or discharged
hereunder: (i) the rights of Holders of outstanding Securities to receive solely
from the trust fund described in paragraph (d) below and as more fully set forth
in such paragraph, payments in respect of the principal of, premium, if any, and
interest on such  Securities  when such  payments  are due,  (ii) the  Company's
obligations  with respect to such  Securities  under  Sections 2.5, 2.6 and 3.2,
and, with respect to the Trustee,  under Section 6.6, (iii) the rights,  powers,
trusts,  duties and  immunities  of the Trustee  hereunder and (iv) this Section
7.1.  Subject to compliance  with this Section 7.1, the Company may exercise its
option under this paragraph (b) notwithstanding the prior exercise of its option
under paragraph (c) below with respect to the Securities.

     (c)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable to this  paragraph  (c), the Company shall be released and discharged
from its  obligations  under any covenant  contained in Article 4 and in Section
3.3, 3.4 and 3.6 through 3.8 with respect to the  outstanding  Securities on and
after the date the  conditions  set  forth  below  are  satisfied  (hereinafter,
"covenant defeasance"),  and the Securities shall thereafter be deemed to be not
"outstanding" for the purpose of any direction,  waiver,  consent or declaration
or act of Holders (and the  consequences of any thereof) in connection with such
covenants,  but shall continue to be deemed "outstanding" for all other purposes
hereunder.  For this purpose,  such covenant defeasance means that, with respect
to the  outstanding  Securities,  the  Company may omit to comply with and shall
have no liability in respect of any term,  condition or limitation  set forth in
any such covenant,  whether  directly or indirectly,  by reason of any reference
elsewhere  herein to any such covenant or by reason of any reference in any such
covenant  to any  other  provision  herein  or in any  other  document  and such
omission to comply shall not  constitute a Default or an Event of Default  under
Section 5.1, but, except as specified above, the remainder of this Indenture and
such Securities shall be unaffected thereby.

     (d) The  following  shall be the  conditions to the  application  of either
paragraph (b) or (c) above to the outstanding Securities:



                                      -29-



<PAGE>



          (1) the Company has  irrevocably  deposited  in trust with the Trustee
     or,  at the  option of the  Trustee,  with a  trustee  satisfactory  to the
     Trustee and the Company under the terms of an irrevocable  trust  agreement
     in form and substance  satisfactory to the Trustee in its sole  discretion,
     money  or U.S.  Government  Obligations  sufficient  to pay  principal  of,
     premium,  if any, and interest on the  Securities to maturity or redemption
     (in the opinion of a nationally  recognized  accounting firm of independent
     certified public accountants  expressed in a written certificate  delivered
     to the Trustee) and to pay all other sums payable by it hereunder; provided
     that (i) the trustee of the irrevocable  trust shall have been  irrevocably
     instructed  to pay  such  money or the  proceeds  of such  U.S.  Government
     Obligations to the Trustee and (ii) the Trustee shall have been irrevocably
     instructed  to apply such  money or the  proceeds  of such U.S.  Government
     Obligations to the payment of said principal, premium, if any, and interest
     with respect to the Securities;

          (2) the Company has delivered to the Trustee an Officer's  Certificate
     stating that (a) all conditions  precedent  provided for relating to either
     the legal defeasance  under paragraph (b) above or the covenant  defeasance
     under  paragraph (c) above, as the case may be, have been complied with and
     (b) if any other  Indebtedness  of the Company shall then be outstanding or
     committed,  such legal  defeasance or covenant  defeasance will not violate
     the   provisions  of  the  agreements  or   instruments   evidencing   such
     Indebtedness;

          (3) no  Default  or  Event  of  Default  shall  have  occurred  and be
     continuing on the date of such deposit;

          (4) the Trustee shall not have received notice from any holder of Bank
     Debt or any holder of Senior  Indebtedness in an aggregate principal amount
     in excess of $20 million that such legal defeasance or covenant  defeasance
     would violate the provisions of the  agreements or  instruments  evidencing
     such Senior Indebtedness;

          (5) such legal defeasance or covenant defeasance shall not result in a
     breach or violation of, or constitute a default or event of default  under,
     this Indenture or any other  material  agreement or instrument to which the
     Company is a party or by which it is bound;

          (6) in the case of an election under paragraph (b) above,  the Company
     shall have  delivered to the Trustee an Opinion of Counsel from  nationally
     recognized  counsel  acceptable to the Trustee stating that (x) the Company
     has received  from, or there has been  published  by, the Internal  Revenue
     Service a ruling, (y) there exists controlling precedent,  or (z) since the
     date of this Indenture,  there has been a change in the applicable  Federal
     income  tax  law,  in any  case  to the  effect  that  the  Holders  of the
     outstanding  Securities will not recognize income, gain or loss for Federal
     income  tax  purposes  as a result  of such  legal  defeasance  and will be
     subject to federal income tax on the same amount and in the same manner and
     at the same time as would have been the case if such legal  defeasance  had
     not occurred; and

          (7) in the case of an election under paragraph (c) above,  the Company
     shall have  delivered to the Trustee an Opinion of Counsel from  nationally
     recognized  counsel  acceptable  to the  Trustee (i) to the effect that the
     Holders of the outstanding  Securities will not recognize  income,  gain or
     loss  for  Federal  income  tax  purposes  as a  result  of  such  covenant
     defeasance and will be subject to Federal income tax on the same amount and
     in the same manner and at the same time as would have been the case if such
     covenant  defeasance had not occurred or (ii) that the Company has received
     from, or there has been published by, the Internal Revenue Service a ruling
     to the foregoing effect.

     After such  irrevocable  deposit  made  pursuant  to this  Section  7.1 and
satisfaction of the other conditions set forth herein,  the Trustee upon request
shall  acknowledge in writing the discharge of the Company's  obligations  under
this Indenture except for those surviving obligations specified above.



                                      -30-



<PAGE>



     The Company may make an  irrevocable  deposit  pursuant to this Section 7.1
only if at such time it is not prohibited  from doing so under the provisions of
Article 9 and the  Company  shall have  delivered  to the Trustee and any Paying
Agent an Officers' Certificate to that effect.

     In  order to have  money  available  on a  payment  date to pay  principal,
premium, if any, or interest on the Securities,  the U.S. Government Obligations
shall be payable as to principal, premium, if any, or interest on or before such
payment date in such amounts as will provide the  necessary  money to effect the
applicable defeasance.  U.S. Government Obligations shall not be callable at the
issuer's option.

SECTION 7.2 APPLICATION OF TRUST MONEY

     The Trustee or a trustee  satisfactory to the Trustee and the Company shall
hold in trust money or U.S. Government Obligations deposited with it pursuant to
Section  7.1.  It shall  apply  the  deposited  money  and the  money  from U.S.
Government  Obligations  through the Paying  Agent and in  accordance  with this
Indenture to the payment of principal of,  premium,  if any, and interest on the
Securities.

SECTION 7.3 REPAYMENT TO THE COMPANY

     The Trustee and the Paying  Agent shall  promptly  pay to the Company  upon
written request any excess money or securities held by them at any time.

     The Trustee and the Paying  Agent shall pay to the Company at their  option
or upon  written  request any money held by them for the  payment of  principal,
premium, if any, or interest that remains unclaimed for two years after the date
upon which such  payment  shall have become  due;  provided,  however,  that the
Company  shall have either  caused  notice of such  payment to be mailed to each
Holder  entitled  thereto no less than 30 days prior to such repayment or within
such  period  shall have  published  such  notice in a  financial  newspaper  of
widespread  circulation  published in The City of New York. After payment to the
Company,  Holders  entitled to the money must look to the Company for payment as
general creditors unless an applicable abandoned property law designates another
Person,  and all  liability of the Trustee and such Paying Agent with respect to
such money shall cease.

SECTION 7.4 REINSTATEMENT

     If the  Trustee  or  Paying  Agent is  unable  to apply  any  money or U.S.
Government  Obligations  in  accordance  with Section 7.1 by reason of any legal
proceeding  or by reason of any order or judgment  of any court or  governmental
authority enjoining,  restraining or otherwise prohibiting such application, the
Company's  obligations  under this Indenture and the Securities shall be revived
and  reinstated as though no deposit had occurred  pursuant to Section 7.1 until
such time as the Trustee or Paying Agent is permitted to apply all such money or
U.S. Government  Obligations in accordance with Section 7.1; provided,  however,
that if the Company  has made any payment of premium,  if any, or interest on or
principal of any Securities because of the reinstatement of its obligations, the
Company shall be  subrogated to the rights of the Holders of such  Securities to
receive such payment from the money or U.S.  Government  Obligations held by the
Trustee or Paying Agent.




                                      -31-



<PAGE>



                                   ARTICLE 8

                                   AMENDMENTS

SECTION 8.1 WITHOUT CONSENT OF HOLDERS

     The Company and the Trustee may amend this  Indenture or the  Securities or
waive any provision hereof without the consent of any Holder:

     (1)  to cure any ambiguity, defect or inconsistency;

     (2)  to comply with Section 4.1;

     (3)  to evidence and provide for the acceptance of appointment hereunder by
          a successor Trustee with respect to the Securities;

     (4)  to make any change  that does not  adversely  affect the legal  rights
          hereunder of any Holder; or

     (5)  to comply with a provision or provisions of the TIA applicable to this
          Indenture.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon  receipt by the Trustee of the  documents  described  in Section  8.6,  the
Trustee  shall  join  with the  Company  in the  execution  of any  supplemental
indenture  authorized  or permitted by the terms of this  Indenture and make any
further  appropriate  agreements and stipulations that may be therein contained,
but the Trustee shall not be obligated to enter into any supplemental  indenture
that  affects its own  rights,  duties or  immunities  under this  Indenture  or
otherwise.  After an amendment or waiver under this Section  becomes  effective,
the Company shall mail to the Holders of each Security affected thereby a notice
briefly  describing the amendment or waiver.  Any failure of the Company to mail
such notice,  or any defect therein,  shall not,  however,  in any way impair or
affect the validity of any such supplemental indenture.

SECTION 8.2 WITH CONSENT OF HOLDERS

     Except as provided  in this  Section  8.2,  the Company and the Trustee may
amend this Indenture or the Securities  with the written  consent of the Holders
of at least a majority in principal amount of the then outstanding Securities.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon the filing  with the  Trustee of  evidence of the consent of the Holders as
aforesaid, and upon receipt by the Trustee of the documents described in Section
8.6,  the  Trustee  shall  join  with  the  Company  in the  execution  of  such
supplemental  indenture unless such supplemental indenture affects the Trustee's
own rights,  duties or immunities  under this  Indenture or otherwise,  in which
case the Trustee may in its  discretion,  but shall not be  obligated  to, enter
into such supplemental indenture.

     It shall not be necessary for the consent of the Holders under this Section
to approve the particular form of any proposed amendment or waiver, but it shall
be sufficient if such consent approves the substance thereof.

     The  Holders of a  majority  in  principal  amount of the  Securities  then
outstanding  may waive  compliance in a particular  instance by the Company with
any provision of this Indenture or the Securities.  However, without the consent
of each Holder affected, an amendment or waiver under this Section may not:



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     (1)  change the Stated  Maturity of the principal of, or any installment of
          interest on, any Security;

     (2)  reduce the  principal  amount of, or premium,  if any, or interest on,
          any Security;

     (3)  modify the  provisions of Article 9 hereof in a manner  adverse to the
          Holders;

     (4)  change the place of payment  where,  or the coin or currency in which,
          any Security or any premium or interest thereon is payable;

     (5)  adversely  affect  the right of  Holders  to  require  the  Company to
          repurchase  Securities  pursuant  to Section  3.7 hereof or modify the
          obligations  of the Company to make an Asset Sale Offer in  accordance
          with Sections 3.8;

     (6)  impair the right of Holders to institute  suit for the  enforcement of
          payment of the  principal  of and  premium,  if any,  and  interest on
          Securities on or after the Stated Maturity  thereof (or in the case of
          redemption, on or after the redemption date);

     (7)  reduce the percentage in principal  amount of Securities,  the consent
          of whose Holders is required for any  modification or amendment of the
          Indenture,  or the consent of whose Holders is required for any waiver
          of compliance  with certain  provisions  of this  Indenture or certain
          Defaults  or  Events  of  Default  hereunder  and  their  consequences
          provided for in this Indenture; or

     (8)  modify any of the  provisions  of Section 5.4 or this sentence of this
          Section 8.2.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of this  Indenture  (and the obligation of the Company
to obtain any such consent  otherwise  required from such Holder) may be subject
to the requirement  that such Holder shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of this Indenture.

SECTION 8.3 COMPLIANCE WITH TRUST INDENTURE ACT

     Every  amendment to this Indenture or the  Securities  shall comply in form
and substance with the TIA as then in effect.

SECTION 8.4 REVOCATION AND EFFECT OF CONSENTS

     Until an  amendment  (which  includes  any  supplement)  or waiver  becomes
effective,  a consent to it by a Holder of a Security is a continuing consent by
the Holder and every  subsequent  Holder of a Security  or portion of a Security
that  evidences  the same  debt as the  consenting  Holder's  Security,  even if
notation of the consent is not made on any  Security.  However,  any such Holder
may revoke the consent as to his or her Security or portion of a Security if the
Trustee receives  written notice of revocation  before the date the amendment or
waiver becomes effective. An amendment or waiver becomes effective in accordance
with  its  terms  and  thereafter  binds  every  Holder  of a  Security  whether
theretofore or thereafter authenticated and delivered.

     The Company may,  but shall not be obligated  to, fix a record date for the
purpose of  determining  the  Holders  entitled to consent to any  amendment  or
waiver. If the Company elects to fix a record date for such purpose,  the record
date shall be fixed at (i) the later of 30 days prior to the first  solicitation
of such consent or the date of the most recent list of Holders  furnished to the
Trustee prior to such solicitation, or (ii) such other date as the Company shall
designate. If a record date is fixed, then notwithstanding the provisions of the
immediately preceding paragraph, those


                                      -33-



<PAGE>



Persons who were Holders at such record date (or their duly designated proxies),
and only those Persons, shall be entitled to consent to such amendment or waiver
or to revoke any consent previously given,  whether or not such Persons continue
to be Holders after such record date. No consent shall be valid or effective for
more than 90 days after such  record date unless  consents  from  Holders of the
principal amount of Securities  required  hereunder for such amendment or waiver
to be  effective  shall have also been given and not revoked  within such 90-day
period.

SECTION 8.5 NOTATION ON OR EXCHANGE OF SECURITIES

     The Trustee may place an appropriate  notation about an amendment or waiver
on any  Security  thereafter  authenticated.  The  Company in  exchange  for the
Securities  may issue and the Trustee shall  authenticate  new  Securities  that
reflect the amendment or waiver.

SECTION 8.6 TRUSTEE TO SIGN AMENDMENTS, ETC.

     The Trustee shall sign any amendment or supplemental  indenture  authorized
pursuant  to this  Article 8 if the  amendment  does not  adversely  affect  the
rights,  duties,  liabilities  or  immunities  of the Trustee.  If it does,  the
Trustee  may,  but need  not,  sign it.  In  signing  or  refusing  to sign such
amendment or  supplemental  indenture,  the Trustee shall be entitled to receive
and, subject to Section 6.1 and 6.2 shall be fully protected in relying upon, an
Officers' Certificate and an Opinion of Counsel as conclusive evidence that such
amendment  or  supplemental   indenture  is  authorized  or  permitted  by  this
Indenture,  that it is not inconsistent  herewith, and that it will be valid and
binding upon the Company in accordance with its terms.


                                    ARTICLE 9

                                  SUBORDINATION

SECTION 9.1 SECURITIES SUBORDINATED TO SENIOR INDEBTEDNESS

     The Company  covenants  and agrees,  and each Holder of a Security,  by his
acceptance  thereof,  likewise covenants and agrees,  that, to the extent and in
the manner hereinafter set forth in this Article 9, the indebtedness represented
by the Securities and all Payments or Distributions in Respect of the Securities
are hereby  expressly  made  subordinate  and subject in right of payment to the
prior payment in full of all Senior Indebtedness.

     If at any time  following  the  payment of any amount to a holder of Senior
Indebtedness with respect to such Senior Indebtedness, such payment is rescinded
or must  otherwise be returned by such holder upon the  insolvency,  bankruptcy,
reorganization, dissolution or liquidation of the Company or any other Person or
otherwise,  and is so rescinded or returned to the party or parties  making such
payment,  such Senior  Indebtedness  shall be  reinstated  to the extent of such
payment and the  provisions  of this  Article 9 shall be  applicable  as if such
payment were never made.

     The  provisions  of this  Article 9 are for the  benefit of the  holders of
Senior Indebtedness, and each Holder of the Securities, by his purchase or other
acquisition of the  Securities,  hereby agrees for the benefit of each holder of
Senior  Indebtedness  that his  Securities are subject to the provisions of this
Article 9.

SECTION 9.2 PAYMENT OVER OF PROCEEDS UPON DISSOLUTION, ETC.

     In the event of (a) any insolvency or bankruptcy case or proceeding, or any
receivership,  liquidation,  reorganization or other similar case or proceeding,
relative to the Company or to its creditors,  as such, or to a substantial  part
of its assets,  or (b) any proceeding for the liquidation,  dissolution or other
winding up of the Company,  whether  voluntary or involuntary and whether or not
involving insolvency or bankruptcy, or (c) any assignment for the benefit


                                      -34-



<PAGE>



of creditors or any other  marshalling of assets and liabilities of the Company,
then and in any such event the holders of Senior  Indebtedness shall be entitled
to receive  payment in full of all amounts due or to become due on or in respect
of all Senior  Indebtedness  (including,  without  limitation,  all  Allowed and
Disallowed  Post-Commencement Interest and Expenses), or provision shall be made
for such payment in cash or in a manner otherwise satisfactory to the holders of
Senior  Indebtedness,  before the  Holders of the  Securities  are  entitled  to
receive any Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 7 hereof),  and to that end the holders of Senior  Indebtedness shall be
entitled to receive,  for  application  to the payment  thereof,  any payment or
distribution of any kind or character,  whether in cash, property or securities,
including any such payment or  distribution  which may be payable or deliverable
by  reason  of the  payment  of any  other  indebtedness  of the  Company  being
subordinated  to the  payment  of  the  Securities,  which  may  be  payable  or
deliverable  in  respect  of  the  Securities  in  any  such  case,  proceeding,
dissolution, liquidation or other winding up or event.

     In the  event  that,  notwithstanding  the  foregoing  provisions  of  this
Section,  the  Trustee or the Holder of any  Security  shall have  received  any
Payment  or  Distribution  in  Respect  of  the  Securities  in any  such  case,
proceeding,  dissolution,  liquidation  or other winding up or event (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 7  hereof),  including  any such  payment or  distribution  which may be
payable or deliverable by reason of the payment of any other indebtedness of the
Company being  subordinated to the payment of the Securities,  before all Senior
Indebtedness  (including,   without  limitation,   all  Allowed  and  Disallowed
Post-Commencement  Interest  and  Expenses)  is paid in full or payment  thereof
provided for,  and, if (i) subject to Section 9.8, such fact shall,  at or prior
to the  time of such  payment  or  distribution,  have  been  made  known to the
Trustee,  then and in such event such payment or distribution shall be paid over
or  delivered   forthwith  to  the  holders  of  Senior  Indebtedness  or  to  a
representative   duly  appointed  by  any  such  holder  or  holders  of  Senior
Indebtedness  unless otherwise  required by law or court order or (ii) such fact
shall  have been made  known to such  Holder  at any time  before or after  such
payment, then and in such event such Holder shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed  by any such  holder or holders  of such  Senior  Indebtedness  unless
otherwise required by law or court order, in either such case for application to
the payment of all Senior Indebtedness remaining unpaid, to the extent necessary
to pay all Senior Indebtedness (including,  without limitation,  all Allowed and
Disallowed  Post-  Commencement  Interest and  Expenses)  in full,  after giving
effect to any concurrent payment or distribution to or for the holders of Senior
Indebtedness.

     The  consolidation  of the Company with, or the merger of the Company into,
another Person or the  liquidation  or dissolution of the Company  following the
conveyance or transfer of its properties and assets substantially as an entirety
to another Person upon the terms and conditions set forth in Article 4 shall not
be deemed a dissolution, winding up, liquidation, reorganization, assignment for
the benefit of creditors or marshalling of assets and liabilities of the Company
for the purposes of this Section if the Person formed by such  consolidation  or
into which the  Company is merged or which  acquires by  conveyance  or transfer
such  properties and assets  substantially  as an entirety,  as the case may be,
shall, as a part of such consolidation,  merger,  conveyance or transfer, comply
with the conditions set forth in Article 4.

SECTION  9.3 PRIOR  PAYMENT  TO  SENIOR   INDEBTEDNESS   UPON  ACCELERATION  OF
              SECURITIES

     In the event that any  Securities are declared due and payable before their
Stated  Maturity,  then and in such  event the  holders  of Senior  Indebtedness
outstanding  at the time such  Securities  so become  due and  payable  shall be
entitled  to  receive  payment  in  full  in  cash,  or  in a  manner  otherwise
satisfactory to the holders of Senior Indebtedness,  of all amounts due on or in
respect of such Senior Indebtedness (including,  without limitation, all Allowed
and Disallowed  Post-Commencement  Interest and Expenses)  before the Holders of
the Securities are entitled to receive any Payment or Distribution in Respect of
the  Securities  (including  any  payment  which may be payable by reason of the
payment of any other  indebtedness  of the  Company  being  subordinated  to the
payment of the Securities), other than


                                      -35-



<PAGE>



payment  of amounts  previously  deposited  in  accordance  with the  defeasance
provisions of Article 7 hereof, by or for the account of the Company.

     In the event that,  notwithstanding  the foregoing,  the Company shall make
any Payment or  Distribution  in Respect of the Securities to the Trustee or the
Holder of any Security  prohibited by the foregoing  provisions of this Section,
then if (i) subject to Section 9.8,  such fact shall,  prior to the time of such
payment, have been made known to the Trustee, then and in such event the Trustee
shall  forthwith pay over and deliver such payment to the holders of such Senior
Indebtedness or to a representative duly appointed by any such holder or holders
of such Senior Indebtedness or (ii) such fact shall have been made known to such
Holder at any time  before or after  such  payment,  then and in such event such
Holder  shall  forthwith  pay over and  deliver  such  payment to the holders of
Senior  Indebtedness or to a representative duly appointed by any such holder or
holders of such Senior Indebtedness,  in either such case for application to the
payment of all Senior  Indebtedness  then remaining unpaid  (including,  without
limitation, all Allowed and Disallowed Post-Commencement Interest and Expenses),
after giving  effect to any  concurrent  payment or  distribution  to or for the
benefit of holders of Senior Indebtedness.

     The  provisions of this Section shall not apply to any payment with respect
to which Section 9.2 is applicable.

SECTION 9.4  NO  PAYMENT   UPON  CERTAIN   DEFAULTS   WITH  RESPECT  TO  SENIOR
             INDEBTEDNESS

     (a) No Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts  previously  deposited  in  accordance  with the  defeasance
provisions  of  Article 7  hereof)  shall be made by or for the  account  of the
Company  upon the  occurrence  of any default in the payment of any Bank Debt or
any Senior  Indebtedness  (other than Bank Debt) in excess of $20 million beyond
any applicable grace period, unless and until such default is cured or waived or
ceases to exist or such Senior  Indebtedness  has been paid in full or provision
for such  payment in cash or in a manner  otherwise  satisfactory  to holders of
Senior Indebtedness has been made.

     (b) Upon any default  with  respect to the  financial  covenants  under the
Credit Agreement as specified therein,  or if any payment or distribution by the
Company with  respect to any Security  would,  immediately  after giving  effect
thereto,  result in such default,  no Payment or  Distribution in Respect of the
Securities  (other than payments of amounts  previously  deposited in accordance
with the defeasance provisions of Article 7 hereof), including any payment which
may be  payable  by  reason  of the  payment  of any  other  indebtedness  being
subordinated  to the  payment  of the  Securities,  shall  be made by or for the
account of the  Company  on  account of  principal  of or  premium,  if any,  or
interest on the  Securities or on account of the  purchase,  redemption or other
acquisition  of the  Securities  for the period  specified  below (the  "Payment
Blockage  Period").  The Payment Blockage Period shall commence upon the receipt
of notice by the Company or the Trustee from the Bank Agent and shall end on the
earlier of (i) 179 days  thereafter,  (ii) the date on which such  default  with
respect to the financial covenants under the Credit Agreement is cured or waived
or ceases to exist or on which such Bank Debt is paid in full or  provision  for
such  payment in money or money's  worth has been made,  (iii) the date on which
the maturity of any  Indebtedness  (other than Senior  Indebtedness)  shall have
been accelerated by virtue of such event, or (iv) the date on which such Payment
Blockage  Period  shall  have been  terminated  by notice to the  Company or the
Trustee  from the Bank  Agent,  after  which any and all  required  payments  in
respect of the Securities,  including any missed payments,  may resume. Only one
Payment  Blockage  Period may be commenced  during any period of 365 consecutive
days.  No default  with  respect  to the  financial  covenants  under the Credit
Agreement that existed or was continuing on the date of the  commencement of any
Payment  Blockage Period will be, or can be, made the basis for the commencement
of a second  Payment  Blockage  Period  whether  or not  within a period  of 365
consecutive  days,  unless such default has been cured or waived for a period of
not less than 90 consecutive  days. In no event will a Payment  Blockage  Period
extend beyond 179 days.

     (c) In the event that,  notwithstanding  the  foregoing,  the Company shall
make any payment to the Trustee or the Holder of any Security  prohibited by the
foregoing  provisions of this Section,  then (i) subject to Section 9.8, if such
fact shall, at or prior to the time of such payment, have been made known to the
Trustee, then and


                                      -36-



<PAGE>



in such event the Trustee  shall  forthwith pay over and deliver such payment to
the holders of Senior  Indebtedness or to a representative duly appointed by any
such holder or holders of such Senior  Indebtedness or (ii) such fact shall have
been made known to such  Holder at any time before or after such  payment,  then
and in such event such Holder shall  forthwith pay over and deliver such payment
to the holders of Senior  Indebtedness or to a representative  duly appointed by
any such holder or holders of such Senior Indebtedness.

     The  provisions of this Section shall not apply to any payment with respect
to which Section 9.2 is applicable.

SECTION 9.5 PAYMENT PERMITTED IF NO DEFAULT

     Nothing  contained in this Article or elsewhere in this Indenture or in any
of the Securities  shall prevent (a) the Company,  at any time except during the
pendency of any case, proceeding, dissolution,  liquidation or other winding up,
assignment  for the  benefit of  creditors  or other  marshalling  of assets and
liabilities  of the Company  referred to in Section 9.2 or under the  conditions
described in Section 9.3 or Section 9.4, from making any Payment or Distribution
in Respect of the Securities, or (b) the application by the Trustee of any money
deposited  with it  hereunder  with  respect to any Payment or  Distribution  in
Respect of the  Securities or the retention of such Payment or  Distribution  in
Respect of the Securities by the Holders, if, at the time of such application by
the Trustee,  it had not been notified in accordance  with Section 9.8 that such
payment was prohibited by the provisions of this Article 9.

SECTION 9.6 SUBROGATION TO RIGHTS OF HOLDERS OF SENIOR INDEBTEDNESS

     Subject to the  payment in full in cash of all amounts due on or in respect
of  Senior  Indebtedness  (including,   without  limitation,   all  Allowed  and
Disallowed  Post-Commencement  Interest  and  Expenses,  except  to  the  extent
provided below), the Holders of the Securities shall be subrogated to the extent
of the payments or distributions made to the holders of such Senior Indebtedness
pursuant to the  provisions  of this  Article 9 (equally  and  ratably  with the
holders  of all  indebtedness  of the  Company  which  by its  express  terms is
subordinated  to other  indebtedness  of the Company to  substantially  the same
extent as the  Securities  are  subordinated  and are entitled to like rights of
subrogation) to the rights of the holders of such Senior Indebtedness to receive
payments and  distributions of cash,  property and securities  applicable to the
Senior  Indebtedness until the principal of and premium, if any, and interest on
the  Securities  shall be paid in full.  For  purposes of such  subrogation,  no
payments or distributions to the holders of the Senior Indebtedness of any cash,
property or  securities  to which the Holders of the  Securities  or the Trustee
would be entitled  except for the  provisions of this Article 9, and no payments
over  pursuant  to the  provisions  of this  Article  to the  holders  of Senior
Indebtedness  by Holders of the Securities or the Trustee,  shall,  as among the
Company, its creditors other than holders of Senior Indebtedness and the Holders
of the  Securities,  be deemed to be a payment or distribution by the Company to
or on account of the Senior Indebtedness.

     Notwithstanding  anything to the  contrary in this Section 9.6, the Holders
of the  Securities  hereby  agree that they shall have no rights of  subrogation
with respect to amounts paid to the holders of Senior Indebtedness in payment of
any  interest,  reimbursements,  costs,  expenses  or  indemnities  that are not
allowed  claims  enforceable  against the Company in a case or proceeding  under
Bankruptcy Law.

SECTION 9.7 PROVISIONS SOLELY TO DEFINE RELATIVE RIGHTS

     The  provisions  of this  Article  9 are and are  intended  solely  for the
purpose of defining the relative  rights of the Holders of the Securities on the
one hand and the  holders  of Senior  Indebtedness  on the other  hand.  Nothing
contained in this Article or elsewhere in this Indenture or in the Securities is
intended to or shall (a) impair, as among the Company,  its creditors other than
holders of Senior Indebtedness and the Holders of the Securities, the obligation
of the Company,  which is absolute and  unconditional,  to pay to the Holders of
the  Securities  the  principal  of and  premium,  if any,  and  interest on the
Securities as and when the same shall become due and payable in accordance  with
their  terms;  or (b) affect the  relative  rights  against  the  Company of the
Holders of the Securities and creditors of


                                      -37-



<PAGE>



the Company  other than the holders of Senior  Indebtedness;  or (c) prevent the
Trustee or the Holder of any Security  from  exercising  all remedies  otherwise
permitted by applicable  law upon default under this  Indenture,  subject to the
rights,  if any, under this Article 9 of the holders of Senior  Indebtedness  to
receive cash,  property and securities  otherwise  payable or deliverable to the
Trustee or such  Holder.  The failure to make a payment on account of  principal
of,  premium,  if any, or interest  on, or any other  amounts  then payable with
respect  to,  the  Securities  by any  reason  of this  Article  9 shall  not be
construed as preventing the occurrence of an Event of Default under Section 5.1.

SECTION 9.8 APPLICATION BY TRUSTEE OF MONIES DEPOSITED WITH IT

     Money and U.S. Government  Obligations  deposited in trust with the Trustee
pursuant to Section 7.2 and in compliance with Section 7.1 shall be for the sole
benefit  of the  Holders  and,  to the  extent  allocated  for  the  payment  of
Securities, shall not be subject to the subordination provisions of this Article
9.  Otherwise,  any  deposit of monies by the  Company  with the  Trustee or any
Paying Agent  (whether or not in trust) for payment on account of principal  of,
premium, if any, and interest on the Securities or that otherwise  constitutes a
Payment or  Distribution  in Respect of the  Securities  shall be subject to the
provisions  of Sections  9.1,  9.2, 9.3 and 9.4 except  that,  if at least three
Business Days prior to the date on which by the terms of this Indenture any such
monies may become payable for any purpose (including,  without  limitation,  the
payment of the principal of,  premium,  if any, or the interest on any Security)
the  Trustee  shall not have  received  with  respect to such  monies the notice
provided for in Section  9.4(b) or 9.11,  then the Trustee shall have full power
and  authority  to receive  such monies and to apply the same to the purpose for
which  they  were  received,  and  shall not be  affected  by any  notice to the
contrary  which may be received by it within three  Business  Days of such date.
This Section shall be construed solely for the benefit of the Trustee and Paying
Agent  and  shall  not  otherwise   affect  the  rights  of  holders  of  Senior
Indebtedness.

SECTION 9.9 TRUSTEE TO EFFECTUATE SUBORDINATION

     Each holder of a Security by his acceptance  thereof authorizes and directs
the Trustee on his behalf to take such action as may be necessary or appropriate
to  effectuate  the  subordination  provided in this  Article and  appoints  the
Trustee his attorney-in-fact for any and all such purposes.

SECTION 9.10 NO WAIVER OF SUBORDINATION PROVISIONS

     No right of any  present  or future  holder of any Senior  Indebtedness  to
enforce  subordination  as  herein  provided  shall  at any  time  in any way be
prejudiced  or  impaired by any act or failure to act on the part of the Company
or by any act or failure to act, in good faith,  by any such  holder,  or by any
noncompliance  by the Company with the terms,  provisions  and covenants of this
Indenture,  regardless of any  knowledge  thereof any such holder may have or be
otherwise charged with.

     Without in any way limiting the generality of the foregoing paragraph,  the
holders of Senior  Indebtedness may, at any time and from time to time,  without
the  consent  of or notice to the  Trustee  or the  Holders  of the  Securities,
without  incurring  responsibility  to the Holders of the Securities and without
impairing  or  releasing  the  subordination  provided  in this  Article  or the
obligations  hereunder of the Holders of the Securities to the holders of Senior
Indebtedness,  do any one or more of the following: (i) change the manner, place
or terms of  payment  or  extend  the time of  payment  of,  or renew or  alter,
compromise,  accelerate,  extend or refinance Senior Indebtedness,  or otherwise
amend  or  supplement  in any  manner  Senior  Indebtedness  or  any  instrument
evidencing  the  same  or any  agreement  under  which  Senior  Indebtedness  is
outstanding; (ii) sell, exchange, release, foreclose upon or otherwise deal with
any property pledged, mortgaged or otherwise securing Senior Indebtedness; (iii)
release any Person  liable in any manner for the payment or collection of Senior
Indebtedness;  (iv) exercise or refrain from  exercising  any rights against the
Company  and any other  Person;  (v)  increase or reduce the rate of interest or
amount  of  principal  payable  on any  Senior  Indebtedness;  (vi)  release  or
discharge  the  Company,  by  acceptance  of a deed  or  assignment  in  lieu of
foreclosure or otherwise,  as to all or any portion of the Senior  Indebtedness;
or (vii)  release,  substitute  or add any one or more  guarantors or endorsers,
accept  additional or  substituted  security for payment or  performance  of the
Senior Indebtedness,


                                      -38-



<PAGE>



or release or subordinate any security therefor. No exercise,  delay in exercise
or failure to  exercise  by any holder of any Senior  Indebtedness  of any right
hereby  given it, no dealing by any holder of any Senior  Indebtedness  with the
Company or any other guarantor,  endorser or other person, no change, impairment
or suspension  of any right or remedy of any holder of any Senior  Indebtedness,
and no act or thing  which but for this  provision  could  act as a  release  or
exoneration of the Holders of the Securities hereunder, shall in any way affect,
decrease,  diminish  or impair  any of the  obligations  of the  Holders  of the
Securities and the Trustee or give to the Holders of the Securities, the Trustee
or any other person or entity any recourse or defense  against any holder of any
Senior Indebtedness.

SECTION 9.11 NOTICE TO TRUSTEE

     The  Company  shall give prompt  written  notice to the Trustee of any fact
known to the Company which would prohibit the making of any payment to or by the
Trustee in respect of the  Securities.  Notwithstanding  the  provisions of this
Article or any other provision of this Indenture, the


                                      -39-



<PAGE>



Trustee shall not be charged with  knowledge of the existence of any facts which
would  prohibit the making of any payment to or by the Trustee in respect of the
Securities,  unless and until the Trustee  shall have  received  written  notice
thereof from the Company or a holder of Senior  Indebtedness or from any trustee
or other representative  therefor; and, prior to the receipt of any such written
notice, the Trustee, subject to the provisions of Sections 6.1 and 6.2, shall be
entitled in all respects to assume that no such facts exist.

     Subject to the  provisions  of Sections 6.1 and 6.2,  the Trustee  shall be
entitled  to  rely  on  the  delivery  to it of a  written  notice  by a  Person
representing  himself  to be a  holder  of  Senior  Indebtedness  (or a  trustee
therefor)  to  establish  that such  notice has been given by a holder of Senior
Indebtedness (or a trustee  therefor).  In the event that the Trustee determines
in good faith that further evidence is required with respect to the right of any
Person as a holder of Senior  Indebtedness  to  participate  in any  payment  or
distribution  pursuant to this Article 9, the Trustee may request such Person to
furnish evidence to the reasonable  satisfaction of the Trustee as to the amount
of Senior  Indebtedness held by such Person,  the extent to which such Person is
entitled to  participate  in such  payment or  distribution  and any other facts
pertinent  to the  rights  of such  Person  under  this  Article  9, and if such
evidence  is not  furnished,  the  Trustee  may defer any payment to such Person
pending  judicial  determination  as to the right of such Person to receive such
payment.

SECTION 9.12 RELIANCE ON JUDICIAL ORDER OR CERTIFICATE OF LIQUIDATING AGENT

     Upon any payment or  distribution  of assets of the Company  referred to in
this Article 9, the Trustee,  subject to the provisions of Sections 6.1 and 6.2,
and the  Holders of the  Securities  shall be entitled to rely upon any order or
decree entered by any court of competent  jurisdiction in which such insolvency,
bankruptcy, receivership, liquidation,  reorganization,  dissolution, winding up
or similar case or  proceeding is pending,  or a  certificate  of the trustee in
bankruptcy,  receiver,  liquidating trustee, custodian, assignee for the benefit
of  creditors,  agent or other  person  making  such  payment  or  distribution,
delivered  to the  Trustee or to the Holders of  Securities,  for the purpose of
ascertaining   the  Persons   entitled  to   participate   in  such  payment  or
distribution,  the holders of the Senior  Indebtedness and other indebtedness of
the Company,  the amount thereof or payable thereon,  the amount or amounts paid
or distributed  thereon and all other facts pertinent thereto or to this Article
9.

SECTION 9.13 TRUSTEE NOT FIDUCIARY FOR HOLDERS OF SENIOR INDEBTEDNESS

     The Trustee shall not be deemed to owe any fiduciary duty to the holders of
Senior  Indebtedness  and shall not be liable to any such holders if it shall in
good faith  mistakenly pay over or distribute to Holders of Securities or to the
Company or to any other Person cash,  property or securities to which holders of
Senior Indebtedness shall be entitled by virtue of this Article 9 or otherwise.

SECTION 9.14 RIGHTS OF TRUSTEE AS HOLDER OF SENIOR  INDEBTEDNESS;  PRESERVATION
             OF TRUSTEE'S RIGHTS

     The Trustee in its individual  capacity shall be entitled to all the rights
set forth in this Article with respect to any Senior  Indebtedness  which may at
any  time be held by it,  to the same  extent  as any  other  holder  of  Senior
Indebtedness,  and nothing in this Indenture shall deprive the Trustee of any of
its rights as such holder.

     Nothing  in this  Article  shall  apply to claims of, or  payments  to, the
Trustee under or pursuant to Section 6.6.



                                      -40-



<PAGE>



                                   ARTICLE 10

                                  MISCELLANEOUS

SECTION 10.1 TRUST INDENTURE ACT CONTROLS

     If any provision of this Indenture limits,  qualifies or conflicts with the
duties imposed by TIA ss. 318(c), the imposed duties shall control.

SECTION 10.2 NOTICES

     Any notice or  communication  by the Company or the Trustee to the other is
duly given if in writing and delivered in Person or mailed by  first-class  mail
(registered  or  certified,  return  receipt  requested),  telex,  telecopier or
overnight air courier guaranteeing next day delivery, to the other's address:

      If to the Company:

      Integrated Health Services, Inc.
      10065 Red Run Boulevard
      Owings Mills, Maryland  21117
      Attention:  General Counsel


      If to the Trustee:

      Signet Trust Company
      7 St. Paul Street
      Baltimore, MD  21202
      Attn:  Corporate Trust Department

     The Company or the Trustee by notice to the other may designate  additional
or different addresses for subsequent notices or communications.

     All notices and communications  shall be deemed to have been duly given: at
the time  delivered by hand, if personally  delivered;  five Business Days after
being deposited in the mail, postage prepaid,  if mailed; when answered back, if
telexed;  when receipt  acknowledged,  if telecopied;  and the next Business Day
after  timely  delivery  to the  courier,  if  sent  by  overnight  air  courier
guaranteeing next day delivery.

     Any notice or communication to a Holder shall be mailed by first-class mail
to the Holder's address shown on the register kept by the Registrar.  Failure to
mail a notice or  communication to a Holder or any defect in it shall not affect
its sufficiency with respect to other Holders.

     If a notice or  communication is mailed in the manner provided above within
the time prescribed, it is duly given, whether or not the addressee receives it.

     If the Company mails a notice or communication to Holders,  it shall mail a
copy to the Trustee and each Agent at the same time.



                                      -41-



<PAGE>



SECTION 10.3 CERTIFICATE AND OPINION AS TO CONDITIONS PRECEDENT

     Upon any request or  application  by the Company to the Trustee to take any
action under this Indenture, the Company shall furnish to the Trustee:

          (1) an Officers'  Certificate  (which shall include the statements set
     forth in Section 10.4)  stating  that,  in the opinion of the signers,  all
     conditions precedent and covenants,  if any, provided for in this Indenture
     relating to the proposed action have been complied with; and

          (2) an Opinion of Counsel  (which  shall  include the  statements  set
     forth in Section 10.4)  stating  that, in the opinion of such counsel,  all
     such conditions precedent and covenants have been complied with.

SECTION 10.4 STATEMENTS REQUIRED IN CERTIFICATE OR OPINION

     Each  certificate or opinion with respect to compliance with a condition or
covenant  provided  for in this  Indenture  (other than a  certificate  provided
pursuant to TIA ss. 314(a)(4)) shall include:

          (1) a statement that the Person making such certificate or opinion has
     read such covenant or condition;

          (2) a brief statement as to the nature and scope of the examination or
     investigation  upon which the  statements  or  opinions  contained  in such
     certificate or opinion are based;

          (3) a statement that, in the opinion of such Person,  he has made such
     examination  or  investigation  as is necessary to enable him to express an
     informed  opinion as to whether or not such  covenant or condition has been
     complied with; and

          (4) a statement  as to whether or not, in the opinion of such  Person,
     such condition or covenant has been complied with.

SECTION 10.5 RULES BY TRUSTEE AND AGENTS

     The  Trustee  may make  reasonable  rules for  action by or at a meeting of
Holders.  The  Registrar  or  Paying  Agent  may make  reasonable  rules and set
reasonable requirements for its functions.

SECTION 10.6 LEGAL HOLIDAYS

     A  "Legal  Holiday"  is a  Saturday,  a Sunday  or a day on  which  banking
institutions  in The  City of New  York  are  authorized  or  obligated  by law,
regulation  or executive  order to remain  closed.  If a payment date is a Legal
Holiday  at a place of  payment,  payment  may be made at that place on the next
succeeding day that is not a Legal Holiday, and no interest shall accrue for the
intervening period.

SECTION 10.7 NO RECOURSE AGAINST OTHERS

     A director, officer, employee or stockholder of the Company or the Trustee,
as such,  shall not have any liability for any  obligations of the Company under
the  Securities or this Indenture or for any claim based on, in respect of or by
reason  of such  obligations  or their  creation.  Each  Holder by  accepting  a
Security waives and releases all such liability.



                                      -42-



<PAGE>



SECTION 10.8 GOVERNING LAW

     THIS  INDENTURE  AND THE  SECURITIES  SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK,  WITHOUT REGARD TO PRINCIPLES
OF CONFLICTS OF LAW.

SECTION 10.9 NO ADVERSE INTERPRETATION OF OTHER AGREEMENTS

     This Indenture may not be used to interpret another indenture, loan or debt
agreement  of the  Company or a  Subsidiary.  Any such  indenture,  loan or debt
agreement may not be used to interpret this Indenture.

SECTION 10.10 SUCCESSORS

     All agreements of the Company in this  Indenture and the  Securities  shall
bind its successor.  All agreements of the Trustee in this Indenture  shall bind
its successor.

SECTION 10.11 SEVERABILITY

     In case any  provision  in this  Indenture  or in the  Securities  shall be
invalid, illegal or unenforceable,  the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby.

SECTION 10.12 COUNTERPART ORIGINALS

     The  parties may sign any number of copies of this  Indenture.  Each signed
copy  shall  be an  original,  but  all of  them  together  represent  the  same
agreement.

SECTION 10.13 TRUSTEE AS PAYING AGENT AND REGISTRAR

     The Company initially appoints the Trustee as Paying Agent and Registrar.

SECTION 10.14 TABLE OF CONTENTS, HEADINGS, ETC.

     The Table of Contents,  Cross-Reference  Table and Headings of the Articles
and Sections of this Indenture  have been inserted for  convenience of reference
only,  are not to be  considered  a part  hereof  and shall in no way  modify or
restrict any of the terms or provisions hereof.

SECTION 10.15 EFFECTIVE DATE

     This Second Amended and Restated Supplemental Indenture shall be effective,
and the effective date shall be deemed to have occurred, upon the receipt by the
Trustee of a written notice from the Company that the conditions to the Offer to
Purchase the Company's 9 5/8% Senior  Subordinated  Notes due 2002, Series A and
Consent  Solicitation  dated May 1, 1997,  have been  satisfied or waived by the
Company and that the Acceptance Date (as defined therein) has occurred.

                            [Signatures on Next Page]


                                      -43-



<PAGE>



                                   SIGNATURES





Dated as of May 15, 1997
                                               (SEAL)

                                               INTEGRATED HEALTH SERVICES, INC.



                                               By:/s/
                                                  ------------------------------
                                                  Name:
                                                  Title:

Attest:
/s/
- -------------------------------


Dated as of May 15, 1997
                                               (SEAL)

                                               SIGNET TRUST COMPANY,
                                               as Trustee



                                               By:/s/
                                                  ------------------------------
                                                  Name:
                                                  Title:

Attest:
/s/
- -------------------------------



                                      -44-



<PAGE>




                                    EXHIBIT A

LEGENDS FOR GLOBAL SECURITY:

     UNLESS  AND UNTIL IT IS  EXCHANGED  IN WHOLE OR IN PART FOR  SECURITIES  IN
DEFINITIVE  FORM, THIS SECURITY MAY NOT BE TRANSFERRED  EXCEPT AS A WHOLE BY THE
DEPOSITARY TO A NOMINEE OF THE  DEPOSITARY OR BY A NOMINEE OF THE  DEPOSITARY TO
THE DEPOSITARY OR ANOTHER  NOMINEE OF THE DEPOSITARY OR BY THE DEPOSITARY OR ANY
SUCH  NOMINEE  TO  A  SUCCESSOR  DEPOSITARY  OR  A  NOMINEE  OF  SUCH  SUCCESSOR
DEPOSITARY. UNLESS THIS SECURITY IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF
THE DEPOSITORY TRUST COMPANY (55 WATER STREET,  NEW YORK, NEW YORK) ("DTC"),  TO
THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER,  EXCHANGE OR PAYMENT,  AND
ANY SECURITY  ISSUED IS  REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME
AS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO
CEDE & CO. OR SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE
OF DTC),  ANY TRANSFER,  PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR
TO ANY PERSON IS WRONGFUL  INASMUCH AS THE REGISTERED OWNER HEREOF,  CEDE & CO.,
HAS AN INTEREST HEREIN.

     THIS SECURITY HAS NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE  "SECURITIES  ACT"),  OR ANY STATE  SECURITIES  LAWS.  NEITHER THIS
SECURITY  NOR ANY  INTEREST  OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED  OR  OTHERWISE  DISPOSED OF IN THE
ABSENCE OF SUCH  REGISTRATION OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR NOT
SUBJECT TO, REGISTRATION.

     THE HOLDER OF THIS SECURITY BY ITS  ACCEPTANCE  HERETO AGREES NOT TO OFFER,
SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY,  PRIOR  TO THE DATE  (THE  "RESALE
RESTRICTION  TERMINATION  DATE")  WHICH IS THREE  YEARS  AFTER  THE LATER OF THE
ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST  DATE ON WHICH  THE  COMPANY  OR ANY
AFFILIATED  PERSON  OF THE  COMPANY  WAS  THE  OWNER  OF THIS  SECURITY  (OR ANY
PREDECESSOR OF SUCH SECURITY)  UNLESS SUCH OFFER,  SALE OR OTHER TRANSFER IS (A)
TO THE COMPANY, (B) PURSUANT TO A REGISTRATION STATEMENT WHICH HAS BEEN DECLARED
EFFECTIVE  UNDER  THE  SECURITIES  ACT,  (C) FOR SO LONG AS THE  SECURITIES  ARE
ELIGIBLE  FOR RESALE  PURSUANT TO RULE 144A,  TO A PERSON THE HOLDER  REASONABLY
BELIEVES IS A "QUALIFIED  INSTITUTIONAL BUYER" AS DEFINED IN RULE 144A UNDER THE
SECURITIES  ACT THAT  PURCHASES  FOR ITS OWN  ACCOUNT  OR FOR THE  ACCOUNT  OF A
QUALIFIED INSTITUTIONAL BUYER TO WHOM NOTICE IS GIVEN THAT THE TRANSFER IS BEING
MADE IN  RELIANCE  ON RULE  144A,  (D)  PURSUANT  TO OFFERS AND SALES THAT OCCUR
OUTSIDE  THE  UNITED  STATES  WITHIN  THE  MEANING  OF  REGULATION  S UNDER  THE
SECURITIES ACT, (E) TO AN INSTITUTIONAL "ACCREDITED INVESTOR" WITHIN THE MEANING
OF  SUBPARAGRAPH  (A)(1),  (A)(2),  (A)(3)  OR  (A)(7)  OF RULE  501  UNDER  THE
SECURITIES  ACT THAT IS ACQUIRING  THE SECURITY FOR ITS OWN ACCOUNT,  OR FOR THE
ACCOUNT OF SUCH AN INSTITUTIONAL  "ACCREDITED INVESTOR," FOR INVESTMENT PURPOSES
AND  NOT  WITH A  VIEW  TO,  OR FOR  OFFER  OR  SALE  IN  CONNECTION  WITH,  ANY
DISTRIBUTION  IN  VIOLATION  OF THE  SECURITIES  ACT, OR (F) PURSUANT TO ANOTHER
AVAILABLE  EXEMPTION FROM THE  REGISTRATION  REQUIREMENTS OF THE SECURITIES ACT,
SUBJECT TO THE COMPANY'S AND THE TRUSTEE'S  RIGHT PRIOR TO ANY SUCH OFFER,  SALE
OR TRANSFER  PURSUANT TO CLAUSES  (D),  (E) OR (F) TO REQUIRE THE DELIVERY OF AN
OPINION OF COUNSEL,  CERTIFICATION AND/OR OTHER INFORMATION SATISFACTORY TO EACH
OF THEM, AND IN EACH OF THE FOREGOING CASES,

                                       A-1


<PAGE>



A  CERTIFICATE  OF TRANSFER IN THE FORM  APPEARING ON THIS SECURITY IS COMPLETED
AND DELIVERED BY THE TRANSFEROR TO THE TRUSTEE. THIS LEGEND WILL BE REMOVED UPON
THE REQUEST OF THE THEN  HOLDER OF THIS  SECURITY  AFTER THE RESALE  RESTRICTION
TERMINATION DATE.


LEGENDS FOR DEFINITIVE SECURITY

     THIS SECURITY HAS NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE  "SECURITIES  ACT"),  OR ANY STATE  SECURITIES  LAWS.  NEITHER THIS
SECURITY  NOR ANY  INTEREST  OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED  OR  OTHERWISE  DISPOSED OF IN THE
ABSENCE OF SUCH  REGISTRATION OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR NOT
SUBJECT TO, REGISTRATION.

     THE HOLDER OF THIS SECURITY BY ITS  ACCEPTANCE  HEREOF AGREES NOT TO OFFER,
SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY,  PRIOR  TO THE DATE  (THE  "RESALE
RESTRICTION  TERMINATION  DATE")  WHICH IS THREE  YEARS  AFTER  THE LATER OF THE
ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST  DATE ON WHICH  THE  COMPANY  OR ANY
AFFILIATED  PERSON  OF THE  COMPANY  WAS  THE  OWNER  OF THIS  SECURITY  (OR ANY
PREDECESSOR OF SUCH SECURITY)  UNLESS SUCH OFFER,  SALE OR OTHER TRANSFER IS (A)
TO THE COMPANY, (B) PURSUANT TO A REGISTRATION STATEMENT WHICH HAS BEEN DECLARED
EFFECTIVE  UNDER  THE  SECURITIES  ACT,  (C) FOR SO LONG AS THE  SECURITIES  ARE
ELIGIBLE  FOR RESALE  PURSUANT TO RULE 144A,  TO A PERSON THE HOLDER  REASONABLY
BELIEVES IS A "QUALIFIED  INSTITUTIONAL BUYER" AS DEFINED IN RULE 144A UNDER THE
SECURITIES  ACT THAT  PURCHASES  FOR ITS OWN  ACCOUNT  OR FOR THE  ACCOUNT  OF A
QUALIFIED INSTITUTIONAL BUYER TO WHOM NOTICE IS GIVEN THAT THE TRANSFER IS BEING
MADE IN  RELIANCE  ON RULE  144A,  (D)  PURSUANT  TO OFFERS AND SALES THAT OCCUR
OUTSIDE  THE  UNITED  STATES  WITHIN  THE  MEANING  OF  REGULATION  S UNDER  THE
SECURITIES ACT, (E) TO AN INSTITUTIONAL "ACCREDITED INVESTOR" WITHIN THE MEANING
OF  SUBPARAGRAPH  (A)(1),  (A)(2),  (A)(3)  OR  (A)(7)  OF RULE  501  UNDER  THE
SECURITIES  ACT THAT IS ACQUIRING  THE SECURITY FOR ITS OWN ACCOUNT,  OR FOR THE
ACCOUNT OF SUCH AN INSTITUTIONAL  "ACCREDITED INVESTOR," FOR INVESTMENT PURPOSES
AND  NOT  WITH A  VIEW  TO,  OR FOR  OFFER  OR  SALE  IN  CONNECTION  WITH,  ANY
DISTRIBUTION  IN  VIOLATION  OF THE  SECURITIES  ACT, OR (F) PURSUANT TO ANOTHER
AVAILABLE  EXEMPTION FROM THE  REGISTRATION  REQUIREMENTS OF THE SECURITIES ACT,
SUBJECT TO THE COMPANY'S AND THE TRUSTEE'S  RIGHT PRIOR TO ANY SUCH OFFER,  SALE
OR TRANSFER  PURSUANT TO CLAUSES  (D),  (E) OR (F) TO REQUIRE THE DELIVERY OF AN
OPINION OF COUNSEL,  CERTIFICATION AND/OR OTHER INFORMATION SATISFACTORY TO EACH
OF THEM,  AND IN EACH OF THE FOREGOING  CASES,  A CERTIFICATE OF TRANSFER IN THE
FORM  APPEARING ON THIS SECURITY IS COMPLETED AND DELIVERED BY THE TRANSFEROR TO
THE TRUSTEE.  THIS LEGEND WILL BE REMOVED UPON THE REQUEST OF THE THEN HOLDER OF
THIS SECURITY AFTER THE RESALE RESTRICTION TERMINATION DATE.

                                       A-2


<PAGE>



                    9 5/8% SENIOR SUBORDINATED NOTES DUE 2002


Cusip No.                                                                    $


INTEGRATED HEALTH SERVICES, INC.

promises to pay to



or registered assigns,

the principal sum of



Dollars  [or such  greater or lesser  amount as  indicated  on the  Schedule  of
Exchanges of Definitive Securities on the reverse hereof]1 on May 31, 2002

Interest Payment Dates:         May 31 and November 30

Record Dates:                   May 15 and November 15



Authentication:                                      Dated:               , 1995

This is one of the Securities referred to in the within-mentioned Indenture.

SIGNET TRUST COMPANY,
as Trustee                                      INTEGRATED HEALTH SERVICES, INC.



By:                                             By:
   --------------------------                      -----------------------------

               Authorized Officer


                                                By:
                                                   -----------------------------


                                                                          (SEAL)

- --------
1    This  phrase  should be included  only if the  Security is issued in global
     form.

                                       A-3


<PAGE>



                    9 5/8% SENIOR SUBORDINATED NOTES DUE 2002


     1. INTEREST.  INTEGRATED HEALTH SERVICES, INC., a Delaware corporation (the
"Company"), promises to pay interest on the principal amount of this Security at
9 5/8% per annum  from the date this  Security  is issued  until  maturity.  The
Company will pay interest  semiannually  on May 31 and November 30 of each year,
or if any such day is not a Business  Day, on the next  succeeding  Business Day
(each an "Interest  Payment Date") and any Penalty  Interest payable pursuant to
Section 6 of the  Registration  Rights  Agreement on such Interest Payment Date.
Interest  on the  Securities  will  accrue  from the most  recent  date on which
interest  has been  paid or,  if no  interest  has been  paid,  from the date of
issuance;  provided,  that if there is no  existing  Default  in the  payment of
interest,  and if this Security is authenticated  between a record date referred
to on the face hereof and the next succeeding  Interest  Payment Date,  interest
shall accrue from such next succeeding Interest Payment Date; provided, further,
that the first Interest  Payment Date shall be November 30, 1995.  Interest will
be computed on the basis of a 360-day year of twelve 30-day months.

     2.  METHOD OF  PAYMENT.  The Company  will pay  interest on the  Securities
(except  defaulted  interest)  to the  Persons  who are  registered  Holders  of
Securities  at the close of  business  on the  record  date next  preceding  the
Interest  Payment Date,  even if such  Securities are canceled after such record
date and on or before such  Interest  Payment Date. In the case of a Security to
be repurchased by the Company in connection with a Change in Control  Repurchase
pursuant to paragraph 6, on or after an interest  payment  record date and prior
to the next Interest Payment Date, the registered  holder of such Security as of
such  record  date shall be  entitled  to accrued  and  unpaid  interest  to the
repurchase  date,  as provided in paragraph 6 below.  The Holder must  surrender
this Security to a Paying Agent to collect principal payments.  The Company will
pay the principal of,  premium,  if any, and interest on the Securities in money
of the United  States of America that at the time of payment is legal tender for
payment of public and private debts. The Company,  however, may pay such amounts
by check payable in such money mailed to a Holder's registered address.

     3. PAYING AGENT AND REGISTRAR. Initially, SIGNET TRUST COMPANY, the Trustee
under the  Indenture,  will act as Paying Agent and  Registrar.  The Company may
change any Paying Agent, Registrar or co-registrar without notice to any Holder.
The Company or any of its Subsidiaries may act in any such capacity.

     4. INDENTURE. The Company issued the Securities under an Indenture dated as
of May 15, 1995, as subsquently  amended and restated by an Amended and Restated
Supplemental Indenture dated as of May 15, 1995,  supplemented by a Supplemental
Indenture dated as of June 13, 1996 and amended and restated by a Second Amended
and  Restated  Supplemental  Indenture  dated as of May 15,  1997  ("Indenture")
between the Company and the Trustee.  The terms of the Securities  include those
stated in the Indenture and those made part of the Indenture by reference to the
Trust Indenture Act of 1939, as amended (15 U.S. Code ss.ss.  77aaa-77bbbb),  as
in effect on the date of execution of the Indenture.  The Securities are subject
to all such terms,  and Holders are referred to the Indenture and such Act for a
statement of such terms. The Securities are unsecured general obligations of the
Company limited to $115,000,000 in aggregate  principal amount, plus amounts, if
any,  sufficient  to pay  interest  on  outstanding  Securities  as set forth in
Paragraph 2 hereof.  The  Securities  will rank pari passu with the Company's 10
3/4% Senior Subordinated Notes due 2004.

     5. OPTIONAL  REDEMPTION.  The Securities are not redeemable  prior to their
Stated Maturity.

     6. RIGHT TO REQUIRE  REPURCHASE.  Following the occurrence of any Change in
Control,  each Holder will have the right to require that the Company repurchase
(a "Change in Control  Repurchase") such Holder's Securities at a purchase price
equal to 101% of the aggregate principal amount of the Securities,  plus accrued
and unpaid interest thereon,  if any, to the date of repurchase.  Within 30 days
after any Change in  Control,  the  Company or, at the  Company's  request,  the
Trustee, shall cause to be mailed a notice to all Holders notifying such Holders
of the occurrence

                                       A-4


<PAGE>



of such Change in Control,  the Holder's  rights arising as a result thereof and
the procedures to be followed by Holders wishing to exercise such rights.

     A Holder  of  Securities  may  exercise  the  right to  require a Change in
Control  Repurchase  after  receipt of notice of the  existence of such right by
completing the form entitled  "OPTION OF HOLDER TO ELECT PURCHASE"  appearing on
this  Security  and by  complying  with the other  procedures  set forth in such
notice.  Any portion of  Securities  with respect to which the Holder  wishes to
exercise such right must be in integral multiples of $1,000.

     7. DENOMINATIONS, TRANSFER, EXCHANGE. The Securities are in registered form
without coupons in denominations of $1,000 and integral multiples of $1,000. The
transfer of Securities  may be  registered  and  Securities  may be exchanged as
provided in the  Indenture.  The Registrar and the Trustee may require a Holder,
among other things, to furnish  appropriate  endorsements and transfer documents
and to pay any taxes and fees required by law or permitted by the Indenture.

     8.  PERSONS  DEEMED  OWNERS.  The  registered  Holder of a Security  may be
treated as its owner for all purposes.

     9. AMENDMENTS AND WAIVERS. Subject to certain exceptions,  the Indenture or
the Securities may be amended or supplemented with the consent of the Holders of
at least a majority in principal amount of the Securities then outstanding,  and
any existing  default under,  or compliance with any provision of, the Indenture
may be waived  (other  than any  continuing  Default  or Event of Default in the
payment of interest or premium, if any, on or the principal of the Securities or
in respect of a  provision  under the  Indenture  which  cannot be  modified  or
amended  without the consent of the Holder of each  Security  then  outstanding)
with the  consent  of the  Holders  of a  majority  in  principal  amount of the
Securities then outstanding.  Without the consent of any Holder, the Company and
the Trustee may amend or supplement  the Indenture or the Securities to cure any
ambiguity,  defect  or  inconsistency;  to  provide  for the  assumption  of the
Company's  obligations  to  Holders in the case of a merger or  acquisition;  to
evidence and provide for the acceptance of appointment of any successor  Trustee
under the Indenture; to make any change that does not adversely affect the legal
rights of any Holder;  or to comply with the requirements of the Trust Indenture
Act of 1939, as amended.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of the Indenture (and the obligation of the Company to
obtain any such consent  otherwise  required from such Holder) may be subject to
the  requirement  that such  Holder  shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of the Indenture.

     Without  the consent of each Holder  affected,  the Company may not,  among
other  things,  (i) change  the  Stated  Maturity  of the  principal  of, or any
installment of interest on, any Security,  (ii) reduce the principal  amount of,
or premium, if any, or interest on, any Security, (iii) modify the subordination
provisions of the Indenture in a manner adverse to the Holders,  (iv) change the
place of payment  where,  or the coin or currency in which,  any Security or any
premium  or  interest  thereon is  payable,  (v)  adversely  affect the right of
Holders to require the Company to make a Change in Control  Repurchase or modify
the  obligations  of the  Company  to make an Asset  Sale  Offer or  modify  the
redemption  provisions  of the  Indenture,  (vi) impair the right of a Holder to
institute  suit for the  enforcement of payment of the principal of and premium,
if any, and interest on any Security on or after the Stated Maturity thereof (or
in the case of a redemption,  on or after the  redemption  date) or (vii) reduce
the percentage in principal amount of Securities the consent of whose Holders is
required for any  modification or amendment of the Indenture,  or the consent of
whose Holders is required for any waiver of compliance  with certain  provisions
of the Indenture or certain Defaults or Events of Default thereunder.

     10.  DEFAULTS  AND  REMEDIES.  Events of Default  include:  (i)  default in
payment of  principal or premium on the  Securities;  (ii) default in payment of
interest on the Securities for 30 days; (iii) failure by the Company for 45 days
after notice to it to comply with any of its other  agreements  in the Indenture
or the Securities; (iv) any

                                       A-5


<PAGE>



acceleration  of  Indebtedness  of the  Company  or its  Subsidiaries  having an
outstanding   principal  amount  of  $50  million  or  a  failure  to  pay  such
Indebtedness  at its stated  maturity;  and (v) certain  events of bankruptcy or
insolvency. If an Event of Default occurs and is continuing,  the Trustee or the
Holders of at least 25% in principal amount of the then  outstanding  Securities
may declare all the Securities to be  immediately  due and payable for an amount
equal to 100% of the principal  amount of the Securities,  and premium,  if any,
plus  accrued  interest  to the date of  payment,  except that in the case of an
Event of Default  arising from certain events of bankruptcy or  insolvency,  all
outstanding Securities become due and payable immediately without further action
or notice.  Holders may not enforce the  Indenture or the  Securities  except as
provided in the Indenture.  The Trustee may require indemnity satisfactory to it
before  it  enforces  the  Indenture  or  the  Securities.  Subject  to  certain
limitations,  Holders of a majority in principal  amount of the then outstanding
Securities  may direct the Trustee in its  exercise  of any trust or power.  The
Trustee may withhold from Holders  notice of any  continuing  default  (except a
default in payment of principal or interest or that resulted from the failure of
the Company to comply with its  obligations  with respect to Holders'  rights to
require repurchase of Securities upon a Change in Control) if it determines that
withholding  notice is in their  interests.  The Company  must furnish an annual
compliance certificate to the Trustee.

     11. TRUSTEE  DEALINGS WITH COMPANY.  The Trustee,  in its individual or any
other capacity,  may make loans to, accept  deposits from, and perform  services
for the Company or its  Affiliates,  and may otherwise  deal with the Company or
its Affiliates, as if it were not Trustee.

     12.  NO  RECOURSE  AGAINST  OTHERS.  A  director,   officer,   employee  or
stockholder,  as such,  of the  Company  shall  not have any  liability  for any
obligations  of the Company  under the  Securities  or the  Indenture or for any
claim  based  on,  in  respect  of or by  reason  of such  obligations  or their
creation.  Each Holder by  accepting  a Security  waives and  releases  all such
liability. The waiver and release are part of the consideration for the issuance
of the Securities.

     13. AUTHENTICATION. This Security shall not be valid until authenticated by
the manual signature of the Trustee or an authenticating agent.

     14.  ABBREVIATIONS.  Customary  abbreviations  may be used in the name of a
Holder  or an  assignee,  such  as:  TEN  COM  (--tenants  in  common),  TEN ENT
(--tenants  by  the   entireties),   JT  TEN  (--joint  tenants  with  right  of
survivorship  and not as tenants in  common),  CUST  (--Custodian),  and U/G/M/A
(--Uniform Gifts to Minors Act).


     The Company  will  furnish to any Holder upon  written  request and without
charge a copy of the Indenture. Request may be made to:

             Integrated Health Services, Inc.
             10065 Red Run Boulevard
             Owings Mills, Maryland  21117
             Attention:  Secretary


                                       A-6


<PAGE>



                                 ASSIGNMENT FORM



To assign this Security, fill in the form below: (I) or (we) assign and transfer
this Security to

- ----------------------------------------------------------------
(Insert assignee's Soc. Sec. or Tax I.D. no.)

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

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

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

- ----------------------------------------------------------------
(Print or type assignee's name, address and zip code)

and  irrevocably  appoint  ________________________________________  to transfer
this Security on the books of the Company.  The agent may substitute  another to
act for him.


Date:  ______________

                                       Your Signature:__________________________
                                              (Sign exactly as your name appears
                                               on the face of this Security)




Signature Guarantee:____________________________


                                       A-7


<PAGE>



                       OPTION OF HOLDER TO ELECT PURCHASE



     If you  want to  elect  to have  this  Security  purchased  by the  Company
pursuant to Section 3.7 of the Indenture, check the box:

                                     YES [ ]

     If you want to elect to have only  part of the  Security  purchased  by the
Company pursuant to Section 3.7 of the Indenture,  state the amount you elect to
have purchased: $_______________.


Date:  ______________

                                       Your Signature:__________________________
                                              (Sign exactly as your name appears
                                               on the face of this Security)


Signature Guarantee:_______________________________


                                       A-8


<PAGE>



            [FORM OF SCHEDULE OF EXCHANGES OF DEFINITIVE SECURITIES2]


     The following  exchanges of a part of this Global  Security for  Definitive
Securities have been made.

<TABLE>
<CAPTION>

                  Amount of              Amount of             Principal Amount of
                  decrease in            increase in           this Global Security
                  Principal Amount       Principal Amount      following such           Signature of autho
   Date of        of this Global         of this Global        decrease (or             rized officer of
   Exchange       Security               Security              increase)                Trustee
   --------       ----------------       ----------------      --------------------     ------------------
<S>               <C>                    <C>                   <C>                      <C>
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.
</TABLE>

- --------
2    This  schedule  should be included only if the Security is issued in global
     form.

                                       A-9


<PAGE>



                                    EXHIBIT B


LEGEND FOR GLOBAL SECURITY:

     UNLESS  AND UNTIL IT IS  EXCHANGED  IN WHOLE OR IN PART FOR  SECURITIES  IN
DEFINITIVE  FORM, THIS SECURITY MAY NOT BE TRANSFERRED  EXCEPT AS A WHOLE BY THE
DEPOSITARY TO A NOMINEE OF THE  DEPOSITARY OR BY A NOMINEE OF THE  DEPOSITARY TO
THE DEPOSITARY OR ANOTHER  NOMINEE OF THE DEPOSITARY OR BY THE DEPOSITARY OR ANY
SUCH  NOMINEE  TO  A  SUCCESSOR  DEPOSITARY  OR  A  NOMINEE  OF  SUCH  SUCCESSOR
DEPOSITARY. UNLESS THIS SECURITY IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF
THE DEPOSITORY TRUST COMPANY (55 WATER STREET,  NEW YORK, NEW YORK) ("DTC"),  TO
THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER,  EXCHANGE OR PAYMENT,  AND
ANY SECURITY  ISSUED IS  REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME
AS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO
CEDE & CO. OR SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE
OF DTC),  ANY TRANSFER,  PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR
TO ANY PERSON IS WRONGFUL  INASMUCH AS THE REGISTERED OWNER HEREOF,  CEDE & CO.,
HAS AN INTEREST HEREIN.



                                       B-1

<PAGE>



               9 5/8% SENIOR SUBORDINATED NOTES DUE 2002, SERIES A


Cusip No.                                                                  $


INTEGRATED HEALTH SERVICES, INC.

promises to pay to



or registered assigns,

the principal sum of



Dollars  [or such  greater or lesser  amount as  indicated  on the  Schedule  of
Exchanges of Definitive Securities on the reverse hereof]* on May 31, 2002

Interest Payment Dates:    May 31 and November 30

Record Dates:              May 15 and November 15



Authentication:                                      Dated:               , 1995

This is one of the Securities referred to in the within-mentioned Indenture.

SIGNET TRUST COMPANY,
as Trustee                                      INTEGRATED HEALTH SERVICES, INC.



By:                                             By:
   --------------------------                      -----------------------------

               Authorized Officer


                                                By:
                                                   -----------------------------


                                                                          (SEAL)

- --------
*    This  phrase  should be included  only if the  Security is issued in global
     form.

                                       B-2

<PAGE>



               9 5/8% SENIOR SUBORDINATED NOTES DUE 2002, SERIES A


     1. INTEREST.  INTEGRATED HEALTH SERVICES, INC., a Delaware corporation (the
"Company"),  promises to pay interest on the  principal  amount of this Security
(which has been  exchanged for one of the  Company's 9 5/8% Senior  Subordinated
Notes due 2002 (the  "Rule  144A  Notes)) at 9 5/8% per annum from the date this
Security is issued until maturity. The Company will pay interest semiannually on
May 31 and November 30 of each year,  or if any such day is not a Business  Day,
on the next succeeding Business Day (each an "Interest Payment Date").  Interest
on the  Securities  will accrue from the most recent date on which  interest has
been paid or, if no interest  has been paid,  from the most recent date on which
interest was paid on the Rule 144A Notes or, if no interest was paid on the Rule
144A Notes, from the date of original issuance of the Rule 144A Notes; provided,
that if there is no  existing  Default in the payment of  interest,  and if this
Security is  authenticated  between a record date referred to on the face hereof
and the next succeeding  Interest Payment Date,  interest shall accrue from such
next  succeeding  Interest  Payment  Date;  provided,  further,  that the  first
Interest  Payment Date shall be November 30, 1995.  Interest will be computed on
the basis of a 360-day year of twelve 30-day months.

     2.  METHOD OF  PAYMENT.  The Company  will pay  interest on the  Securities
(except  defaulted  interest)  to the  Persons  who are  registered  Holders  of
Securities  at the close of  business  on the  record  date next  preceding  the
Interest  Payment Date,  even if such  Securities are canceled after such record
date and on or before such  Interest  Payment Date. In the case of a Security to
be repurchased by the Company in connection with a Change in Control  Repurchase
pursuant to paragraph 6, on or after an interest  payment  record date and prior
to the next Interest Payment Date, the registered  holder of such Security as of
such  record  date shall be  entitled  to accrued  and  unpaid  interest  to the
repurchase  date,  as provided in paragraph 6 below.  The Holder must  surrender
this Security to a Paying Agent to collect principal payments.  The Company will
pay the principal of,  premium,  if any, and interest on the Securities in money
of the United  States of America that at the time of payment is legal tender for
payment of public and private debts. The Company,  however, may pay such amounts
by check payable in such money mailed to a Holder's registered address.

     3. PAYING AGENT AND REGISTRAR. Initially, SIGNET TRUST COMPANY, the Trustee
under the  Indenture,  will act as Paying Agent and  Registrar.  The Company may
change any Paying Agent, Registrar or co-registrar without notice to any Holder.
The Company or any of its Subsidiaries may act in any such capacity.

     4.  INDENTURE.  The  Company  issued the  Securities  under an Amended  and
Restated  Supplemental  Indenture  dated  as of May  15,  1995,  as  subsquently
supplemented  by a Supplemental  Indenture dated as of June 13, 1996 and amended
and restated by a Second Amended and Restated Supplemental Indenture dated as of
May 15, 1997 ("Indenture") between the Company and the Trustee. The terms of the
Securities  include  those  stated in the  Indenture  and those made part of the
Indenture by reference to the Trust  Indenture  Act of 1939, as amended (15 U.S.
Code  ss.ss.  77aaa-  77bbbb),  as in  effect  on the date of  execution  of the
Indenture.  The  Securities  are  subject to all such  terms,  and  Holders  are
referred  to the  Indenture  and such Act for a  statement  of such  terms.  The
Securities  are  unsecured  general   obligations  of  the  Company  limited  to
$115,000,000 in aggregate  principal amount, plus amounts, if any, sufficient to
pay interest on outstanding  Securities as set forth in Paragraph 2 hereof.  The
Securities  will rank pari passu with the Company's 10 3/4% Senior  Subordinated
Notes due 2004 and the Company's 9 5/8% Senior Subordinated Notes due 2002.

     5. OPTIONAL  REDEMPTION.  The Securities are not redeemable  prior to their
Stated Maturity.

     6. RIGHT TO REQUIRE  REPURCHASE.  Following the occurrence of any Change in
Control,  each Holder will have the right to require that the Company repurchase
(a "Change in Control  Repurchase") such Holder's Securities at a purchase price
equal to 101% of the aggregate principal amount of the Securities,  plus accrued
and unpaid interest thereon,  if any, to the date of repurchase.  Within 30 days
after any Change in  Control,  the  Company or, at the  Company's  request,  the
Trustee, shall cause to be mailed a notice to all Holders notifying such Holders
of the  occurrence of such Change in Control,  the Holder's  rights arising as a
result thereof and the procedures to be followed by Holders  wishing to exercise
such rights.

     A Holder  of  Securities  may  exercise  the  right to  require a Change in
Control  Repurchase  after  receipt of notice of the  existence of such right by
completing the form entitled  "OPTION OF HOLDER TO ELECT PURCHASE"  appearing on
this  Security  and by  complying  with the other  procedures  set forth in such
notice.  Any portion of  Securities  with respect to which the Holder  wishes to
exercise such right must be in integral multiples of $1,000.

     7. DENOMINATIONS, TRANSFER, EXCHANGE. The Securities are in registered form
without coupons in denominations of $1,000 and integral multiples of $1,000. The
transfer of Securities  may be  registered  and  Securities  may be exchanged as
provided in the  Indenture.  The Registrar and the Trustee may require a Holder,
among other things, to

                                       B-3

<PAGE>



furnish appropriate endorsements and transfer documents and to pay any taxes and
fees required by law or permitted by the Indenture.

     8.  PERSONS  DEEMED  OWNERS.  The  registered  Holder of a Security  may be
treated as its owner for all purposes.

     9. AMENDMENTS AND WAIVERS. Subject to certain exceptions,  the Indenture or
the Securities may be amended or supplemented with the consent of the Holders of
at least a majority in principal amount of the Securities then outstanding,  and
any existing  default under,  or compliance with any provision of, the Indenture
may be waived  (other  than any  continuing  Default  or Event of Default in the
payment of interest or premium, if any, on or the principal of the Securities or
in respect of a  provision  under the  Indenture  which  cannot be  modified  or
amended  without the consent of the Holder of each  Security  then  outstanding)
with the  consent  of the  Holders  of a  majority  in  principal  amount of the
Securities then outstanding.  Without the consent of any Holder, the Company and
the Trustee may amend or supplement  the Indenture or the Securities to cure any
ambiguity,  defect  or  inconsistency;  to  provide  for the  assumption  of the
Company's  obligations  to  Holders in the case of a merger or  acquisition;  to
evidence and provide for the acceptance of appointment of any successor  Trustee
under the Indenture; to make any change that does not adversely affect the legal
rights of any Holder;  or to comply with the requirements of the Trust Indenture
Act of 1939, as amended.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of the Indenture (and the obligation of the Company to
obtain any such consent  otherwise  required from such Holder) may be subject to
the  requirement  that such  Holder  shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of the Indenture.

     Without  the consent of each Holder  affected,  the Company may not,  among
other  things,  (i) change  the  Stated  Maturity  of the  principal  of, or any
installment of interest on, any Security,  (ii) reduce the principal  amount of,
or premium, if any, or interest on, any Security, (iii) modify the subordination
provisions of the Indenture in a manner adverse to the Holders,  (iv) change the
place of payment  where,  or the coin or currency in which,  any Security or any
premium  or  interest  thereon is  payable,  (v)  adversely  affect the right of
Holders to require the Company to make a Change in Control  Repurchase or modify
the  obligations  of the  Company  to make an Asset  Sale  Offer or  modify  the
redemption  provisions  of the  Indenture,  (vi) impair the right of a Holder to
institute  suit for the  enforcement of payment of the principal of and premium,
if any, and interest on any Security on or after the Stated Maturity thereof (or
in the case of a redemption,  on or after the  redemption  date) or (vii) reduce
the percentage in principal amount of Securities the consent of whose Holders is
required for any  modification or amendment of the Indenture,  or the consent of
whose Holders is required for any waiver of compliance  with certain  provisions
of the Indenture or certain Defaults or Events of Default thereunder.

     10.  DEFAULTS  AND  REMEDIES.  Events of Default  include:  (i)  default in
payment of  principal or premium on the  Securities;  (ii) default in payment of
interest on the Securities for 30 days; (iii) failure by the Company for 45 days
after notice to it to comply with any of its other  agreements  in the Indenture
or the Securities;  (iv) any  acceleration of Indebtedness of the Company or its
Subsidiaries having an outstanding  principal amount of $50 million or a failure
to pay such  Indebtedness  at its stated  maturity;  and (v)  certain  events of
bankruptcy or insolvency.  If an Event of Default occurs and is continuing,  the
Trustee  or  the  Holders  of at  least  25% in  principal  amount  of the  then
outstanding  Securities may declare all the Securities to be immediately due and
payable for an amount equal to 100% of the principal  amount of the  Securities,
and premium,  if any, plus accrued interest to the date of payment,  except that
in the case of an Event of Default  arising from certain events of bankruptcy or
insolvency,  all  outstanding  Securities  become  due and  payable  immediately
without  further action or notice.  Holders may not enforce the Indenture or the
Securities  except  as  provided  in the  Indenture.  The  Trustee  may  require
indemnity satisfactory to it before it enforces the Indenture or the Securities.
Subject to certain limitations, Holders of a majority in principal amount of the
then outstanding  Securities may direct the Trustee in its exercise of any trust
or power. The Trustee may withhold from Holders notice of any continuing default
(except a default in payment of principal or interest or that  resulted from the
failure of the Company to comply with its  obligations  with respect to Holders'
rights to require  repurchase  of  Securities  upon a Change in  Control)  if it
determines  that  withholding  notice is in their  interests.  The Company  must
furnish an annual compliance certificate to the Trustee.

     11. TRUSTEE  DEALINGS WITH COMPANY.  The Trustee,  in its individual or any
other capacity,  may make loans to, accept  deposits from, and perform  services
for the Company or its  Affiliates,  and may otherwise  deal with the Company or
its Affiliates, as if it were not Trustee.

     12.  NO  RECOURSE  AGAINST  OTHERS.  A  director,   officer,   employee  or
stockholder,  as such,  of the  Company  shall  not have any  liability  for any
obligations  of the Company  under the  Securities  or the  Indenture or for any
claim based

                                       B-4

<PAGE>



on, in  respect  of or by reason of such  obligations  or their  creation.  Each
Holder by  accepting a Security  waives and  releases  all such  liability.  The
waiver  and  release  are  part of the  consideration  for the  issuance  of the
Securities.

     13. AUTHENTICATION. This Security shall not be valid until authenticated by
the manual signature of the Trustee or an authenticating agent.

     14.  ABBREVIATIONS.  Customary  abbreviations  may be used in the name of a
Holder  or an  assignee,  such  as:  TEN  COM  (--tenants  in  common),  TEN ENT
(--tenants  by  the   entireties),   JT  TEN  (--joint  tenants  with  right  of
survivorship  and not as tenants in  common),  CUST  (--Custodian),  and U/G/M/A
(--Uniform Gifts to Minors Act).


     The Company  will  furnish to any Holder upon  written  request and without
charge a copy of the Indenture. Request may be made to:

               Integrated Health Services, Inc.
               10065 Red Run Boulevard
               Owings Mills, Maryland  21117
               Attention:  Secretary


                                       B-5

<PAGE>



                                 ASSIGNMENT FORM


To assign this Security, fill in the form below: (I) or (we) assign and transfer
this Security to

- ----------------------------------------------------------------
(Insert assignee's Soc. Sec. or Tax I.D. no.)

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

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

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

- ----------------------------------------------------------------
(Print or type assignee's name, address and zip code)

and  irrevocably  appoint  ________________________________________  to transfer
this Security on the books of the Company.  The agent may substitute  another to
act for him.


Date:  ______________

                                       Your Signature:__________________________
                                              (Sign exactly as your name appears
                                               on the face of this Security)




Signature Guarantee:____________________________


                                       B-6

<PAGE>



                      OPTION OF HOLDER TO ELECT PURCHASE



     If you  want to  elect  to have  this  Security  purchased  by the  Company
pursuant to Section 3.7 of the Indenture, check the box:

                                     YES [ ]

     If you want to elect to have only  part of the  Security  purchased  by the
Company pursuant to Section 3.7 of the Indenture,  state the amount you elect to
have purchased: $_______________.


Date:  ______________

                                       Your Signature:__________________________
                                              (Sign exactly as your name appears
                                               on the face of this Security)


Signature Guarantee:_______________________________



                                       B-7

<PAGE>



            [FORM OF SCHEDULE OF EXCHANGES OF DEFINITIVE SECURITIES*]


     The following  exchanges of a part of this Global  Security for  Definitive
Securities have been made.

<TABLE>
<CAPTION>

                       Amount of              Amount of             Principal Amount of
                       decrease in            increase in           this Global Security
                       Principal Amount       Principal Amount      following such           Signature of autho
   Date of             of this Global         of this Global        decrease (or             rized officer of
   Exchange            Security               Security              increase)                Trustee
   --------            ----------------       ----------------      --------------------     ------------------
<S>                    <C>                    <C>                   <C>                      <C>
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.
</TABLE>

- --------
*    This  schedule  should be included only if the Security is issued in global
     form.

                                       B-8

<PAGE>



                                    EXHIBIT C

[FORM OF CERTIFICATE TO BE DELIVERED UPON EXCHANGE OR  REGISTRATION  OF TRANSFER
OF RULE 144A NOTES]

                      CERTIFICATE FOR EXCHANGE OR TRANSFER

Re:  9 5/8% Senior Subordinated Notes due 2002 ("Rule 144A Notes")

     This Certificate relates to $_________  Principal amount of Securities held
in *__________  book-entry or *__________  definitive form by  _________________
(the "Transferor").

The Transferor*:

     [ ] has  requested  the Trustee by written order to deliver in exchange for
its beneficial interest in the Global Security held by the Depositary a Security
or Securities in definitive,  registered form of authorized denominations and an
aggregate  principal  amount  equal to its  beneficial  interest  in such Global
Security (or the portion thereof indicated above); or

     [ ] has  requested the Trustee by written order to exchange or register the
transfer of a Security or Securities.

     In connection  with such request and in respect of each such security,  the
Transferor  does hereby  certify that  Transferor is familiar with the Indenture
relating  to the  above-captioned  Notes and as  provided in Section 2.5 of such
Indenture, the transfer of this Security does not require registration under the
Securities Act (as defined below) because*:

     [ ] Such  Security is being  acquired  for the  Transferor's  own  account,
without   transfer  (in   satisfaction  of  Section   2.5(a)(ii)(A)  or  Section
2.5(d)(i)(A) of the Indenture).

     [ ] Such Security is being transferred to a "qualified institutional buyer"
(as  defined  in rule 144A under the  Securities  Act of 1933,  as amended  (the
"Securities  Act")  in  reliance  on  Rule  144A  (in  satisfaction  of  Section
2.5(a)(ii)(B),  section  2.5(b)(i) or Section  2.5(d)(i)(B) of the Indenture) or
pursuant to an exemption from registration in accordance with Regulation S under
the  Securities  Act  (in  satisfaction  of  Section  2.5(a)(ii)(B)  or  Section
2.5(d)(i)(B) of the Indenture.)

     [ ] Such Security is being  transferred  in accordance  with Rule 144 under
the Securities Act, or pursuant to an effective registration statement under the
Securities Act.

     [ ] Such Security is being  transferred in reliance and in compliance  with
an exemption from the  registration  requirements  of the Securities  Act, other
than Rule 144A, 144 or 145 or Regulation S under the Securities  Act. An opinion
of counsel to the effect that such transfer does not require  registration under
the Securities Act accompanies this Certificate.

                           -----------------------------------------------------
                           [INSERT NAME OF TRANSFEROR]

                           By:__________________________________________________

Date:________________________


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


- --------
*    Check applicable box.

                                       C-1



================================================================================





                        INTEGRATED HEALTH SERVICES, INC.,

                             A DELAWARE CORPORATION,

                                    AS ISSUER


                                       TO

                              SIGNET TRUST COMPANY,

                                   AS TRUSTEE


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


                   AMENDED AND RESTATED SUPPLEMENTAL INDENTURE


                            Dated as of May 15, 1997


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



                                  $100,000,000


                   10 3/4% Senior Subordinated Notes due 2004



================================================================================




<PAGE>



                                         CROSS REFERENCE TABLE***

Trust Indenture
Act Section                                                    Indenture Section
- ---------------                                                -----------------
310(a)(1)               .....................................                7.9
   (a)(2)               .....................................                7.9
   (a)(3)               .....................................     Not Applicable
   (a)(4)               .....................................     Not Applicable
   (a)(5)               .....................................                7.9
   (b)                  .....................................                7.9
   (c)                  .....................................     Not Applicable
311(a)                  .....................................               ****
   (b)                  .....................................                 **
   (c)                  .....................................     Not Applicable
312                     .....................................                 **
313(a)                  .....................................                 **
   (b)(1)               .....................................     Not Applicable
   (b)(2)               .....................................                 **
   (c)                  .....................................                 **
   (d)                  .....................................                 **
314(a)                  .....................................            4.3,4.4
   (b)                  .....................................     Not Applicable
   (c)(1)               .....................................               11.3
   (c)(3)               .....................................     Not Applicable
   (d)                  .....................................     Not Applicable
   (e)                  .....................................               11.4
   (f)                  .....................................     Not Applicable
315(a)                  .....................................             7.1(2)
   (b)                  .....................................           7.5,11.2
   (c)                  .....................................             7.1(1)
   (d)                  .....................................             7.1(3)
   (e)                  .....................................               6.11
316(a)(last sentence)   .....................................                2.8
   (a)(1)(A)            .....................................                6.5
   (a)(1)(B)            .....................................                6.4
   (a)(2)               .....................................     Not Applicable
   (b)                  .....................................
    .........................................................................6.7
   (c)                  .....................................                9.4
317(a)(1)               .....................................                6.8
   (a)(2)               .....................................                6.9
   (b)                  .....................................                2.4
318(a)                  .....................................               11.1
- --------

***  This Cross-Reference Table is not part of the Indenture.

**** Included pursuant to Section 318(c) of the Trust Indenture Act of 1939.




<PAGE>


<TABLE>
<CAPTION>
                                             TABLE OF CONTENTS
                                                                                                Page
                                                ARTICLE 1.

                                       DEFINITIONS AND INCORPORATION
                                               BY REFERENCE

<S>     <C>                                                                                     <C>
Section 1.1        Definitions................................................................  1
Section 1.2        Other Definitions..........................................................  8
Section 1.3        Incorporation by Reference of Trust Indenture Act..........................  8
Section 1.4        Rules of Construction......................................................  8

                                       ARTICLE 2.

                                     THE SECURITIES

Section 2.1        Form and Dating............................................................  9
Section 2.2        Execution and Authentication...............................................  9
Section 2.3        Registrar and Paying Agent................................................. 10
Section 2.4        Paying Agent to Hold Money in Trust........................................ 10
Section 2.5        Registration of Transfer and Exchange...................................... 10
Section 2.6        Replacement Securities..................................................... 11
Section 2.7        Outstanding Securities..................................................... 11
Section 2.8        Treasury Securities........................................................ 11
Section 2.9        Temporary Securities....................................................... 11
Section 2.10       Cancellation............................................................... 12
Section 2.11       Defaulted Interest......................................................... 12
Section 2.12       Securities Issuable in the Form of a Global Security....................... 12

                                       ARTICLE 3.

                        OPTIONAL REDEMPTION AND ASSET SALE OFFER

Section 3.1        Notices to Trustee......................................................... 13
Section 3.2        Selection of Securities to Be Redeemed or Purchased........................ 14
Section 3.3        Notices to Holders......................................................... 14
Section 3.4        Effect of Notice of Redemption............................................. 16
Section 3.5        Deposit of Redemption Price or Purchase Price.............................. 16
Section 3.6        Securities Redeemed or Purchased in Part................................... 16
Section 3.7        Optional Redemption........................................................ 16
Section 3.8        Asset Sale Offer........................................................... 17

                                       ARTICLE 4.

                                        COVENANTS

Section 4.1        Payment of Securities...................................................... 17
Section 4.2        Maintenance of Office or Agency............................................ 18
Section 4.3        SEC Reports................................................................ 18
Section 4.4        Compliance Certificate..................................................... 18

                                        i



<PAGE>

<CAPTION>
                                                                                              Page

Section 4.5        Corporate Existence, Taxes, etc............................................ 19
Section 4.6        Stay, Extension and Usury Laws............................................. 19
Section 4.7        Change in Control.......................................................... 19
Section 4.8        Limitations on Asset Sales................................................. 20

                                          ii



<PAGE>

<CAPTION>
                                                                                              Page

                                                ARTICLE 5.

                                       SUCCESSORS
Section 5.1        Limitations on Mergers and Consolidations.................................. 21
Section 5.2        Successor Corporation Substituted.......................................... 21

                                                ARTICLE 6.

                                           DEFAULTS AND REMEDIES
Section 6.1        Events of Default.......................................................... 21
Section 6.2        Acceleration............................................................... 22
Section 6.3        Other Remedies............................................................. 23
Section 6.4        Waiver of Past Defaults.................................................... 23
Section 6.5        Control by Majority........................................................ 23
Section 6.6        Limitations on Suits....................................................... 23
Section 6.7        Rights of Holders to Receive Payment....................................... 24
Section 6.8        Collection Suit by Trustee................................................. 24
Section 6.9        Trustee May File Proofs of Claim........................................... 24
Section 6.10       Priorities................................................................. 24
Section 6.11       Undertaking for Costs...................................................... 25

                                       ARTICLE 7.

                                         TRUSTEE
Section 7.1        Duties of Trustee.......................................................... 25
Section 7.2        Rights of Trustee.......................................................... 26
Section 7.3        Individual Rights of Trustee............................................... 26
Section 7.4        Trustee's Disclaimer....................................................... 26
Section 7.5        Notice of Defaults......................................................... 27
Section 7.6        Compensation and Indemnity................................................. 27
Section 7.7        Replacement of Trustee..................................................... 27
Section 7.8        Successor Trustee by Merger, etc........................................... 28
Section 7.9        Eligibility; Disqualification.............................................. 28

                                       ARTICLE 8.

                                 DISCHARGE OF INDENTURE
Section 8.1        Termination of Company's Obligations....................................... 28
Section 8.2        Application of Trust Money................................................. 31
Section 8.3        Repayment to the Company................................................... 31
Section 8.4        Reinstatement.............................................................. 31

                                       ARTICLE 9.

                                       AMENDMENTS
Section 9.1        Without Consent of Holders................................................. 31
Section 9.2        With Consent of Holders.................................................... 32
Section 9.3        Compliance with Trust Indenture Act........................................ 33

                                          iii



<PAGE>

<CAPTION>
                                                                                              Page
Section 9.4        Revocation and Effect of Consents.......................................... 33
Section 9.5        Notation on or Exchange of Securities...................................... 33
Section 9.6        Trustee to Sign Amendments, etc............................................ 33

                                       ARTICLE 10.

                                      SUBORDINATION
Section 10.1       Securities Subordinated to Senior Indebtedness............................. 34
Section 10.2       Payment Over of Proceeds Upon Dissolution, Etc............................. 34
Section 10.3       Prior Payment to Senior Indebtedness Upon Acceleration of Securities....... 35
Section 10.4       No Payment Upon Certain Defaults with Respect to Senior Indebtedness....... 36
Section 10.5       Payment Permitted If No Default............................................ 36
Section 10.6       Subrogation to Rights of Holders of Senior Indebtedness.................... 37
Section 10.7       Provisions Solely to Define Relative Rights................................ 37
Section 10.8       Application by Trustee of Monies Deposited With It......................... 37
Section 10.9       Trustee to Effectuate Subordination........................................ 38
Section 10.10      No Waiver of Subordination Provisions...................................... 38
Section 10.11      Notice to Trustee.......................................................... 38
Section 10.12      Reliance on Judicial Order or Certificate of Liquidating Agent............. 39
Section 10.13      Trustee Not Fiduciary for Holders of Senior Indebtedness................... 39
Section 10.14      Rights of Trustee as Holder of Senior Indebtedness; Preservation of
                   Trustee's Rights........................................................... 39

                                       ARTICLE 11.

                                      MISCELLANEOUS
Section 11.1       Trust Indenture Act Controls............................................... 39
Section 11.2       Notices.................................................................... 40
Section 11.3       Certificate and Opinion as to Conditions Precedent......................... 40
Section 11.4       Statements Required in Certificate or Opinion.............................. 41
Section 11.5       Rules by Trustee and Agents................................................ 41
Section 11.6       Legal Holidays............................................................. 41
Section 11.7       No Recourse Against Others................................................. 41
Section 11.8       Governing Law.............................................................. 41
Section 11.9       No Adverse Interpretation of Other Agreements.............................. 41
Section 11.10      Successors................................................................. 42
Section 11.11      Severability............................................................... 42
Section 11.12      Counterpart Originals...................................................... 42
Section 11.13      Trustee as Paying Agent and Registrar...................................... 42
Section 11.14      Table of Contents, Headings, etc........................................... 42
Section 11.15      Effective Date............................................................. 42
SIGNATURES.................................................................................... 43

EXHIBIT A     FORM OF SECURITY
</TABLE>


                                       iv

<PAGE>

     AMENDED  AND  RESTATED  SUPPLEMENTAL  INDENTURE  dated as of May 15,  1997,
between   INTEGRATED  HEALTH  SERVICES,   INC.,  a  Delaware   corporation  (the
"Company"),  and SIGNET TRUST COMPANY, a Virginia  corporation,  as Trustee (the
"Trustee").


                             RECITALS OF THE COMPANY

     The Company duly  authorized  the issue of its 10 3/4% Senior  Subordinated
Notes  due  2004  (the  "Securities")  in  the  aggregate  principal  amount  of
$100,000,000,  and to provide the terms and conditions upon which the Securities
were  authenticated,  issued and delivered  the Company and the Trustee  entered
into an Indenture dated as of July 1, 1994 with regard to the Securities.

     On June 13, 1996, the Company, with the consent of Holders of not less than
a  majority  in  principal  amount  of the  Outstanding  Securities  executed  a
Supplemental  Indenture  amending the  Indenture  (such  Indenture,  as amended,
restated and supplemented through the date hereof, the "Original Indenture").

     The Company by Board Resolution has authorized, and the Holders of not less
than a majority in principal amount of the Company's Outstanding Securities have
by consents delivered to the Trustee consented to, the execution and delivery of
this Amended and Restated  Supplemental  Indenture  amending and  restating  the
Original Indenture.

     Each party  agrees as follows for the benefit of the other  parties and for
the equal and ratable benefit of the Holders of the Securities:


                                   ARTICLE 1.

                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

SECTION 1.1 DEFINITIONS

     "Affiliate"  of any  specified  Person means any other  Person  directly or
indirectly controlling, controlled by or under direct or indirect common control
with such specified Person. For purposes of this definition, "control" when used
with respect to any  specified  Person means the power to direct the  management
and  policies  of such  Person,  directly  or  indirectly,  whether  through the
ownership  of  voting  securities,  by  contract  or  otherwise,  and the  terms
"controlling" and "controlled" have meanings correlative to the foregoing.

     "Agent" means any Registrar or Paying Agent.

     "Allowed and Disallowed  Post-Commencement Interest and Expenses" means all
interest,  at  the  rate  provided  in  the  applicable  document  or  documents
(including  any rate  applicable  upon any default or event of  default,  to the
extent lawful), and all reimbursements,  costs, expenses and indemnities, to the
extent provided in the applicable document or documents,  accruing or claimed at
any time after  commencement of any insolvency or bankruptcy case or proceeding,
or any  receivership,  liquidation,  reorganization,  dissolution,  winding  up,
assignment for the benefit of creditors,  marshalling of assets and  liabilities
or  other   similar  case  or   proceeding,   whether  or  not  such   interest,
reimbursement,  cost or expense  is an allowed  claim  enforceable  against  the
Company in a case or proceeding  under  Bankruptcy Law or in any other such case
or proceeding.

     "Asset  Sale" for any Person  means the sale,  lease,  conveyance  or other
disposition  (including,  without  limitation,  by merger or consolidation,  and
whether by operation of law or otherwise) of any of that Person's assets


                                       -1-



<PAGE>



(including,  without limitation,  the sale or other disposition of Capital Stock
of any Subsidiary of such Person, whether by such Person or by such Subsidiary),
whether owned on the date hereof or hereafter acquired,  in one transaction or a
series of related  transactions,  in which such Person  and/or its  Subsidiaries
sell, lease,  convey or otherwise dispose of (i) all or substantially all of the
Capital Stock of any of such Person's Subsidiaries, (ii) assets which constitute
substantially  all of an operating unit or business of such Person or any of its
Subsidiaries,  or (iii) any health care facility;  provided,  however,  that the
following  shall not  constitute  Asset Sales:  (a) a  transaction  or series of
related  transactions  that results in a Change in Control,  or (b) transactions
between  the  Company  and any of its Wholly  Owned  Subsidiaries  or among such
Wholly  Owned  Subsidiaries  or (c)  transactions  in which  either (x) the fair
market value of the asset  disposed of does not exceed 2.5% of the  Consolidated
Tangible  Assets of the  Company or (y) the  Consolidated  EBITDA of the company
associated  with the asset disposed of does not exceed 2.5% of the  Consolidated
EBITDA of the Company.

     "Attributable  Indebtedness,"  when  used  with  respect  to any  Sale  and
Leaseback  Transaction  or an  operating  lease with  respect  to a health  care
facility means, as at the time of  determination,  the present value (discounted
at a rate equivalent to the interest rate implicit in the lease, compounded on a
semi-annual  basis) of the total  obligations of the lessee for rental payments,
after  excluding all amounts  required to be paid on account of maintenance  and
repairs,  insurance,  taxes, utilities and other similar expenses payable by the
lessee  pursuant  to the terms of the lease,  during the  remaining  term of the
lease  included in any such Sale and  Leaseback  Transaction  or such  operating
lease or until the earliest  date on which the lessee may  terminate  such lease
without  penalty or upon payment of a penalty (in which case the rental payments
shall include such penalty);  provided, that the Attributable  Indebtedness with
respect  to a Sale and  Leaseback  Transaction  shall  be no less  than the fair
market value of the property subject to such Sale and Leaseback Transaction.

     "Bank Agent" means  Citicorp USA,  Inc.,  as Agent for the Lenders,  or any
successor under the Credit Agreement.

     "Bank Debt" means all obligations of the Company and its Subsidiaries,  now
or  hereafter  existing  under the  Credit  Agreement,  whether  for  principal,
interest, reimbursement of amounts drawn under letters of credit issued pursuant
thereto, guarantees in respect thereof, fees, expenses, premiums, indemnities or
otherwise,   including  such   obligations   incurred  by  the  Company  or  its
Subsidiaries  in  connection  with  any  extension,  refunding,  refinancing  or
replacement of, or successor to, the Credit Agreement.

     "Bankruptcy  Law" means Title 11, U.S. Code or any similar federal or state
law for the relief of debtors.

     "Board of  Directors"  means the Board of  Directors  of the Company or any
authorized committee of the Board of Directors of the Company.

     "Business Day" means any day other than a Legal Holiday.

     "Capital Stock" of any Person means any and all shares, rights to purchase,
warrants or options  (whether or not currently  exercisable),  participation  or
other equivalents of or interests in (however designated) the equity (including,
without  limitation,  common stock,  preferred  stock and  partnership and joint
venture  interests)  of such  Person  (excluding  any debt  securities  that are
convertible into, or exchangeable for, such equity).

     "Capitalized Lease Obligations" of any Person means the obligations of such
Person  to pay  rent or  other  amounts  under a lease  that is  required  to be
capitalized  for financial  reporting  purposes in accordance with GAAP, and the
amount of such obligation shall be the capitalized  amount thereof determined in
accordance with GAAP.

     "Change  in  Control"  means any of the  following:  (i) the  sale,  lease,
conveyance or other  disposition  of all or  substantially  all of the Company's
assets as an entirety or substantially as an entirety to any Person or "group"


                                       -2-



<PAGE>



(within the meaning of Section  13(d)(3) of the  Exchange  Act) (other than to a
Permitted  Holder) in one or a series of transactions;  (ii) stockholders of the
Company shall approve any plan or proposal for the liquidation or dissolution of
the Company;  (iii)  consummation of any  consolidation or merger of the Company
(A) in which the Company is not the continuing or surviving  corporation  (other
than a consolidation  or merger with a Wholly Owned Subsidiary of the Company in
which  all  shares  of  Common  Stock  outstanding   immediately  prior  to  the
effectiveness  thereof are changed into or exchanged for the same consideration)
or (B)  pursuant  to which  the  Common  Stock  would be  converted  into  cash,
securities or other property,  in each case other than a consolidation or merger
of the Company in which the holders of the Common Stock immediately prior to the
consolidation or merger have, directly or indirectly, at least a majority of the
common stock of the continuing or surviving  corporation  immediately after such
consolidation or merger; or (iv) any transaction or series of transactions (as a
result of a tender offer,  merger,  consolidation  or otherwise) that results in
any Person  (other than a  Permitted  Holder),  including a "group"  (within the
meaning of Section  13(d)(3) of the  Exchange  Act) that  includes  such Person,
acquiring  "beneficial  ownership"  (as defined in Rule 13d-3 under the Exchange
Act),  directly or indirectly,  of 50% or more of the aggregate  voting power of
all classes of capital  stock of the Company  entitled to vote  generally in the
election of directors of the Company.

     "Common  Equity" of any Person means all Capital  Stock of such Person that
is generally entitled to (i) vote in the election of directors of such Person or
(ii) if such Person is not a corporation,  vote or otherwise  participate in the
selection of the governing body, partners,  managers or others that will control
the management and policies of such Person.

     "Company"  means  (i)  Integrated   Health   Services,   Inc.,  a  Delaware
corporation, and (ii) any successor of Integrated Health Services, Inc.

     "Consolidated  Amortization Expense" of any Person for any period means the
amortization expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated  Depreciation Expense" of any Person for any period means the
depreciation expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated   EBITDA"  of  any  Person   means,   with   respect  to  any
determination  date,  Consolidated  Net Income before  extraordinary  losses and
losses realized in connection with Asset Sales, plus (i) Consolidated Income Tax
Expense,  plus (ii) Consolidated  Depreciation  Expense, plus (iii) Consolidated
Amortization  Expense,  plus (iv) Consolidated  Interest  Expense,  plus (v) all
other  non-cash items  reducing  Consolidated  Net Income of such Person and its
Subsidiaries,  determined on a consolidated  basis in accordance  with GAAP, and
less all non-cash items  increasing  Consolidated  Net Income of such Person and
its Subsidiaries, determined on a consolidated basis in accordance with GAAP, in
each case, for such Person's prior four full fiscal quarters for which financial
results have been reported immediately preceding the determination date.

     "Consolidated  Income Tax  Expense" of any Person for any period  means the
provision  for  taxes  based  on  income  and  profits  of such  Person  and its
Subsidiaries  to the extent such income or profits  were  included in  computing
Consolidated Net Income of such Person for such period.

     "Consolidated  Interest  Expense"  of any Person  for any period  means the
Interest Expense of such Person and its Subsidiaries for such period, determined
on a consolidated  basis in accordance with GAAP, plus any dividends accrued for
such period on any Preferred  Stock of any Subsidiary not held by the Company or
any Wholly Owned Subsidiary.

                  "Consolidated  Net Income" of any Person for any period  means
the net income (or loss) of such  Person and its  Subsidiaries  for such  period
Idetermined on a consolidated basis in accordance with GAAP, without


                                       -3-



<PAGE>



giving effect to dividends on any series of preferred stock of any Subsidiary of
such Person,  whether or not in cash, to the extent such consolidated net income
was reduced thereby;  provided that there shall be excluded from such net income
(to the extent otherwise included  therein),  without  duplication:  (i) the net
income (or loss) of any Person (other than a Subsidiary of the referent  Person)
in which any Person  other than the referent  Person has an ownership  interest,
except to the extent  that any such  income has  actually  been  received by the
referent Person or any of its Wholly Owned Subsidiaries in the form of dividends
or  similar  distributions  during  such  period;  (ii)  except  to  the  extent
includible in the consolidated net income of the referent Person pursuant to the
foregoing  clause (i), the net income (or loss) of any Person that accrued prior
to the date that (a) such Person becomes a Subsidiary of the referent  Person or
is  merged  into  or  consolidated  with  the  referent  Person  or  any  of its
Subsidiaries  or (b) the assets of such  Person  are  acquired  by the  referent
Person or any of its Subsidiaries; (iii) the net income of any Subsidiary of the
referent  Person (other than a Wholly Owned  Subsidiary)  to the extent that the
declaration or payment of dividends or similar  distributions by such Subsidiary
of that income is not  permitted by operation of the terms of its charter or any
agreement,  instrument,  judgment,  decree, order, statute, rule or governmental
regulation  applicable to that Subsidiary during such period; (iv) any gain (but
not loss),  together  with any  related  provisions  for taxes on any such gain,
realized  during such period by the referent  Person or any of its  Subsidiaries
upon  (a)  the  acquisition  of any  securities,  or the  extinguishment  of any
Indebtedness, of the referent Person or any of its Subsidiaries or (b) any Asset
Sale by the referent Person or any of its  Subsidiaries;  (v) any  extraordinary
gain (but not extraordinary loss), together with any related provision for taxes
on any such  extraordinary  gain,  realized by the referent Person or any of its
Subsidiaries  during such  period;  and (vi) in the case of a successor  to such
Person by consolidation,  merger or transfer of its assets,  any earnings of the
successor prior to such merger, consolidation or transfer of assets.

     "Consolidated Tangible Assets" of any Person as of any date means the total
assets of such Person and its  Subsidiaries  (excluding any assets that would be
classified as "intangible  assets" under GAAP) on a  consolidated  basis at such
date,  as determined in  accordance  with GAAP,  less all write-ups  (other than
write-ups  in  connection  with  acquisitions)  subsequent  to the  date of this
Indenture  in the book value of any asset  (except any such  intangible  assets)
owned by such Person or any of its Subsidiaries.

     "Corporate  Trust  Office of the  Trustee"  shall be at the  address of the
Trustee  specified in Section 11.2 or such other address as the Trustee may give
notice to the Company.

     "Credit  Agreement"  means the  Revolving  Credit and Term Loan  Agreement,
dated  December 1, 1993, as amended as of December 21, 1993,  March 25, 1994 and
May 9, 1994,  among the Company and the Bank Agent,  Citibank,  N.A., as LC Bank
and the  other  financial  institutions  signatory  thereto,  together  with the
related documents thereto, including, without limitation, any security documents
and all exhibits and schedules thereto, and any agreement or agreements relating
to any extension,  refunding,  refinancing,  successor or replacement  facility,
whether or not with the same lenders, and whether or not the principal amount or
amount of letters of credit outstanding  thereunder or the interest rate payable
in respect  thereof shall be thereby  increased,  in each case as amended and in
effect from time to time.

     "Default" means any event, act or condition that is, or after notice or the
passage of time or both would be, an Event of Default.

     "Definitive Securities" means any Securities other than a Global Security.

     "Depositary"  means, with respect to Securities issuable or issued in whole
or in part in global form hereunder,  unless otherwise  specified by the Company
pursuant to Section 2.12, The Depository  Trust Company,  New York, New York, or
any successor thereto  registered as a clearing agency under the Exchange Act or
other applicable statute or regulation.

     "Exchange Act" means the Securities Exchange Act of 1934, as amended.


                                       -4-



<PAGE>



     "GAAP" means  generally  accepted  accounting  principles  set forth in the
opinions and  pronouncements of the Accounting  Principles Board of the American
Institute of Certified Public  Accountants and statements and  pronouncements of
the Financial  Accounting  Standards  Board or in such other  statements by such
other  entity as may be  approved  by a  significant  segment of the  accounting
profession of the United States, as in effect from time to time.

     "Global  Security"  means a Security  which is  executed by the Company and
authenticated  and delivered by the Trustee to the Depositary or pursuant to the
Depositary's instruction,  all in accordance with this Indenture and pursuant to
a written  order of the Company,  which shall be  registered  in the name of the
Depositary or its nominee and which shall represent, and shall be denominated in
an amount equal to the aggregate  principal  amount of, all of the Securities or
any  portion  thereof,  but not  including  any  Securities  that are no  longer
outstanding,  and having the same terms, including, without limitation, the same
original  issue  date,  date or  dates on which  principal  is due,  and rate of
interest.

     "Guarantee" by any Person means any obligation, contingent or otherwise, of
such Person  directly  or  indirectly  guaranteeing  any  Indebtedness  or other
obligation  of any other  Person and,  without  limiting the  generality  of the
foregoing, any obligation,  direct or indirect, contingent or otherwise, of such
Person (i) to purchase or pay (or  advance or supply  funds for the  purchase or
payment of) such  Indebtedness or other obligation of such other Person (whether
arising by virtue of  partnership  arrangements,  by agreement  to keepwell,  to
purchase assets, goods,  securities or services, to take-or-pay,  or to maintain
financial  statement  conditions  or  otherwise)  or (ii)  entered  into for the
purpose of assuring  in any other  manner the  obligee of such  Indebtedness  or
other  obligation of the payment thereof or to protect such obligee against loss
in respect thereof (in whole or in part); provided that the term Guarantee shall
not include  endorsements  for  collection or deposit in the ordinary  course of
business. The term "Guarantee" used as a verb has a corresponding meaning.

     "Hedging  Obligations"  of any Person means the  obligations of such Person
pursuant  to  any  interest  rate  swap  agreement,  foreign  currency  exchange
agreement,  interest rate collar agreement,  option or futures contract or other
similar agreement or arrangement  relating to interest rates or foreign exchange
rates.

     "Holder" means a Person in whose name a Security is registered.

     "Indebtedness" of any Person at any date means,  without  duplication:  (i)
all Bank Debt;  (ii) all other  Indebtedness  of such Person for borrowed  money
(whether or not the recourse of the lender is to the whole of the assets of such
Person  or only to a portion  thereof);  (iii) all  obligations  of such  Person
evidenced by bonds,  debentures,  notes or other similar  instruments;  (iv) all
obligations  of such  Person in respect  of  letters of credit or other  similar
instruments  (or  reimbursement  obligations  with  respect  thereto);  (v)  all
obligations of such Person with respect to Hedging Obligations (other than those
that fix the interest rate on variable rate indebtedness  otherwise permitted by
this  Indenture  or that  protect the Company  and/or its  Subsidiaries  against
changes in foreign exchange  rates);  (vi) all obligations of such Person to pay
the deferred  and unpaid  purchase  price of property or services,  except trade
payables and accrued expenses incurred in the ordinary course of business; (vii)
all Capitalized  Lease  Obligations of such Person;  (viii) all  Indebtedness of
others  secured  by a Lien on any  asset  of such  Person,  whether  or not such
Indebtedness  is  assumed  by such  Person;  (ix)  all  Indebtedness  of  others
guaranteed  by  such  Person  to the  extent  of  such  guarantee;  and  (x) all
Attributable Indebtedness.  The amount of Indebtedness of any Person at any date
shall be the outstanding  balance at such date of all unconditional  obligations
as  described  above;  and in the case of  clauses  (iv) and (ix),  the  maximum
liability of such Person for any such  contingent  obligations at such date and,
in the case of clause (viii), the amount of the Indebtedness secured.

     "Indenture" means this Amended and Restated Indenture, as amended from time
to time.

     "Interest  Expense" of any Person for any period means the aggregate amount
of interest which,  in accordance  with GAAP,  would be set opposite the caption
"interest  expense" or any like caption on an income  statement  for such Person
(including,  without  limitation or duplication,  imputed  interest  included in
Capitalized Lease Obligations,


                                       -5-



<PAGE>



all  commissions,  discounts  and other fees and  charges  owed with  respect to
letters of credit and bankers'  acceptance  financing,  the net costs associated
with Hedging  Obligations,  amortization  of financing  fees and  expenses,  the
interest  portion of any deferred payment  obligation,  amortization of discount
and all other non-cash interest expense).

     "Interest Payment Date" shall have the meaning assigned to such term in the
Securities.

     "Lien"  means,  with  respect to any asset,  any  mortgage,  lien,  pledge,
charge, security interest or other similar encumbrance of any kind in respect of
such  asset,  whether  or not  filed,  recorded  or  otherwise  perfected  under
applicable law (including,  without  limitation,  any conditional  sale or other
title retention  agreement,  and any financing lease in the nature thereof,  any
agreement  to sell,  and any  filing of, or  agreement  to give,  any  financing
statement  (other than notice filings not perfecting a security  interest) under
the Uniform Commercial Code (or equivalent statutes) of any jurisdiction).

     "Net  Proceeds"  with  respect  to any Asset  Sale  means (i) cash (in U.S.
dollars or freely  convertible into U.S. dollars) received by the Company or any
of its Subsidiaries from such Asset Sale (including,  without  limitation,  cash
received as  consideration  for the  assumption  or  incurrence  of  liabilities
incurred in connection with or in  anticipation  of such Asset Sale),  after (a)
provision for all income or other taxes measured by or resulting from such Asset
Sale or the transfer of the proceeds of such Asset Sale to the Company or any of
its Subsidiaries,  (b) payment of all brokerage commissions and the underwriting
and other fees and  expenses  related to such  Asset Sale and (c)  deduction  of
appropriate  amounts to be provided by the Company or any of its Subsidiaries as
a reserve, in accordance with GAAP, against any liabilities  associated with the
assets  sold or  otherwise  disposed  of in such Asset Sale and  retained by the
Company or any of its  Subsidiaries  after such Asset Sale  (including,  without
limitation,   pension  and  other   post-employment   benefit   liabilities  and
liabilities  related to  environmental  matters) or against any  indemnification
obligations  associated with the sale or other disposition of the assets sold or
otherwise  disposed  of in such Asset Sale and (ii) all  non-cash  consideration
received by the Company or any of its Subsidiaries from such Asset Sale upon the
liquidation or conversion of such consideration into cash.

     "Officer" means the Chief Executive  Officer,  the Chief Financial Officer,
the  Treasurer,  any  Assistant  Treasurer,  Controller,  Secretary  or any Vice
President of the Company.

     "Officers'  Certificate" means a certificate signed by two Officers, one of
whom must be the Company's Chief Executive Officer or Chief Financial Officer.

     "Opinion of Counsel"  means an opinion from legal counsel who is acceptable
to the  Trustee in its sole  discretion.  The  counsel  may be an employee of or
counsel to the Company or the Trustee.

     "Payment or Distribution in Respect of the Securities"  means, for purposes
of Article 10 hereof,  any  payment or  distribution  of any kind or  character,
whether in cash,  property  or  securities,  on  account  of the  payment of the
principal  of and  premium,  if  any,  and  interest  on any of the  Securities,
including,  without limitation,  any redemption or repurchase price paid for any
optional or mandatory redemption, Asset Sale Offer, Change in Control Repurchase
or other  repurchase  or  retirement  of the  Securities or any other payment on
account of the Securities  (including payments with respect to claims related to
the  issuance of the  Securities).  For purposes of this  definition,  the words
"cash,  property or securities" shall not be deemed to include securities of the
Company as reorganized or readjusted,  or securities of the Company or any other
corporation  provided for by a plan of reorganization or readjustment  which are
subordinated  in  right of  payment  to all  Senior  Indebtedness  which  may be
outstanding  to  substantially  the same extent as, or to a greater extent than,
the  Securities  are so  subordinated  as  provided  in  Article  10  and  which
securities  are not  subject to maturity or  mandatory  prepayment  prior to the
maturity of any Senior Indebtedness then outstanding.

     "Permitted Holder" means Robert N. Elkins and any group (within the meaning
of Section  13(d)(3) of the Exchange  Act) of which Mr.  Elkins is a member;  so
long as, with respect to any group, Mr. Elkins owns more


                                       -6-



<PAGE>



than 20% of the  total  voting  power of all  classes  of  Capital  Stock of the
acquiring  entity entitled to vote generally in the election of directors of the
acquiring entity.

     "Person" means any  individual,  corporation,  partnership,  joint venture,
incorporated  or  unincorporated   association,   joint-stock  company,   trust,
unincorporated   organization   or  government  or  other  agency  or  political
subdivision thereof or other entity of any kind.

     "Preferred  Stock"  means with  respect to any Person all Capital  Stock of
such Person which has a preference in liquidation  or a preference  with respect
to the payment of dividends.

     "Sale and  Leaseback  Transaction"  means with  respect to any  Person,  an
arrangement with any bank,  insurance  company or other lender or investor or to
which such  lender or  investor  is a party,  providing  for the leasing by such
Person or any of its Subsidiaries of any property or asset of such Person or any
of its  Subsidiaries  which  has been or is being  sold or  transferred  by such
Person or such  Subsidiary  to such  lender or investor or to any Person to whom
funds have been or are to be advanced by such lender or investor on the security
of such property or asset.

     "SEC" means the Securities and Exchange Commission.

     "Securities"  means  the  Securities  described  above  issued  under  this
Indenture.

     "Securities Act" means the Securities Act of 1933, as amended.

     "Senior  Indebtedness"  means the  principal  of and  premium,  if any, and
interest on and other amounts due on or in connection  with any  Indebtedness of
the  Company  (including,   without  limitation,   all  Allowed  and  Disallowed
Post-Commencement Interest and Expenses in respect of such Indebtedness) and any
amounts  with  respect  to Hedging  Obligations  that fix the  interest  rate on
variable rate indebtedness otherwise permitted by this Indenture, other than the
Securities,  the Company's 5 3/4% Convertible Senior Subordinated Debentures due
2001 and the Company's 6% Convertible  Subordinated Debentures due 2003, whether
outstanding  on the  date  of the  Original  Indenture  or  thereafter  created,
incurred or assumed,  unless,  in the case of any particular  Indebtedness,  the
instrument  creating  or  evidencing  the same or  pursuant to which the same is
outstanding  expressly  provides that such  Indebtedness  shall not be senior in
right of payment to the Securities;  provided that Senior  Indebtedness will not
include (i) any Indebtedness,  liability or obligation of the Company to (A) any
of its  Subsidiaries,  (B) trade  creditors or (C) any person arising out of any
lawsuit against the Company or any of its Subsidiaries or any settlement thereof
(other than any lawsuit or settlement  thereof  respecting  amounts payable with
regard  to  Senior  Indebtedness),  (ii) any  redemption  or other  payments  on
Preferred Stock, (iii) any Indebtedness  incurred in violation of the provisions
of the  Indenture or (iv) amounts  owing under  leases  (other than  Capitalized
Lease Obligations).

     "Significant  Subsidiary" has the meaning ascribed to it under Regulation C
promulgated under the Securities Act of 1933, as amended.

     "Stated  Maturity"  means,  when used with  respect to any  security or any
installment  of interest  thereon,  that date  specified in such security as the
fixed  date on which the  principal  of such  security  or such  installment  of
interest is due and payable.

     "Subsidiary" of any Person means (i) any corporation of which Common Equity
having  ordinary  voting  power to elect a  majority  of the  directors  of such
corporation  is owned by such  Person  directly  or  through  one or more  other
Subsidiaries  of such Person,  and (ii) any entity other than a  corporation  in
which such  Person,  directly  or  indirectly,  owns at least a majority  of the
Common Equity of such entity.

     "TIA" means the Trust  Indenture Act of 1939, as amended (15 U.S.C.  ss.ss.
77aaa-77bbbb),  as in effect on the date hereof (unless  otherwise  specifically
provided herein).


                                       -7-



<PAGE>



     "Trustee" means the party named as such above until a successor replaces it
in accordance  with the  applicable  provisions of this Indenture and thereafter
means the successor serving hereunder.

     "Trust  Officer"  means any  officer or  assistant  officer of the  Trustee
assigned by the Trustee to administer its corporate trust matters.

     "U.S. Government Obligations" means direct obligations of the United States
of  America  for the  payment  of which the full  faith and credit of the United
States of America is pledged.

     "Wholly  Owned  Subsidiary"  of any Person means (i) a Subsidiary  of which
100% of the Common Equity  (except for directors'  qualifying  shares or certain
minority  interests owned by other Persons solely due to local law  requirements
that there be more than one stockholder,  but which interest is not in excess of
what is required for such  purpose) is owned  directly by such Person or through
one or more other Wholly Owned  Subsidiaries  of such Person and (ii) any entity
other than a corporation in which such Person, directly or indirectly,  owns all
of the Common Equity of such entity.

SECTION 1.2 OTHER DEFINITIONS

                                                                       Defined
     Term                                                             in Section

     "Asset Sale Offer"............................................     4.8
     "Asset Sale Offer Period".....................................     3.8
     "Asset Sale Payment Date".....................................     3.8
     "Custodian"...................................................     6.1
     "Change in Control Repurchase"................................     4.7
     "Event of Default"............................................     6.1
     "Legal Holiday"...............................................    11.6
     "Payment Blockage Period".....................................    10.4
     "Paying Agent"................................................     2.3
     "Registrar"...................................................     2.3
     "Repurchase Date".............................................     4.7
     "Successor"...................................................     5.1


SECTION 1.3 INCORPORATION BY REFERENCE OF TRUST INDENTURE ACT

     Whenever this Indenture  refers to a provision of the TIA, the provision is
incorporated by reference in and made a part of this Indenture.

     All terms used in this  Indenture  that are defined by the TIA,  defined by
TIA  reference to another  statute or defined by SEC rule under the TIA have the
meanings so assigned to them.

SECTION 1.4 RULES OF CONSTRUCTION

     Unless the context otherwise requires:

     (1)  a term has the meaning assigned to it;

     (2)  an accounting term not otherwise  defined has the meaning  assigned to
          it in accordance with GAAP;


                                       -8-



<PAGE>



     (3)  "or" is not exclusive;

     (4)  words in the singular  include the plural,  and in the plural  include
          the singular;

     (5)  provisions apply to successive events and transactions;

     (6)  any amount may be negative; and

     (7)  "herein",  "hereof"  and other words of similar  import  refer to this
          Indenture  as a whole and not to any  particular  Article,  Section or
          Subdivision.


                                   ARTICLE 2.

                                 THE SECURITIES

SECTION 2.1 FORM AND DATING

     The Securities and the Trustee's  certificate  of  authentication  shall be
substantially  in the form of  Exhibit  A. The  Securities  may have  notations,
legends or  endorsements  required by law,  stock  exchange rule or usage.  Each
Security shall be dated the date of its authentication.  The Securities shall be
in denominations of $1,000 and integral multiples thereof.

                  The Securities may be initially issued either in the form of a
Global Security or Securities or in the form of Definitive Securities or both. A
Global Security shall  represent such of the outstanding  Securities as shall be
specified therein and shall provide that it shall represent the aggregate amount
of  outstanding  Securities  from  time to time  endorsed  thereon  and that the
aggregate amount of outstanding  Securities represented thereby may from time to
time  be  reduced  or  increased,  as  appropriate,  to  reflect  exchanges  and
redemptions.  Any  endorsement of a Global Security to reflect the amount of any
increase or decrease in the amount of outstanding Securities represented thereby
shall  be made by the  Trustee  or an agent  thereof,  at the  direction  of the
Trustee, in accordance with instructions given by the Holder thereof. Definitive
Securities  shall be  printed,  lithographed  or  engraved  or  produced  by any
combination of these methods on steel engraved borders or may be produced in any
other  manner  permitted  by the rules of any  securities  exchange on which the
Securities  may be listed,  all as  determined  by the officers  executing  such
Securities, as evidenced by their execution of such Securities.

     The terms and provisions contained in the Securities shall constitute,  and
are  hereby  expressly  made,  a part  of  this  Indenture  and  to  the  extent
applicable, the Company and the Trustee, by their execution and delivery of this
Indenture, expressly agree to such terms and provisions and to be bound thereby.

SECTION 2.2 EXECUTION AND AUTHENTICATION

     Two  Officers  shall  sign the  Securities  for the  Company  by  manual or
facsimile  signature.  The Company's  seal shall be reproduced on the Securities
and may be in facsimile form.

     If an Officer whose  signature is on a Security no longer holds that office
at the time the Security is authenticated,  the Security  nevertheless  shall be
valid.

     A Security shall not be valid until  authenticated  by the manual signature
of the Trustee. The signature shall be conclusive evidence that the Security has
been authenticated under this Indenture.



                                       -9-



<PAGE>



     The Trustee  shall  authenticate  Securities  for original  issue up to the
aggregate  principal  amount  stated in  paragraph 4 of the  Securities,  upon a
written  order of the Company  signed by two Officers.  The aggregate  principal
amount of Securities  outstanding  at any time may not exceed such amount except
as provided in Section 2.6.

     The Trustee may appoint an  authenticating  agent acceptable to the Company
to authenticate Securities.  An authenticating agent may authenticate Securities
whenever  the  Trustee  may  do  so.  Each   reference  in  this   Indenture  to
authentication  by  the  Trustee  includes  authentication  by  such  agent.  An
authenticating agent has the same rights as an Agent to deal with the Company or
an Affiliate.

SECTION 2.3 REGISTRAR AND PAYING AGENT

     The Company shall maintain or cause to be maintained through the Trustee or
such  other  Person as may be  appointed  hereunder  an  office or agency  where
Securities  may be  presented  for  registration  of  transfer  or for  exchange
("Registrar")  and an office or agency where  Securities  may be  presented  for
payment ("Paying Agent").  The Registrar shall keep a register of the Securities
and of  their  transfer  and  exchange.  The  Company  may  appoint  one or more
co-registrars  and one or more additional  paying agents.  The term  "Registrar"
includes any  co-registrar  and the term "Paying Agent"  includes any additional
paying  agent.  The Company  may change any Paying  Agent or  Registrar  without
notice to any  Holder.  The  Company  shall  notify the  Trustee of the name and
address  of any Agent not a party to this  Indenture.  If the  Company  fails to
appoint or maintain  another  entity as Registrar or Paying  Agent,  the Trustee
shall act as such.  The  Company  or any of its  Subsidiaries  may act as Paying
Agent or Registrar.

SECTION 2.4 PAYING AGENT TO HOLD MONEY IN TRUST

     The Company shall require each Paying Agent other than the Trustee to agree
in  writing  that the  Paying  Agent  will hold in trust for the  benefit of the
Holders or the  Trustee  all money held by the Paying  Agent for the  payment of
principal of or premium, if any, or interest on the Securities,  and will notify
the Trustee of any default by the Company in making any such payment.  While any
such default continues,  the Trustee may require a Paying Agent to pay all money
held by it to the Trustee. The Company at any time may require a Paying Agent to
pay all money held by it to the Trustee.  Upon payment over to the Trustee,  the
Paying Agent (if other than the Company or a  Subsidiary)  shall have no further
liability for the money. If the Company or a Subsidiary acts as Paying Agent, it
shall segregate and hold in a separate trust fund for the benefit of the Holders
all money held by it as Paying Agent.

SECTION 2.5 REGISTRATION OF TRANSFER AND EXCHANGE

     Where  Securities are presented to the Registrar with a request to register
a transfer of or to exchange the  Securities  for an equal  principal  amount of
Securities of other denominations,  the Registrar shall register the transfer or
make the exchange if its requirements for such  transactions are met;  provided,
however, that any Security presented or surrendered for registration of transfer
or exchange shall be duly endorsed or  accompanied  by a written  instruction of
transfer in a form  satisfactory  to the Company,  the Registrar and the Trustee
duly executed by the Holder thereof or the Holder's  attorney duly authorized in
writing. To permit  registrations of transfers and exchanges,  the Company shall
issue and the Trustee shall authenticate Securities at the Registrar's request.

     Without the prior written consent of the Company the Registrar shall not be
required  (i) to register  the  transfer of or to exchange  Securities  during a
period beginning at the opening of business on a Business Day 15 days before the
day of the mailing of a notice of redemption under Section 3.1 and ending at the
close of business on the day of such mailing or (ii) to register the transfer of
or to exchange  any  Security so selected  for  redemption  in whole or in part,
except the unredeemed portion of any Security being redeemed in part.

     No  service  charge  shall  be made to a  Holder  for any  registration  of
transfer or exchange (except as otherwise expressly  permitted herein),  but the
Company may require  payment of a sum  sufficient  to cover any  transfer tax or
similar  governmental  charge payable and any other expenses (including the fees
and expenses of the Trustee) in


                                      -10-



<PAGE>



connection  therewith  (other  than such  transfer  tax or similar  governmental
charge payable upon exchanges pursuant to Section 3.6 or 9.5).

     The transfer  and exchange of Global  Securities  or  beneficial  interests
therein shall be effected through the Depositary in accordance with the terms of
this Indenture and the procedures of the Depositary therefor.

SECTION 2.6 REPLACEMENT SECURITIES

     If any mutilated Security is surrendered to the Trustee, or the Company and
the Trustee receive evidence to their  satisfaction of the destruction,  loss or
theft of any Security, the Company shall issue and the Trustee, upon the written
order of the Company  signed by two Officers,  shall  authenticate a replacement
Security if the  Trustee's  requirements  are met. If required by the Trustee or
the Company, an indemnity bond must be supplied by the Holder that is sufficient
in the  judgment of the Trustee  and the  Company to protect  the  Company,  the
Trustee,  the Agent or any authenticating  agent from any loss which any of them
may suffer if a Security is replaced. The Company may charge for its expenses in
replacing a Security.

     Every replacement Security is an additional obligation of the Company.

SECTION 2.7 OUTSTANDING SECURITIES

     The Securities outstanding at any time are all the Securities authenticated
by the  Trustee  except for those  canceled  by it,  those  delivered  to it for
cancellation and those described in this Section 2.7 as not outstanding.

     If a  Security  is  replaced  pursuant  to  Section  2.6,  it  ceases to be
outstanding  unless  the  Trustee  receives  proof  satisfactory  to it that the
replaced Security is held by a bona fide purchaser.

     If the principal  amount of any Security is  considered  paid under Section
4.1, it ceases to be  outstanding  and interest on it ceases to accrue as of the
date it is deemed paid. Upon a "legal defeasance"  pursuant to Section 8.1(b) or
a "covenant  defeasance"  pursuant to Section  8.1(c),  the Securities  shall be
deemed to be  outstanding  or not  outstanding  as  provided  in the  applicable
Section 8.1(b) or 8.1(c).

                  Except as set forth in Section 2.8, a Security  does not cease
to be outstanding because the Company or an Affiliate holds the Security.

SECTION 2.8 TREASURY SECURITIES

     In  determining  whether the Holders of the  required  principal  amount of
Securities have concurred in any direction,  waiver or consent, Securities owned
by the Company or by any Person directly or indirectly controlling or controlled
by or  under  direct  or  indirect  common  control  with the  Company  shall be
considered  as  though  not  outstanding,   except  that  for  the  purposes  of
determining  whether  the  Trustee  shall be  protected  in  relying on any such
direction,  waiver or consent,  only  Securities  which the Trustee knows are so
owned shall be so disregarded.

SECTION 2.9 TEMPORARY SECURITIES

     Until definitive Securities are ready for delivery, the Company may prepare
and the Trustee shall authenticate  temporary  Securities.  Temporary Securities
shall  be  substantially  in the  form of  definitive  Securities  but may  have
variations  that the Company  considers  appropriate  for temporary  Securities.
Without  unreasonable  delay,  the Company  shall  prepare and the Trustee shall
authenticate definitive Securities in exchange for temporary Securities.



                                      -11-



<PAGE>



SECTION 2.10 CANCELLATION

     The  Company  at  any  time  may  deliver  Securities  to the  Trustee  for
cancellation.  The  Registrar  and Paying Agent shall forward to the Trustee any
Securities  surrendered  to them  for  registration  of  transfer,  exchange  or
payment. The Trustee shall cancel all Securities surrendered for registration of
transfer, exchange, payment,  replacement or cancellation,  and, upon request of
the  Company,  certification  of their  destruction  shall be  delivered  to the
Company  unless,  by a written order signed by two  Officers,  the Company shall
direct that canceled Securities be returned to it. The Company may not issue new
Securities to replace Securities that it has paid or that have been delivered to
the Trustee for cancellation.

SECTION 2.11 DEFAULTED INTEREST

     If the Company  defaults in a payment of  interest  on the  Securities,  it
shall pay the  defaulted  interest  in any  lawful  manner  plus,  to the extent
lawful,  interest  payable on the  defaulted  interest,  to the  Persons who are
Holders on a subsequent  special  record date, in each case at the rate provided
in the Securities.  The Company, with the consent of the Trustee, shall fix each
such special  record date and payment  date. At least 15 days before the special
record date, the Company (or, upon request of the Company,  the Trustee,  in the
name of and at the expense of the  Company)  shall mail to Holders a notice that
states the special record date, the related  payment date and the amount of such
interest to be paid.

SECTION 2.12 SECURITIES ISSUABLE IN THE FORM OF A GLOBAL SECURITY

     (a) If the Company shall  establish that the Securities are to be issued in
whole or in part in the form of one or more Global Securities,  then the Company
shall execute and the Trustee or an agent  thereof  shall,  in  accordance  with
Section 2.2 and the written order of the Company delivered to the Trustee or its
agent  thereunder,  authenticate and deliver such Global Security or Securities,
which (i) shall  represent,  and shall be  denominated in an amount equal to the
aggregate  principal amount of, the outstanding  Securities to be represented by
such Global Security or Securities, or such portion thereof as the Company shall
specify in a written order of the Company signed by two Officers,  (ii) shall be
registered in the name of the Depositary for such Global  Security or Securities
or its  nominee,  (iii)  shall be  delivered  by the Trustee or its agent to the
Depositary  or pursuant to the  Depositary's  instruction  and (iv) shall bear a
legend substantially to the following effect:  "Unless and until it is exchanged
in whole or in part for securities in definitive  form, this security may not be
transferred  except as a whole by the  Depositary to a nominee of the Depositary
or by a nominee of the  Depositary to the  Depositary or another  nominee of the
Depositary or by the Depositary or any such nominee to a successor Depositary or
a nominee of such successor Depositary.  Unless this certificate is presented by
an authorized  representative  of the Depositary to the Company or its agent for
registration of transfer,  exchange,  or payment,  and any certificate issued is
registered in the name of the nominee of the Depositary or in such other name as
is requested by an authorized  representative of the Depositary (and any payment
is made to the nominee of the Depositary or to such other entity as is requested
by an authorized  representative  of the Depositary),  ANY TRANSFER,  PLEDGE, OR
OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch
as the registered owner hereof,  the nominee of the Depositary,  has an interest
herein."

     (b)  Notwithstanding any other provision of this Section 2.12 or of Section
2.5, and subject to the provisions of paragraph (c) below, a Global Security may
be  transferred,  in whole but not in part and in the manner provided in Section
2.5, only to a nominee of the  Depositary  for such Global  Security,  or to the
Depositary,  or a  successor  Depositary  for such Global  Security  selected or
approved by the Company, or to a nominee of such successor Depositary.

     (c) (i) If at any time the  Depositary for a Global  Security  notifies the
Company that it is unwilling or unable to continue as Depositary for such Global
Security or if at any time the Depositary for the Securities  shall no longer be
eligible or in good  standing  under the  Exchange  Act or any other  applicable
statute or regulation, the Company


                                      -12-



<PAGE>



shall appoint a successor Depositary with respect to such Global Security.  If a
successor  Depositary  for such Global  Security is not appointed by the Company
within 90 days after the Company  receives  such notice or becomes aware of such
ineligibility,  the Company will execute,  and the Trustee or an agent  thereof,
upon  receipt of a written  order of the Company  signed by two Officers for the
authentication and delivery of individual  Definitive Securities in exchange for
such Global  Security,  will  authenticate  and deliver,  individual  Definitive
Securities of like tenor and terms in an aggregate principal amount equal to the
principal amount of the Global Security in exchange for such Global Security.

     (ii) The Company may at any time and in its sole discretion  determine that
the  Securities  issued in the form of one or more  Global  Securities  shall no
longer be represented by such Global  Security or Securities.  In such event the
Company will  execute,  and the Trustee,  upon receipt of a written order of the
Company signed by two Officers for the authentication and delivery of individual
Definitive  Securities in exchange in whole or in part for such Global Security,
will authenticate and deliver individual Definitive Securities of like tenor and
terms in an aggregate  principal  amount equal to the  principal  amount of such
Global   Security  or  Securities  in  exchange  for  such  Global  Security  or
Securities.

     (iii) If  specified  by the  Company  pursuant  to a  written  order of the
Company  signed  by two  Officers,  the  Depositary  for a Global  Security  may
surrender  such Global  Security in exchange in whole or in part for  individual
Definitive Securities of like tenor and terms on such terms as are acceptable to
the Company and such  Depositary.  Thereupon the Company shall execute,  and the
Trustee or an agent  thereof,  upon a written order of the Company signed by two
Officers,  shall  authenticate and deliver,  without service charge, (1) to each
Person  specified by such Depositary a new Definitive  Security or Securities of
like tenor and terms and of any  authorized  denomination  as  requested by such
Person  in an  aggregate  principal  amount  equal to and in  exchange  for such
Person's  beneficial  interest as  specified  by such  Depositary  in the Global
Security;  and (2) to such  Depositary  a new Global  Security of like tenor and
terms and in an authorized denomination equal to the difference, if any, between
the  principal  amount of the  surrendered  Global  Security  and the  aggregate
principal amount of Definitive Securities delivered to Holders thereof.

     (iv) In any exchange  provided for in (i), (ii) or (iii) of this  paragraph
(c),  the  Company  will  execute  and the  Trustee  or an  agent  thereof  will
authenticate and deliver individual  Definitive Securities in registered form in
authorized denominations.  Upon the exchange of the entire principal amount of a
Global Security for individual  Definitive  Securities,  such Global  Securities
shall be  cancelled  by the Trustee or an agent  thereof.  Except as provided in
(iii) above,  Definitive  Securities  issued in exchange  for a Global  Security
pursuant  to  this  Section  shall  be  registered  in  such  names  and in such
authorized denominations as the Depositary for such Global Security, pursuant to
instructions  from its  direct or  indirect  participants  or  otherwise,  shall
instruct  either the Trustee or the  Registrar.  Such  Trustee or the  Registrar
shall  deliver  such  Definitive  Securities  to the Persons in whose names such
Securities are so registered.


                                   ARTICLE 3.

                    OPTIONAL REDEMPTION AND ASSET SALE OFFER

SECTION 3.1 NOTICES TO TRUSTEE

     (a) If the Company  elects to redeem  Securities  pursuant to the  optional
redemption  provisions of Section 3.7, it shall furnish to the Trustee, at least
45 days but not  more  than 60 days  before  a  redemption  date,  an  Officers'
Certificate  stating  that the  Company  has  exercised  its  option  to  redeem
Securities  pursuant to Section 3.7 and setting forth the  redemption  date, the
principal amount of Securities to be redeemed and the redemption price.

     (b) If the Company offers to purchase Securities pursuant to the provisions
of Section  3.8,  it shall  furnish to the  Trustee,  on or before the fifth day
preceding  the  commencement  of  an  Asset  Sale  Offer  Period,  an  Officers'
Certificate  stating that the Company is making an Asset Sale Offer  pursuant to
Section 3.8 and setting forth


                                      -13-



<PAGE>



the Asset Sale Payment Date,  the principal  amount of Securities the Company is
offering to purchase  and the  purchase  price of such  Securities,  and further
setting forth a statement to the effect that (a) the Company has  consummated an
Asset Sale and (b) the conditions set forth in the first sentence of Section 4.8
have been satisfied.

SECTION 3.2 SELECTION OF SECURITIES TO BE REDEEMED OR PURCHASED

     (a) If less  than all of the  Securities  are to be  redeemed  pursuant  to
Section 3.7, the Trustee shall select the  Securities to be redeemed by lot. The
particular  Securities  to be  redeemed  shall  be  selected,  unless  otherwise
provided  herein,  prior to the date notice of redemption is required to be sent
by the  Trustee  from the  outstanding  Securities  not  previously  called  for
redemption.

     The Trustee  promptly shall notify the Company in writing of the Securities
selected for  redemption  and, in the case of any Security  selected for partial
redemption, the principal amount thereof to be redeemed. Securities and portions
of them selected shall be in amounts of $1,000 or integral  multiples of $1,000.
Provisions of this Indenture that apply to Securities called for redemption also
apply to portions of Securities called for redemption.

     (b) If less than all of the  Securities  are to be  purchased  pursuant  to
Section 3.8, the Trustee shall select the Securities to be purchased by lot. The
particular  Securities  to be  purchased  shall be  selected,  unless  otherwise
provided herein,  prior to the date notice of purchase is required to be sent by
the Trustee from the outstanding  Securities tendered pursuant to the Asset Sale
Offer.

     The Trustee  promptly shall notify the Company in writing of the Securities
selected  for  purchase  and, in the case of any  Security  selected for partial
purchase, the principal amount thereof to be purchased.  Securities and portions
of them selected shall be in amounts of $1,000 or integral  multiples of $1,000.
Provisions of this Indenture  that apply to Securities  called for purchase also
apply to portions of Securities called for purchase.

SECTION 3.3 NOTICES TO HOLDERS

     (a) At least 30 days but not more than 60 days  before a  redemption  date,
the  Company  shall  mail a notice to each  Holder  whose  Securities  are to be
redeemed.

     The notice shall identify the Securities to be redeemed and shall state:

          (1)  the redemption date;

          (2)  the redemption price;

          (3)  if any  Security is being  redeemed  in part,  the portion of the
               principal  amount of such Security to be redeemed and that, after
               the  redemption  date,  upon  surrender of such  Security,  a new
               Security  or  Securities   in  principal   amount  equal  to  the
               unredeemed portion will be issued;

          (4)  the name and address of the Paying Agent;

          (5)  that Securities  called for redemption must be surrendered to the
               Paying  Agent at the address  specified in such notice to collect
               the redemption price;

          (6)  that  interest  on  Securities  called for  redemption  ceases to
               accrue on and after the redemption date;



                                      -14-



<PAGE>



          (7)  the paragraph of the Securities  pursuant to which the Securities
               are being redeemed; and

          (8)  the  aggregate  principal  amount  of  Securities  that are being
               redeemed.


(b) If the Company determines to make an Asset Sale Offer as provided in Section
3.8, the Company shall promptly mail a notice to each Holder.

     The Notice shall state:


          (1)  that an Asset Sale Offer is being made  pursuant  to Section  3.8
               and the length of time the Asset Sale Offer will remain open;

          (2)  the purchase price and the Asset Sale Payment Date;

          (3)  the  aggregate  principal  amount of  Securities  the  Company is
               offering to purchase;

          (4)  that any  Security  not  tendered  or accepted  for payment  will
               continue to accrue interest;

          (5)  that any Security accepted for payment pursuant to the Asset Sale
               Offer  shall cease to accrue  interest on the Asset Sale  Payment
               Date;

          (6)  that Holders  electing to have a Security  purchased  pursuant to
               any Asset Sale Offer will be required to surrender  the Security,
               with the form  entitled  "Option of Holder to Elect  Purchase" on
               the reverse side of the  Security  completed,  to the Company,  a
               depositary, if appointed by the Company, or a Paying Agent at the
               address  specified in the notice prior to expiration of the Asset
               Sale Offer Period;

          (7)  that Holders will be entitled to withdraw  their  election if the
               Company,  depositary  or  Paying  Agent,  as  the  case  may  be,
               receives,  not later than the  expiration of the Asset Sale Offer
               Period,  or such  longer  period  as may be  required  by law,  a
               telegram,  telex,  facsimile transmission or letter setting forth
               the name of the Holder,  the principal amount of the Security the
               Holder delivered for purchase and a statement that such Holder is
               withdrawing his election to have the Security purchased;

          (8)  that, if the aggregate principal amount of Securities surrendered
               by Holders exceeds the aggregate  principal  amount of Securities
               offered to be purchased,  the Trustee shall select the Securities
               to be  purchased by lot (with such  adjustments  as may be deemed
               appropriate   by  the   Company  so  that  only   Securities   in
               denominations  of $1,000 or integral  multiples  thereof shall be
               purchased); and

          (9)  that Holders whose  Securities are purchased only in part will be
               issued  new   Securities   equal  in  principal   amount  to  the
               unpurchased portion of the Securities surrendered.





                                      -15-



<PAGE>



(c) At the  Company's  request,  the Trustee  shall give the notice  required in
Section  3.3(a) or 3.3(b) in the  Company's  name and at its expense;  provided,
however,  that the Company shall deliver to the Trustee,  at least 45 days prior
to  the  redemption  date  or  not  later  than  the  fifth  day  preceding  the
commencement  of an Asset Sale Offer  Period,  as the case may be, an  Officers'
Certificate  requesting  that the Trustee give such notice and setting forth the
information to be stated in such notice as provided in Section 3.3(a) or 3.3(b).

SECTION 3.4 EFFECT OF NOTICE OF REDEMPTION

     Once notice of redemption  under Section 3.7 is mailed,  Securities  called
for redemption  become due and payable on the redemption  date at the redemption
price.  However,  if a redemption date is on or before an Interest  Payment Date
and on or after the related record date, any interest  accrued and unpaid to the
redemption  date shall be paid on such  Interest  Payment  Date to the person in
whose name the  Security is  registered  at the close of business on such record
date and the only  remaining  right of the  Holders  of  Securities  called  for
redemption  shall be to receive the redemption  price  (excluding such interest)
upon surrender of such Securities to the Paying Agent.

SECTION 3.5 DEPOSIT OF REDEMPTION PRICE OR PURCHASE PRICE

     One  Business  Day prior to the  redemption  date or the Asset Sale Payment
Date, as the case may be, the Company shall deposit with the Trustee or with the
Paying Agent money  sufficient to pay the redemption price or the purchase price
of, and accrued  interest on, all Securities to be redeemed or purchased on that
date.  The Trustee or the Paying Agent shall return to the Company any money not
required for that purpose.

     If the  Company  complies  with the  preceding  paragraph,  interest on the
Securities  or portions  thereof to be redeemed or  purchased  (in the case of a
redemption, whether or not such Securities are presented for payment) will cease
to accrue on the applicable  redemption  date or Asset Sale Payment Date, as the
case may be. If any  Security  called for  redemption  shall not be so paid upon
surrender,  or if any Security to be purchased shall not be so paid on the Asset
Sale  Payment  Date,  because of the  failure of the  Company to comply with the
preceding paragraph, then interest will be paid on the unpaid principal from the
redemption  date or the Asset Sale Payment  Date, as the case may be, until such
principal is paid and on any interest not paid on such unpaid principal, in each
case, at the rate provided in the Securities and in Section 4.1.

SECTION 3.6 SECURITIES REDEEMED OR PURCHASED IN PART

                  Upon  surrender of a Security that is redeemed or purchased in
part, the Company shall issue and the Trustee shall  authenticate for the Holder
at the expense of the Company a new Security  equal in  principal  amount to the
unredeemed portion or the portion not purchased of the Security surrendered.

SECTION 3.7 OPTIONAL REDEMPTION

     The Company may redeem all or any of the Securities at any time on or after
July 15, 1999, at the following  redemption  prices (expressed as percentages of
principal  amount) plus accrued and unpaid  interest to the redemption  date, if
redeemed during the 12-month period beginning:


                                                            Optional
            Year                                        Redemption Price
            ----                                        ----------------
           July 15, 1999                                    105.375%
           July 15, 2000                                    103.583%
           July 15, 2001                                    101.792%
           July 15, 2002 and thereafter                         100%


                                      -16-



<PAGE>




     Any  redemption  pursuant to this Section 3.7 shall be made,  to the extent
applicable, in accordance with the provisions of Sections 3.1 through 3.6.

SECTION 3.8 ASSET SALE OFFER

     If the Company  determines  to make an Asset Sale Offer,  the Company shall
promptly  mail  (with  notice to the  Trustee)  or shall  cause the  Trustee  to
promptly mail (in the Company's name and at its expense) notice of an Asset Sale
Offer to each Holder of  Securities  as set forth in Section  3.3(b).  The Asset
Sale Offer  shall be deemed to have  commenced  on the date of such  mailing and
shall terminate 30 days after its  commencement  unless a longer offering period
is required by law (the  "Asset  Sale Offer  Period").  On or prior to the fifth
Business  Day  following  the  termination  of the Asset Sale Offer  Period (the
"Asset Sale Payment Date"), the Company shall purchase,  or cause the Trustee to
purchase,  and mail or  deliver  payment  for,  as  selected  by lot (with  such
adjustments as may be deemed  appropriate by the Company so that only Securities
in  denominations of $1,000 or integral  multiples  thereof shall be purchased),
from Holders  tendering their  Securities  pursuant to the Asset Sale Offer, the
amount of  Securities  required to be purchased  pursuant to Section 4.8. If the
Asset Sale Payment Date is on or after an interest payment record date and on or
before the related  interest  payment date, any accrued interest will be paid to
the person in whose name a Security  is  registered  at the close of business on
such record  date,  and no  additional  interest  will be payable to Holders who
tender  Securities  pursuant to the Asset Sale Offer. Any Asset Sale Offer shall
be conducted in compliance with applicable tender offer rules, including Section
14(e) of the Exchange Act and Rule 14e-1 thereunder.

     On or before  any Asset  Sale  Payment  Date,  the  Company,  to the extent
lawful,  shall (i) accept for payment, as selected by lot (with such adjustments
as may  be  deemed  appropriate  by the  Company  so  that  only  Securities  in
denominations  of $1,000 or  integral  multiples  thereof  shall be  purchased),
Securities or portions thereof tendered  pursuant to the Asset Sale Offer,  (ii)
if the  Company  appoints  a  depositary  or  Paying  Agent,  deposit  with such
depositary or Paying Agent money sufficient to pay the purchase price (including
all accrued interest on the purchased  Securities) of all Securities or portions
thereof so accepted,  (iii)  deliver or cause the  depositary or Paying Agent to
deliver to the Trustee  Securities  so accepted  and (iv)  deliver an  Officers'
Certificate  identifying the Securities or portions thereof accepted for payment
by the Company in accordance with the terms of this Section 3.8. The depositary,
the Paying  Agent or the  Company,  as the case may be,  promptly  shall mail or
deliver  to  each  tendering  Holder  an  amount  equal  to the  purchase  price
(including all accrued  interest on the purchased  Securities) of the Securities
tendered by such  Holder and  accepted  by the  Company  for  purchase,  and the
Trustee  promptly shall  authenticate  and mail or deliver to such Holders a new
Security equal in principal  amount to any  unpurchased  portion of the Security
surrendered.  Any  Securities  not so  accepted  promptly  shall  be  mailed  or
delivered  by the  Company to the Holder  thereof.  The  Company  will  publicly
announce the results of the Asset Sale Offer on the Asset Sale Payment Date.

     Other than as  specifically  provided  in this  Section  3.8,  any offer to
purchase  Securities  pursuant to this  Section 3.8 shall be made in  accordance
with the other provisions of this Indenture.


                                   ARTICLE 4

                                    COVENANTS

SECTION 4.1 PAYMENT OF SECURITIES

     The Company shall pay the principal of and premium, if any, and interest on
the  Securities  on the  dates and in the  manner  provided  in the  Securities.
Principal,  premium,  if any, and interest shall be considered  paid on the date
due if the Paying Agent,  other than the Company or a Subsidiary of the Company,
holds on that date money deposited by the Company  designated for and sufficient
to pay all principal, premium, if any, and interest then due.



                                      -17-



<PAGE>



     The Company  shall pay interest  (including  post-petition  interest in any
proceeding  under any Bankruptcy Law) on overdue  principal at the rate equal to
the interest rate on the Securities to the extent lawful;  it shall pay interest
on overdue  payments of premium,  if any, or installments  of interest  (without
regard to any applicable grace period) at the same rate to the extent lawful.

SECTION 4.2 MAINTENANCE OF OFFICE OR AGENCY

     The Company  will  maintain  an office or agency  where  Securities  may be
surrendered  for  registration  of transfer or  exchange  and where  notices and
demands to or upon the Company with respect of the Securities and this Indenture
may be served  pursuant  to Section  2.3.  The  Company  hereby  designates  the
Corporate Trust Office of the Trustee as such office or agency of the Company.

     The Company also from time to time may  designate one or more other offices
or agencies where the Securities may be presented or surrendered  for any or all
such purposes and from time to time may rescind such  designations.  The Company
will give  prompt  written  notice to the  Trustee  of any such  designation  or
rescission and of any change in the location of any such other office or agency.

SECTION 4.3 SEC REPORTS

     (a) The Company  shall  remain  subject to the  reporting  requirements  of
Section 13 or Section 15(d) of the Exchange Act and shall  continue to file with
the SEC such annual  reports and such  information,  documents and other reports
which are specified in Sections 13 and 15(d) of the Exchange Act.

     (b) The Company shall file with the Trustee and cause to be provided to the
Holders,  within 15 days  after it files  the same  with the SEC,  copies of its
annual reports and of the information, documents and other reports (or copies of
such  portions of any of the  foregoing as the SEC may by rules and  regulations
prescribe)  which the  Company or any  subsidiary  of the Company is required to
file with the SEC  pursuant  to Section  13 or 15(d) of the  Exchange  Act.  The
Company shall cause any annual report  furnished to its  stockholders  generally
and any quarterly or other financial reports furnished by it to its stockholders
generally  to be filed  with the  Trustee  and  mailed to the  Holders  at their
addresses appearing in the register of Securities maintained by the Registrar.

SECTION 4.4 COMPLIANCE CERTIFICATE

     (a) The Company shall deliver to the Trustee, within 120 days after the end
of each fiscal year of the  Company,  an  Officers'  Certificate  stating that a
review  of the  activities  of the  Company  and  its  Subsidiaries  during  the
preceding  fiscal  year has been  made  under  the  supervision  of the  signing
Officers  with a view to  determining  whether the  Company has kept,  observed,
performed  and  fulfilled  its  obligations  under this  Indenture,  and further
stating,  as to each such Officer signing such certificate,  that to the best of
his knowledge  the Company has kept,  observed,  performed  and  fulfilled  each
covenant contained in this Indenture and is not in default in the performance or
observance  of any of the terms,  provisions  and  conditions  hereof  (or, if a
Default or Event of Default shall have occurred, describing all such Defaults or
Events of Default of which he may have  knowledge and what action the Company is
taking or proposes  to take with  respect  thereto)  and that to the best of his
knowledge  no event has  occurred  and remains in  existence  by reason of which
payments on account of the principal of or premium, if any, or interest, if any,
on the Securities  are prohibited or, if such event has occurred,  a description
of the event and what  action  the  Company is taking or  proposes  to take with
respect thereto.

     (b) So long as (i) not contrary to the then current  recommendations of the
American  Institute  of  Certified  Public  Accountants  or (ii)  the  Company's
independent  public  accountants  do not have in  effect a  policy,  of  general
applicability  with respect to their  clients,  that such  accountants  will not
prepare  statements  on the subjects  specified  below,  the year-end  financial
statements  delivered  pursuant to Section 4.3 shall be accompanied by a written
statement of the Company's  independent  public accountants (who shall be a firm
of established national reputation) that


                                      -18-



<PAGE>



in  making  the  examination  necessary  for  certification  of  such  financial
statements  nothing has come to their  attention that would lead them to believe
that the Company has violated any  provisions  of Article 4 or 5 or, if any such
violation has occurred,  specifying the nature and period of existence  thereof,
it being  understood  that such  accountants  shall not be  liable  directly  or
indirectly  to any  Person  for any  failure  to  obtain  knowledge  of any such
violation.

     (c) The Company,  so long as any of the  Securities are  outstanding,  will
deliver to the Trustee, forthwith upon any Officer becoming aware of any Default
or Event of Default under this Indenture,  an Officers'  Certificate  specifying
such  Default  or Event of  Default  and what  action  the  Company is taking or
proposes to take with respect thereto.

SECTION 4.5 CORPORATE EXISTENCE, TAXES, ETC.

     Subject to the  provisions of Section 5.1, the Company shall do or cause to
be done all things  necessary  to preserve and keep in full force and effect its
rights (charter and statutory), licenses and franchises; provided, however, that
the Company shall not be required to preserve any such right or franchise if the
Board of Directors  shall determine that the  preservation  thereof is no longer
desirable  in the conduct of the business of the Company and the loss thereof is
not disadvantageous in any material respect to the Holders.

SECTION 4.6 STAY, EXTENSION AND USURY LAWS

     The Company  covenants  (to the extent that it may  lawfully do so) that it
will not at any time insist  upon,  plead or in any manner  whatsoever  claim or
take the  benefit or  advantage  of any stay,  extension  or usury law  wherever
enacted,  now or at any time  hereafter in force,  that may affect the Company's
obligation  to pay the  Securities;  and the  Company (to the extent that it may
lawfully do so) hereby expressly waives all benefit or advantage of any such law
insofar as such law applies to the  Securities,  and covenants that it will not,
by resort to any such law,  hinder,  delay or impede the execution of any power,
right or remedy  herein  granted to the Trustee,  but will suffer and permit the
execution  of every such  power,  right or remedy as though no such law has been
enacted.

SECTION 4.7 CHANGE IN CONTROL

     (a)  Following the  occurrence  of any Change in Control,  each Holder will
have the right, at such Holder's option, to require that the Company purchase (a
"Change  in Control  Repurchase"),  and upon the  exercise  of such  right,  the
Company shall, subject to the provisions of Section 10.3 hereof,  purchase,  all
or any part of such Holder's  Securities on a date (the "Repurchase  Date") that
is no  earlier  than 30 days nor later  than 60 days after the date on which the
Company  gives  notice  of a Change in  Control  as  provided  in (b) below at a
purchase  price  equal  to  101%  of  the  aggregate  principal  amount  of  the
Securities,  plus accrued and unpaid interest thereon, if any, to the Repurchase
Date.

     (b) Within 30 days after any Change in Control, the Company (with notice to
the Trustee),  or the Trustee at the Company's request, will mail or cause to be
mailed  to all  Holders  on the date of the  Change  in  Control a notice of the
occurrence  of such Change in Control and of the  Holders'  rights  arising as a
result  thereof.  Such  notice,  which  shall  govern the terms of the Change in
Control Repurchase, shall state:

          (1) that a Change in Control has occurred and that such Holder has the
     right to require the Company to repurchase such Holder's Notes in cash;

          (2) the  Repurchase  Date (which  will be no earlier  than 30 days nor
     later than 60 days from the date such notice is mailed);

          (3) the purchase price for the repurchase;

          (4) the date by which the repurchase right must be exercised; and


                                      -19-



<PAGE>



          (5) the instructions  determined by the Company,  consistent with this
     Section  4.7,  that a Holder  must  follow in order to have its  Securities
     repurchased.


     (c) To exercise a repurchase  right,  a Holder shall deliver to the Company
(or a depositary  or Paying Agent  designated by the Company for such purpose in
the notice referred to in (b) above),  on or before the close of business on the
Repurchase Date, the Security or Securities with respect to which the repurchase
right is being  exercised,  duly endorsed for transfer to the Company,  with the
form  entitled  "Option  of Holder to Elect  Purchase"  on the  reverse  of each
Security so delivered  completed.  Holders  shall be entitled to withdraw  their
election if the Company (or the  depositary  or Paying Agent  designated  by the
Company for the purpose of receiving  such  election)  receives,  not later than
five Business Days prior to the Repurchase  Date, a telegram,  telex,  facsimile
transmission  or letter  setting  forth the name of the  Holder,  the  principal
amount of the Security or  Securities  the Holder  delivered  for purchase and a
statement that such Holder is withdrawing  its election to the have the Security
or Securities purchased.

     (d) In the event a repurchase  right shall be exercised in accordance  with
the terms  hereof,  then subject to Article 10, the Company shall on or promptly
following  the  Repurchase  Date pay or  cause to be paid in cash to the  Holder
thereof  the  repurchase  price of the  Security or  Securities  as to which the
repurchase  right has been exercised.  In the event that the repurchase right is
exercised with respect to less than the entire principal amount of a surrendered
Security,  the Company  shall execute and deliver to the Trustee and the Trustee
shall  authenticate  for  issuance  in the name of the Holder a new  Security or
Securities in the aggregate  principal  amount of the  unrepurchased  portion of
such surrendered security.

     (e) If the Repurchase Date is on or before an Interest  Payment Date and on
or after the  related  record  date,  any  interest  accrued  and  unpaid to the
Repurchase  Date  will be paid to the  Person  in  whose  name the  Security  is
registered  at the close of  business  on such record  date,  and no  additional
interest will be payable to Holders who exercise their repurchase right pursuant
to this Section 4.7.

     (f) Any Change in Control  Repurchase shall be conducted in compliance with
applicable  tender offer rules,  including Section 14(e) of the Exchange Act and
Rule 14(e)(1)  thereunder.  The Change in Control Repurchase may not be modified
or conditioned by the Company in any manner.

SECTION 4.8 LIMITATIONS ON ASSET SALES

     The Company  shall not,  and shall not permit any of its  Subsidiaries  to,
consummate  any Asset Sale  unless (i) the Company or its  Subsidiaries  receive
consideration  at the time of such Asset Sale at least  equal to the fair market
value of the assets or Capital Stock  included in such Asset Sale (as determined
in good faith by the Board of Directors, whose determination shall be conclusive
and  evidenced  by a board  resolution)  and  (ii)  not  less  than  50% of such
consideration  is in the form of cash.  The Net  Proceeds of Asset Sales  shall,
within 360 days,  (A) be  reinvested  in the lines of business of the Company or
any of its Subsidiaries immediately prior to such investment;  (B) be applied to
the payment of the principal of, and interest on,  Senior  Indebtedness;  (C) be
utilized  to make any  Investment  in any  other  Person  permitted  under  this
Indenture;  or (D) be applied to an offer (an "Asset  Sale  Offer") to  purchase
outstanding Securities. In any such Asset Sale Offer, the Company shall offer to
purchase Securities,  as selected by lot (with such adjustments as may be deemed
appropriate by the Company so that only Securities in denominations of $1,000 or
integral  multiples  thereof shall be  purchased),  at a purchase price equal to
100% of the  aggregate  principal  amount of the  Securities,  plus  accrued and
unpaid  interest  to the  date of  purchase,  in the  manner  set  forth in this
Indenture.  Any Asset Sale Offer will be conducted in compliance with applicable
tender offer rules,  including  Section 14(e) of the Exchange Act and Rule 14e-1
thereunder.  Any Net Proceeds remaining  immediately after the completion of any
Asset Sale Offer may be used by the Company or its  Subsidiaries for any purpose
not inconsistent with the other provisions of this Indenture.




                                      -20-



<PAGE>

                                    ARTICLE 5

                                   SUCCESSORS

SECTION 5.1 LIMITATIONS ON MERGERS AND CONSOLIDATIONS

     The Company shall not  consolidate  or merge with or into, or sell,  lease,
convey or otherwise dispose of all or substantially all of its assets, or assign
any of its obligations hereunder or under the Securities, to any Person unless:

          (i) the Person formed by or surviving such consolidation or merger (if
     other than the  Company),  or to which  sale,  lease,  conveyance  or other
     disposition or assignment shall be made (collectively, the "Successor"), is
     a corporation organized and existing under the laws of the United States or
     any State thereof or the District of Columbia, and the Successor assumes by
     supplemental  indenture  in a form  satisfactory  to the Trustee all of the
     obligations of the Company hereunder and under the Securities; and

          (ii) immediately after giving effect to such  transaction,  no Default
     or Event of Default shall have occurred and be continuing.

     The Company shall deliver to the Trustee prior to the  consummation  of the
proposed  transaction an Officers'  Certificate  to the foregoing  effect and an
Opinion of Counsel stating that the proposed  transaction and such  supplemental
indenture comply with this Indenture.

SECTION 5.2 SUCCESSOR CORPORATION SUBSTITUTED

     Upon any consolidation or merger,  or any sale, lease,  conveyance or other
disposition  of all or  substantially  all of the  assets of the  Company or any
assignment  of  its  obligations  under  this  Indenture  or the  Securities  in
accordance with Section 5.1, the Successor formed by such  consolidation or into
or with which the Company is merged or to which such sale, lease,  conveyance or
other  disposition  or assignment  is made shall succeed to, and be  substituted
for, and may exercise every right and power of, the Company under this Indenture
with the same effect as if such  Successor has been named as the Company  herein
and the predecessor  Company, in the case of a sale, lease,  conveyance or other
disposition or  assignment,  shall be released from all  obligations  under this
Indenture and the Securities.


                                    ARTICLE 6

                              DEFAULTS AND REMEDIES

SECTION 6.1 EVENTS OF DEFAULT

     An "Event of Default" occurs if:

          (1) the Company  defaults in the payment of the  principal  of, or any
     premium on, any Security when the same becomes due and payable,  whether at
     Stated Maturity, upon redemption, upon acceleration or otherwise;

          (2) the Company  defaults  in the payment of interest on any  Security
     when the same  becomes  due and payable  and the  Default  continues  for a
     period  of 30 days  (even if such  payment  is  prohibited  by  Article  10
     hereof);



                                      -21-



<PAGE>


          (3)  the  Company  fails  to  comply  with  any of its  agreements  or
     covenants in, or provisions  of, the  Securities or this Indenture and such
     failure continues for the period and after the notice specified below;

          (4) any acceleration of the maturity of Indebtedness of the Company or
     its Subsidiaries  having an outstanding  principal amount of at least $50.0
     million  or a failure  to pay such  Indebtedness  at its  Stated  Maturity;
     provided  that such  acceleration  or failure to pay is not cured within 10
     days after such acceleration or failure to pay;

          (5) the Company or any of its Significant  Subsidiaries pursuant to or
     within the meaning of any Bankruptcy Law:

               (a)  commences a voluntary case,

               (b)  consents  to the entry of an order for relief  against it in
                    an involuntary case,

               (c)  consents to the  appointment of a Custodian of it or for all
                    or substantially all of its property, or

               (d)  makes a general assignment for the benefit of its creditors;
                    or

          (6) a court of competent  jurisdiction enters an order or decree under
     any Bankruptcy Law that:

               (a)  is for relief against the Company or any of its  Significant
                    Subsidiaries as debtor in an involuntary case,

               (b)  appoints  a   Custodian   of  the  Company  or  any  of  its
                    Significant   Subsidiaries   or  a  Custodian   for  all  or
                    substantially  all of the  property of the Company or any of
                    its Significant Subsidiaries, or

               (c)  orders  the  liquidation  of  the  Company  or  any  of  its
                    Significant Subsidiaries,

     and the order or decree remains unstayed and in effect for 60 days.

     The term "Custodian" means any receiver,  trustee, assignee,  liquidator or
similar official under any Bankruptcy Law.

     The Trustee  shall not be deemed to know of a Default  unless it has actual
knowledge  of such  Default or  receives  written  notice of such  Default  with
specific reference to such Default.

     A Default  under  clause (3) is not an Event of Default  until the  Trustee
notifies  the  Company,  or the Holders of at least 25% in  aggregate  principal
amount of the then outstanding Securities notify the Company and the Trustee, of
the  Default  and the  Company  does not cure the  Default  within 45 days after
receipt of the notice.  The notice must specify the  Default,  demand that it be
remedied and state that the notice is a "Notice of Default."

SECTION 6.2 ACCELERATION

     If an Event of Default  (other than an Event of Default with respect to the
Company specified in clause (5) or (6) of Section 6.1) occurs and is continuing,
the Trustee by written notice to the Company,  or the Holders of at least 25% in
aggregate principal amount of the then outstanding  Securities by written notice
to the Company and the Trustee, may declare all Securities to be due and payable
immediately.   Upon  such  declaration  the  amounts  due  and  payable  on  the
Securities,  as determined in the next  succeeding  paragraph,  shall be due and
payable immediately. If


                                      -22-



<PAGE>



an Event of Default with  respect to the Company  specified in clause (5) or (6)
of Section 6.1 occurs, such an amount shall ipso facto become and be immediately
due and payable without any declaration,  notice or other act on the part of the
Trustee or any Holder.  The Holders of a majority in aggregate  principal amount
of the then outstanding  Securities by written notice to the Trustee may rescind
an acceleration  and its  consequences if the rescission would not conflict with
any judgment or decree and if all existing Events of Default (except  nonpayment
of  principal  of, or premium,  if any, or  interest on the  Securities  or that
resulted from a failure to comply with Section 4.7) have been cured or waived.

     In the event that the maturity of the Securities is accelerated pursuant to
this Section 6.2,  100% of the  principal  amount  thereof and premium,  if any,
shall become due and payable  plus accrued  interest to the date of payment plus
interest on defaulted interest to the extent provided herein.

SECTION 6.3 OTHER REMEDIES

     If an Event of Default occurs and is continuing, the Trustee may pursue any
available remedy to collect the payment of principal of, or premium,  if any, or
interest on the Securities or to enforce the performance of any provision of the
Securities or this Indenture.


     The Trustee may  maintain a  proceeding  even if it does not possess any of
the  Securities  or does not produce any of them in the  proceeding.  A delay or
omission by the Trustee or any Holder in exercising any right or remedy accruing
upon an Event of Default  shall not impair the right or remedy or  constitute  a
waiver of or acquiescence  in the Event of Default.  All remedies are cumulative
to the extent permitted by law.

SECTION 6.4 WAIVER OF PAST DEFAULTS

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding Securities by notice to the Trustee may waive an existing Default or
Event of Default and its consequences,  except a continuing  Default or Event of
Default in the payment of the principal  of, or premium,  if any, or interest on
any Security or in respect of a provision  under this Indenture  which cannot be
modified  or amended  without the  consent of the Holder of each  Security  then
outstanding.  Upon any such waiver,  such Default shall cease to exist,  and any
Event of Default arising  therefrom shall be deemed to have been cured for every
purpose of this Indenture;  but no such waiver shall extend to any subsequent or
other  Default  or Event of  Default  or impair  any right or remedy  consequent
thereon.

SECTION 6.5 CONTROL BY MAJORITY

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding  Securities may direct the time,  method and place of conducting any
proceeding  for any remedy  available to the Trustee or exercising  any trust or
power conferred on it.  However,  the Trustee may refuse to follow any direction
that conflicts with law or this  Indenture,  that the Trustee  determines may be
unduly  prejudicial  to the rights of other  Holders,  or that may  involve  the
Trustee in personal liability, in each case as determined by the Trustee.

SECTION 6.6 LIMITATIONS ON SUITS

     A  Holder  may  pursue a  remedy  with  respect  to this  Indenture  or the
Securities only if:

          (1) the Holder  gives to the Trustee  written  notice of a  continuing
     Event of Default;

          (2) the Holders of at least 25% in aggregate  principal  amount of the
     then outstanding Securities make a written request to the Trustee to pursue
     the remedy;



                                      -23-



<PAGE>



          (3) such Holder or Holders offer to the Trustee indemnity satisfactory
     to the  Trustee  in its sole  discretion  against  any loss,  liability  or
     expense;

          (4) the Trustee does not comply with the request  within 60 days after
     receipt of the request and the offer of indemnity; and

          (5) during such 60-day  period the Holders of a majority in  aggregate
     principal amount of the then outstanding Securities do not give the Trustee
     a direction inconsistent with the request.

A Holder may not use this Indenture to prejudice the rights of another Holder or
to obtain a preference or priority over another Holder.

SECTION 6.7 RIGHTS OF HOLDERS TO RECEIVE PAYMENT

     Notwithstanding  any other  provision of this  Indenture,  the right of any
Holder of a Security to receive  payment and  interest  on the  Security,  on or
after the respective due dates  expressed in the Security,  or to bring suit for
the enforcement of any such payment on or after such respective dates, shall not
be impaired or affected without the consent of the Holder.

SECTION 6.8 COLLECTION SUIT BY TRUSTEE

     If an Event of Default  specified  in  Section  6.1(1) or (2) occurs and is
continuing, the Trustee is authorized to recover judgment in its own name and as
trustee of an express  trust  against the  Company for the amount of  principal,
premium, if any, and interest remaining unpaid on the Securities,  determined in
accordance with Section 6.2, and interest on overdue  principal and premium,  if
any, and, to the extent lawful,  interest on overdue  installments  of interest,
and such further  amount as shall be  sufficient to cover the costs and expenses
of collection,  including the reasonable compensation,  expenses,  disbursements
and advances of the Trustee, its agents and counsel.

SECTION 6.9 TRUSTEE MAY FILE PROOFS OF CLAIM

     The Trustee is  authorized to file such proofs of claim and other papers or
documents  as may be  necessary  or advisable in order to have the claims of the
Trustee  (including  any  claim  for  the  reasonable  compensation,   expenses,
disbursements  and  advances of the  Trustee,  its agents and  counsel)  and the
Holders  allowed  in any  judicial  proceedings  relative  to the  Company,  its
creditors  or its  property  and shall be  entitled  and  empowered  to collect,
receive and distribute any money or other property payable or deliverable on any
such  claims  and any  Custodian  in any  such  judicial  proceeding  is  hereby
authorized by each Holder to make such payments to the Trustee, and in the event
that the Trustee shall  consent to the making of such  payments  directly to the
Holders,  to  pay to the  Trustee  any  amount  due  to it  for  the  reasonable
compensation,  expenses,  disbursements and advances of the Trustee,  its agents
and counsel,  and any other  amounts due the Trustee  under  Section 7.6. To the
extent that the payment of any such  compensation,  expenses,  disbursements and
advances of the Trustee,  its agents and counsel,  and any other amounts due the
Trustee  under  Section 7.6 out of the estate in any such  proceeding,  shall be
denied  for any  reason,  payment of the same shall be secured by a Lien on, and
shall be paid out of, any and all distributions,  dividends,  money,  securities
and other  properties  which the  Holders of the  Securities  may be entitled to
receive  in  such  proceeding  whether  in  liquidation  or  under  any  plan of
reorganization  or arrangement or otherwise.  Nothing herein  contained shall be
deemed to authorize the Trustee to authorize or consent to or accept or adopt on
behalf of any  Holder any plan of  reorganization,  arrangement,  adjustment  or
composition  affecting the Securities or the rights of any Holder thereof, or to
authorize  the Trustee to vote in respect of the claim of any Holder in any such
proceeding;  provided,  however, that the Trustee may, on behalf of the Holders,
vote for the election of a trustee (or similar  official) in bankruptcy  and may
be a member of the creditors' committee.

SECTION 6.10 PRIORITIES


                                      -24-



<PAGE>



     If the Trustee  collects any money pursuant to this Article 6, it shall pay
out the money in the following order:

     First: to the Trustee for amounts due under Section 7.6;

     Second:  to  Holders  for  amounts  due and  unpaid on the  Securities  for
principal,  premium,  if any,  and  interest,  ratably,  without  preference  or
priority of any kind, according to the amounts due and payable on the Securities
for principal, premium, if any, and interest, respectively; and

     Third: to the Company.

     The  Trustee  may fix a record  date and  payment  date for any  payment to
Holders pursuant to this Article.

SECTION 6.11 UNDERTAKING FOR COSTS

     In any suit for the enforcement of any right or remedy under this Indenture
or in any suit  against the  Trustee for any action  taken or omitted by it as a
Trustee,  a court in its discretion may require the filing by any party litigant
in the suit of an undertaking to pay the costs of the suit, and the court in its
discretion may assess reasonable costs,  including  reasonable  attorneys' fees,
against any party litigant in the suit, having due regard to the merits and good
faith of the claims or defenses  made by the party  litigant.  This Section 6.11
does not apply to a suit by the Trustee,  a suit by a Holder pursuant to Section
6.7 or a suit by  Holders  of more  than  10% in  principal  amount  of the then
outstanding Securities.


                                    ARTICLE 7

                                     TRUSTEE

SECTION 7.1 DUTIES OF TRUSTEE

     (1) If an Event of Default  has  occurred  and is  continuing,  the Trustee
shall exercise such of the rights and powers vested in it by this Indenture, and
use the same degree of care and skill in such  exercise,  as a prudent man would
exercise or use under the circumstances in the conduct of his own affairs.

     (2) Except during the continuance of an Event of Default:

          (a) the Trustee need  perform only those duties that are  specifically
     set forth in this  Indenture  and no others,  and no implied  covenants  or
     obligations shall be read into this Indenture against the Trustee; and

          (b)  in the  absence  of  bad  faith  on its  part,  the  Trustee  may
     conclusively rely, as to the truth of the statements and the correctness of
     the opinions expressed therein,  upon certificates or opinions furnished to
     the Trustee and conforming to the requirements of this Indenture;  however,
     the  Trustee  shall  examine the  certificates  and  opinions to  determine
     whether or not, on their face,  they appear to conform to the  requirements
     of this Indenture.

     (3) The Trustee may not be relieved from  liabilities for its own negligent
action, its own negligent failure to act, or its own willful misconduct,  except
that:

          (a) this  paragraph does not limit the effect of paragraph (2) of this
     Section;


                                      -25-



<PAGE>



          (b) the Trustee  shall not be liable for any error of judgment made in
     good faith by a Trust  Officer,  unless it is proved  that the  Trustee was
     negligent in ascertaining the pertinent facts; and

          (c) the  Trustee  shall not be liable  with  respect  to any action it
     takes  or  omits  to take in good  faith  in  accordance  with a  direction
     received by it pursuant to Section 6.5.

     (4) Whether or not therein  expressly so provided,  every provision of this
Indenture  that in any way relates to the Trustee is subject to paragraphs  (1),
(2), (3) and (5) of this Section 7.1.

     (5) No provision of this  Indenture  shall require the Trustee to expend or
risk its own funds or incur any liability. The Trustee may refuse to perform any
duty or exercise any right or power unless it receives indemnity satisfactory to
it against any loss, liability or expense.

     (6) The Trustee  shall not be liable for interest on any money  received by
it except as the Trustee may agree in writing  with the  Company.  Money held in
trust by the  Trustee  need not be  segregated  from other  funds  except to the
extent required by law.

SECTION 7.2 RIGHTS OF TRUSTEE

     (1) Subject to Section 7.1,  the Trustee may rely on any document  believed
by it to be genuine and to have been signed or presented  by the proper  Person,
and the Trustee need not investigate any fact or matter stated in the document.

     (2) Before the Trustee  acts or  refrains  from  acting,  it may require an
Officers' Certificate or an Opinion of Counsel or both. The Trustee shall not be
liable  for any action it takes or omits to take in good  faith in  reliance  on
such Officers'  Certificate or Opinion of Counsel.  The Trustee may consult with
counsel and the written  advice of such counsel or any Opinion of Counsel  shall
be full and  complete  authorization  and  protection  in  respect of any action
taken,  suffered  or  omitted  by it  hereunder  in good  faith and in  reliance
thereon.

     (3) The Trustee may act through agents and shall not be responsible for the
misconduct or negligence of any agent appointed with due care.

     (4) The  Trustee  shall not be liable  for any  action it takes or omits to
take in good faith which it believes  to be  authorized  or within its rights or
powers conferred upon it by this Indenture.

     (5) Unless otherwise  specifically provided in this Indenture,  any demand,
request,  direction or notice from the Company  shall be sufficient if signed by
an Officer of the Company.

SECTION 7.3 INDIVIDUAL RIGHTS OF TRUSTEE

     The Trustee in its individual or any other capacity may become the owner or
pledgee of  Securities  and may  otherwise  deal with the  Company or any of its
Affiliates with the same rights it would have if it were not Trustee.  Any Agent
may do the same with like rights.

SECTION 7.4 TRUSTEE'S DISCLAIMER

     The Trustee makes no  representation as to the validity or adequacy of this
Indenture or the Securities or as to the Company's ability to pay the Securities
when and as due or  perform  its other  obligations  hereunder.  It shall not be
accountable  for the Company's  use of the proceeds  from the  Securities or any
money paid to the Company or upon the  Company's  direction  under any provision
hereof. It shall not be responsible for the use or application of any


                                      -26-



<PAGE>



money  received  by any Paying  Agent  other than the  Trustee.  It shall not be
responsible  for  any  statement  or  recital  herein  or any  statement  in the
Securities other than its certificate of authentication.

SECTION 7.5 NOTICE OF DEFAULTS

     If a Default or Event of  Default  occurs  and is  continuing  and if it is
known to the Trustee,  the Trustee shall mail to Holders a notice of the Default
or Event of  Default  within 90 days  after it  occurs.  Except in the case of a
Default or Event of Default in payment of principal  of, or premium,  if any, or
interest  on any  Security  or that  resulted  from a failure by the  Company to
comply with Section 4.7, the Trustee may withhold the notice if it in good faith
determines that withholding the notice is in the interests of Holders.

SECTION 7.6 COMPENSATION AND INDEMNITY

     The  Company  shall  pay  to the  Trustee  from  time  to  time  reasonable
compensation  for its acceptance of this Indenture and services  hereunder.  The
Trustee's  compensation  shall not be  limited by any law on  compensation  of a
trustee of an express  trust.  The Company  shall  reimburse  the  Trustee  upon
request for all reasonable disbursements,  advances and expenses incurred by it.
Such  expenses  shall include the  reasonable  compensation,  disbursements  and
expenses of the Trustee's agents and counsel.

     The Company shall indemnify the Trustee, its employees, officers, directors
and agents and any predecessor Trustee hereunder against any loss,  liability or
expense  incurred by it arising out of or in connection  with the  acceptance or
administration  of  its  duties  under  this  Indenture  or in  connection  with
enforcing  this  indemnification  provision,  except  as set  forth  in the next
paragraph.  The Trustee promptly shall notify the Company of any claim for which
it may seek indemnity.  The Company shall defend the claim and the Trustee shall
cooperate in the defense.  The Trustee may have separate counsel and the Company
shall pay the reasonable fees and expenses of such counsel. The Company need not
pay for any  settlement  made without its consent,  which  consent  shall not be
unreasonably withheld.

     The Company need not reimburse any expense or indemnify against any loss or
liability incurred by the Trustee through negligence or bad faith.

     To secure the  Company's  payment  obligations  in this  Section  7.6,  the
Trustee shall have a Lien prior to the  Securities on all money or property held
or  collected  by the Trustee,  except that held in trust to pay  principal  of,
premium, if any, and interest on particular Securities.  Such Lien shall survive
the satisfaction and discharge of this Indenture.

     When the  Trustee  incurs  expenses or renders  services  after an Event of
Default  specified  in  Section  6.1(5)  or (6)  occurs,  the  expenses  and the
compensation   for  the  services  are  intended  to   constitute   expenses  of
administration under any Bankruptcy Law.

SECTION 7.7 REPLACEMENT OF TRUSTEE

     A  resignation  or removal of the  Trustee and  appointment  of a successor
Trustee shall become effective only upon the successor  Trustee's  acceptance of
appointment as provided in this Section.

     The Trustee may resign and be discharged  from the trust hereby  created by
so notifying the Company.  The Holders of a majority in principal  amount of the
then  outstanding  Securities may remove the Trustee by so notifying the Trustee
and the Company. The Company may remove the Trustee if:

          (1)  the Trustee fails to comply with Section 310(b) of the TIA;



                                      -27-



<PAGE>



          (2)  the Trustee is adjudged a bankrupt  or an  insolvent  or an order
               for  relief is entered  with  respect  to the  Trustee  under any
               Bankruptcy Law;

          (3)  a Custodian or public  officer takes charge of the Trustee or its
               property; or

          (4)  the Trustee becomes incapable of acting.

     If the Trustee  resigns or is removed or if a vacancy  exists in the office
of Trustee  for any  reason,  the  Company  shall  promptly  appoint a successor
Trustee.

     If a  successor  Trustee  does not take  office  within  60 days  after the
retiring Trustee resigns or is removed, the retiring Trustee, the Company or the
Holders of at least 10% in principal amount of the then  outstanding  Securities
may  petition  any court of  competent  jurisdiction  for the  appointment  of a
successor Trustee.

     If the Trustee  fails to comply with Section 310 of the TIA, any Holder may
petition any court of competent  jurisdiction for the removal of the Trustee and
the appointment of a successor Trustee.

     A successor  Trustee shall deliver a written  acceptance of its appointment
to the retiring Trustee and to the Company. Thereupon the resignation or removal
of the retiring Trustee shall become effective,  and the successor Trustee shall
have all the rights, powers and duties of the Trustee under this Indenture.  The
successor Trustee shall mail a notice of its succession to Holders. The retiring
Trustee  shall  promptly  transfer  all  property  held by it as  Trustee to the
successor   Trustee,   subject  to  the  Lien   provided  for  in  Section  7.6.
Notwithstanding  replacement  of the Trustee  pursuant to this  Section 7.7, the
Company's  obligations  under Section 7.6 shall  continue for the benefit of the
retiring Trustee.

SECTION 7.8 SUCCESSOR TRUSTEE BY MERGER, ETC.

     Subject to Section  7.9,  if the Trustee  consolidates,  merges or converts
into, or transfers all or substantially  all of its corporate trust business to,
another corporation,  the successor corporation without any further act shall be
the successor Trustee.

SECTION 7.9 ELIGIBILITY; DISQUALIFICATION

     There  shall at all times be a Trustee  hereunder  which shall be a bank or
corporation  organized and doing business under the laws of the United States of
America,  any state  thereof or the District of Columbia  authorized  under such
laws to exercise  corporate  trustee  power,  shall be subject to supervision or
examination  by Federal or state (or the  District of  Columbia)  authority  and
shall have a combined  capital  and surplus of at least $50 million as set forth
in its most recent published annual report of condition.

     This Indenture  shall always have a Trustee who satisfies the  requirements
of TIA ss. 310(a)(1) and 310(a)(2). The Trustee is subject to TIA ss. 310(b). If
at any time the  Trustee  shall  cease to be  eligible  in  accordance  with the
provisions of this Section,  it shall resign  immediately in the manner and with
the effect specified in Section 7.7.


                                    ARTICLE 8

                             DISCHARGE OF INDENTURE

SECTION 8.1 TERMINATION OF COMPANY'S OBLIGATIONS



                                      -28-



<PAGE>



     (a) This  Indenture  shall cease to be of further  effect  (except that the
Company's  obligations  under Section 7.6 and the  Trustee's and Paying  Agent's
obligations  under Section 8.3 shall  survive) when all  outstanding  Securities
theretofore  authenticated and issued have been delivered (other than destroyed,
lost or stolen  Securities  that have been  replaced or paid) to the Trustee for
cancellation and the Company has paid all sums payable  hereunder.  In addition,
the Company may elect to have either  paragraph  (b) or  paragraph  (c) below be
applied to the  outstanding  Securities  upon compliance with the conditions set
forth in paragraph (d).

     (b)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable  to this  paragraph  (b),  the  Company  shall be deemed to have been
released and discharged  from its  obligations  with respect to the  outstanding
Securities   on  the  date  the   conditions   set  forth  below  are  satisfied
(hereinafter, "legal defeasance"). For this purpose, such legal defeasance means
that the  Company  shall  be  deemed  to have  paid and  discharged  the  entire
indebtedness  represented by the outstanding Securities,  which shall thereafter
be deemed to be  "outstanding"  only for the  purposes  of the  Sections  of and
matters  under this  Indenture  referred to in (i) and (ii)  below,  and to have
satisfied all its other  obligations  under such  Securities  and this Indenture
insofar as such Securities are concerned (and the Trustee, at the expense of the
Company,  shall execute proper instruments  acknowledging the same),  except for
the  following  which shall  survive  until  otherwise  terminated or discharged
hereunder: (i) the rights of Holders of outstanding Securities to receive solely
from the trust fund described in paragraph (d) below and as more fully set forth
in such paragraph, payments in respect of the principal of, premium, if any, and
interest on such  Securities  when such  payments  are due,  (ii) the  Company's
obligations  with respect to such  Securities  under  Sections 2.5, 2.6 and 4.2,
and, with respect to the Trustee,  under Section 7.6, (iii) the rights,  powers,
trusts,  duties and  immunities  of the Trustee  hereunder and (iv) this Section
8.1.  Subject to compliance  with this Section 8.1, the Company may exercise its
option under this paragraph (b) notwithstanding the prior exercise of its option
under paragraph (c) below with respect to the Securities.

     (c)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable to this  paragraph  (c), the Company shall be released and discharged
from its  obligations  under any covenant  contained in Article 5 and in Section
4.3, 4.4 and 4.6 through 4.8 with respect to the  outstanding  Securities on and
after the date the  conditions  set  forth  below  are  satisfied  (hereinafter,
"covenant defeasance"),  and the Securities shall thereafter be deemed to be not
"outstanding" for the purpose of any direction,  waiver,  consent or declaration
or act of Holders (and the  consequences of any thereof) in connection with such
covenants,  but shall continue to be deemed "outstanding" for all other purposes
hereunder.  For this purpose,  such covenant defeasance means that, with respect
to the  outstanding  Securities,  the  Company may omit to comply with and shall
have no liability in respect of any term,  condition or limitation  set forth in
any such covenant,  whether  directly or indirectly,  by reason of any reference
elsewhere  herein to any such covenant or by reason of any reference in any such
covenant  to any  other  provision  herein  or in any  other  document  and such
omission to comply shall not  constitute a Default or an Event of Default  under
Section 6.1, but, except as specified above, the remainder of this Indenture and
such Securities shall be unaffected thereby.

     (d) The  following  shall be the  conditions to the  application  of either
paragraph (b) or (c) above to the outstanding Securities:

          (1) the Company has  irrevocably  deposited  in trust with the Trustee
     or,  at the  option of the  Trustee,  with a  trustee  satisfactory  to the
     Trustee and the Company under the terms of an irrevocable  trust  agreement
     in form and substance  satisfactory to the Trustee in its sole  discretion,
     money  or U.S.  Government  Obligations  sufficient  to pay  principal  of,
     premium,  if any, and interest on the  Securities to maturity or redemption
     (in the opinion of a nationally  recognized  accounting firm of independent
     certified public accountants  expressed in a written certificate  delivered
     to the Trustee) and to pay all other sums payable by it hereunder; provided
     that (i) the trustee of the irrevocable  trust shall have been  irrevocably
     instructed  to pay  such  money or the  proceeds  of such  U.S.  Government
     Obligations to the Trustee and (ii) the Trustee shall have been irrevocably
     instructed  to apply such  money or the  proceeds  of such U.S.  Government
     Obligations to the payment of said principal, premium, if any, and interest
     with respect to the Securities;


                                      -29-



<PAGE>



          (2) the Company has delivered to the Trustee an Officer's  Certificate
     stating that (A) all conditions  precedent  provided for relating to either
     the legal defeasance  under paragraph (b) above or the covenant  defeasance
     under  paragraph (c) above, as the case may be, have been complied with and
     (B) if any other  Indebtedness  of the Company shall then be outstanding or
     committed,  such legal  defeasance or covenant  defeasance will not violate
     the   provisions  of  the  agreements  or   instruments   evidencing   such
     Indebtedness; and

          (3) no  Default  or  Event  of  Default  shall  have  occurred  and be
     continuing on the date of such deposit;

          (4) the Trustee shall not have received notice from any holder of Bank
     Debt or any holder of Senior  Indebtedness in an aggregate principal amount
     in excess of $20 million that such legal defeasance or covenant  defeasance
     would violate the provisions of the  agreements or  instruments  evidencing
     such Senior Indebtedness;

          (5) such legal defeasance or covenant defeasance shall not result in a
     breach or violation of, or constitute a default or event of default  under,
     this Indenture or any other  material  agreement or instrument to which the
     Company is a party or by which it is bound;

          (6) in the case of an election under paragraph (b) above,  the Company
     shall have  delivered to the Trustee an Opinion of Counsel from  nationally
     recognized  counsel  acceptable to the Trustee stating that (x) the Company
     has received  from, or there has been  published  by, the Internal  Revenue
     Service a ruling, (y) there exists controlling precedent,  or (z) since the
     date of this Indenture,  there has been a change in the applicable  Federal
     income  tax  law,  in any  case  to the  effect  that  the  Holders  of the
     outstanding  Securities will not recognize income, gain or loss for Federal
     income  tax  purposes  as a result  of such  legal  defeasance  and will be
     subject to federal income tax on the same amount and in the same manner and
     at the same time as would have been the case if such legal  defeasance  had
     not occurred; and

          (7) in the case of an election under paragraph (c) above,  the Company
     shall have  delivered to the Trustee an Opinion of Counsel from  nationally
     recognized  counsel  acceptable  to the  Trustee (i) to the effect that the
     Holders of the outstanding  Securities will not recognize  income,  gain or
     loss  for  Federal  income  tax  purposes  as a  result  of  such  covenant
     defeasance and will be subject to Federal income tax on the same amount and
     in the same manner and at the same time as would have been the case if such
     covenant  defeasance had not occurred or (ii) that the Company has received
     from, or there has been published by, the Internal Revenue Service a ruling
     to the foregoing effect.

     After such  irrevocable  deposit  made  pursuant  to this  Section  8.1 and
satisfaction of the other conditions set forth herein,  the Trustee upon request
shall  acknowledge in writing the discharge of the Company's  obligations  under
this Indenture except for those surviving obligations specified above.

     The Company may make an  irrevocable  deposit  pursuant to this Section 8.1
only if at such time it is not prohibited  from doing so under the provisions of
Article 10 and the Company  shall have  delivered  to the Trustee and any Paying
Agent an Officers' Certificate to that effect.

     In  order to have  money  available  on a  payment  date to pay  principal,
premium, if any, or interest on the Securities,  the U.S. Government Obligations
shall be payable as to principal, premium, if any, or interest on or before such
payment date in such amounts as will provide the  necessary  money to effect the
applicable defeasance.  U.S. Government Obligations shall not be callable at the
issuer's option.



                                      -30-



<PAGE>



SECTION 8.2 APPLICATION OF TRUST MONEY

     The Trustee or a trustee  satisfactory to the Trustee and the Company shall
hold in trust money or U.S. Government Obligations deposited with it pursuant to
Section  8.1.  It shall  apply  the  deposited  money  and the  money  from U.S.
Government  Obligations  through the Paying  Agent and in  accordance  with this
Indenture to the payment of principal of,  premium,  if any, and interest on the
Securities.

SECTION 8.3 REPAYMENT TO THE COMPANY

     The Trustee and the Paying  Agent shall  promptly  pay to the Company  upon
written request any excess money or securities held by them at any time.

     The Trustee and the Paying  Agent shall pay to the Company at their  option
or upon  written  request any money held by them for the  payment of  principal,
premium, if any, or interest that remains unclaimed for two years after the date
upon which such  payment  shall have become  due;  provided,  however,  that the
Company  shall have either  caused  notice of such  payment to be mailed to each
Holder  entitled  thereto no less than 30 days prior to such repayment or within
such  period  shall have  published  such  notice in a  financial  newspaper  of
widespread  circulation  published in The City of New York. After payment to the
Company,  Holders  entitled to the money must look to the Company for payment as
general creditors unless an applicable abandoned property law designates another
Person,  and all  liability of the Trustee and such Paying Agent with respect to
such money shall cease.

SECTION 8.4 REINSTATEMENT

     If the  Trustee  or  Paying  Agent is  unable  to apply  any  money or U.S.
Government  Obligations  in  accordance  with Section 8.1 by reason of any legal
proceeding  or by reason of any order or judgment  of any court or  governmental
authority enjoining,  restraining or otherwise prohibiting such application, the
Company's  obligations  under this Indenture and the Securities shall be revived
and  reinstated as though no deposit had occurred  pursuant to Section 8.1 until
such time as the Trustee or Paying Agent is permitted to apply all such money or
U.S. Government  Obligations in accordance with Section 8.1; provided,  however,
that if the Company  has made any payment of premium,  if any, or interest on or
principal of any Securities because of the reinstatement of its obligations, the
Company shall be  subrogated to the rights of the Holders of such  Securities to
receive such payment from the money or U.S.  Government  Obligations held by the
Trustee or Paying Agent.


                                    ARTICLE 9

                                   AMENDMENTS

SECTION 9.1 WITHOUT CONSENT OF HOLDERS

     The Company and the Trustee may amend this  Indenture or the  Securities or
waive any provision hereof without the consent of any Holder:

     (1)  to cure any ambiguity, defect or inconsistency;

     (2)  to comply with Section 5.1;

     (3)  to evidence and provide for the acceptance of appointment hereunder by
          a successor Trustee with respect to the Securities;



                                      -31-



<PAGE>
sss


     (4)  to make any change  that does not  adversely  affect the legal  rights
          hereunder of any Holder; or

     (5)  to comply with a provision or provisions of the TIA applicable to this
          Indenture.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon  receipt by the Trustee of the  documents  described  in Section  9.6,  the
Trustee  shall  join  with the  Company  in the  execution  of any  supplemental
indenture  authorized  or permitted by the terms of this  Indenture and make any
further  appropriate  agreements and stipulations that may be therein contained,
but the Trustee shall not be obligated to enter into any supplemental  indenture
that  affects its own  rights,  duties or  immunities  under this  Indenture  or
otherwise.  After an amendment or waiver under this Section  becomes  effective,
the Company shall mail to the Holders of each Security affected thereby a notice
briefly  describing the amendment or waiver.  Any failure of the Company to mail
such notice,  or any defect therein,  shall not,  however,  in any way impair or
affect the validity of any such supplemental indenture.

SECTION 9.2 WITH CONSENT OF HOLDERS

     Except as provided  in this  Section  9.2,  the Company and the Trustee may
amend this Indenture or the Securities  with the written  consent of the Holders
of at least a majority in principal amount of the then outstanding Securities.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon the filing  with the  Trustee of  evidence of the consent of the Holders as
aforesaid, and upon receipt by the Trustee of the documents described in Section
9.6,  the  Trustee  shall  join  with  the  Company  in the  execution  of  such
supplemental  indenture unless such supplemental indenture affects the Trustee's
own rights,  duties or immunities  under this  Indenture or otherwise,  in which
case the Trustee may in its  discretion,  but shall not be  obligated  to, enter
into such supplemental indenture.

     It shall not be necessary for the consent of the Holders under this Section
to approve the particular form of any proposed amendment or waiver, but it shall
be sufficient if such consent approves the substance thereof.

     The  Holders of a  majority  in  principal  amount of the  Securities  then
outstanding  may waive  compliance in a particular  instance by the Company with
any provision of this Indenture or the Securities.  However, without the consent
of each Holder affected, an amendment or waiver under this Section may not:

     (1)  change the Stated  Maturity of the principal of, or any installment of
          interest on, any Security;

     (2)  reduce the  principal  amount of, or premium,  if any, or interest on,
          any Security;

     (3)  modify the  provisions of Article 10 hereof in a manner adverse to the
          Holders;

     (4)  change the place of payment  where,  or the coin or currency in which,
          any Security or any premium or interest thereon is payable;

     (5)  adversely  affect  the right of  Holders  to  require  the  Company to
          repurchase  Securities  pursuant  to Section  4.7 hereof or modify the
          obligations  of the Company to make an Asset Sale Offer in  accordance
          with  Sections  4.8 and 3.8 or modify  the  redemption  provisions  of
          Section 3.7;



                                      -32-



<PAGE>



     (6)  impair the right of Holders to institute  suit for the  enforcement of
          payment of the  principal  of and  premium,  if any,  and  interest on
          Securities on or after the Stated Maturity  thereof (or in the case of
          redemption, on or after the redemption date);

     (7)  reduce the percentage in principal  amount of Securities,  the consent
          of whose Holders is required for any  modification or amendment of the
          Indenture,  or the consent of whose Holders is required for any waiver
          of compliance  with certain  provisions  of this  Indenture or certain
          Defaults  or  Events  of  Default  hereunder  and  their  consequences
          provided for in this Indenture; or

     (8)  modify any of the  provisions  of Section 6.4 or this sentence of this
          Section 9.2.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of this  Indenture  (and the obligation of the Company
to obtain any such consent  otherwise  required from such Holder) may be subject
to the requirement  that such Holder shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of this Indenture.

SECTION 9.3 COMPLIANCE WITH TRUST INDENTURE ACT

     Every  amendment to this Indenture or the  Securities  shall comply in form
and substance with the TIA as then in effect.

SECTION 9.4 REVOCATION AND EFFECT OF CONSENTS

     Until an  amendment  (which  includes  any  supplement)  or waiver  becomes
effective,  a consent to it by a Holder of a Security is a continuing consent by
the Holder and every  subsequent  Holder of a Security  or portion of a Security
that  evidences  the same  debt as the  consenting  Holder's  Security,  even if
notation of the consent is not made on any  Security.  However,  any such Holder
may revoke the consent as to his or her Security or portion of a Security if the
Trustee receives  written notice of revocation  before the date the amendment or
waiver becomes effective. An amendment or waiver becomes effective in accordance
with  its  terms  and  thereafter  binds  every  Holder  of a  Security  whether
theretofore or thereafter authenticated and delivered.

     The Company may,  but shall not be obligated  to, fix a record date for the
purpose of  determining  the  Holders  entitled to consent to any  amendment  or
waiver. If the Company elects to fix a record date for such purpose,  the record
date shall be fixed at (i) the later of 30 days prior to the first  solicitation
of such consent or the date of the most recent list of Holders  furnished to the
Trustee prior to such solicitation, or (ii) such other date as the Company shall
designate. If a record date is fixed, then notwithstanding the provisions of the
immediately  preceding paragraph,  those Persons who were Holders at such record
date (or their  duly  designated  proxies),  and only  those  Persons,  shall be
entitled  to  consent  to such  amendment  or waiver or to  revoke  any  consent
previously given,  whether or not such Persons continue to be Holders after such
record date.  No consent shall be valid or effective for more than 90 days after
such  record  date  unless  consents  from  Holders of the  principal  amount of
Securities required hereunder for such amendment or waiver to be effective shall
have also been given and not revoked within such 90-day period.

SECTION 9.5 NOTATION ON OR EXCHANGE OF SECURITIES

     The Trustee may place an appropriate  notation about an amendment or waiver
on any  Security  thereafter  authenticated.  The  Company in  exchange  for the
Securities  may issue and the Trustee shall  authenticate  new  Securities  that
reflect the amendment or waiver.

SECTION 9.6 TRUSTEE TO SIGN AMENDMENTS, ETC.


                                      -33-



<PAGE>



     The Trustee shall sign any amendment or supplemental  indenture  authorized
pursuant  to this  Article 9 if the  amendment  does not  adversely  affect  the
rights,  duties,  liabilities  or  immunities  of the Trustee.  If it does,  the
Trustee  may,  but need  not,  sign it.  In  signing  or  refusing  to sign such
amendment or  supplemental  indenture,  the Trustee shall be entitled to receive
and, subject to Section 7.1 and 7.2 shall be fully protected in relying upon, an
Officers' Certificate and an Opinion of Counsel as conclusive evidence that such
amendment  or  supplemental   indenture  is  authorized  or  permitted  by  this
Indenture,  that it is not inconsistent  herewith, and that it will be valid and
binding upon the Company in accordance with its terms.



                                   ARTICLE 10

                                  SUBORDINATION

SECTION 10.1 SECURITIES SUBORDINATED TO SENIOR INDEBTEDNESS

     The Company  covenants  and agrees,  and each Holder of a Security,  by his
acceptance  thereof,  likewise covenants and agrees,  that, to the extent and in
the  manner   hereinafter  set  forth  in  this  Article  10,  the  indebtedness
represented by the Securities  and all Payments or  Distributions  in Respect of
the Securities are hereby  expressly  made  subordinate  and subject in right of
payment to the prior payment in full of all Senior Indebtedness.

     If at any time  following  the  payment of any amount to a holder of Senior
Indebtedness with respect to such Senior Indebtedness, such payment is rescinded
or must  otherwise be returned by such holder upon the  insolvency,  bankruptcy,
reorganization, dissolution or liquidation of the Company or any other Person or
otherwise,  and is so rescinded or returned to the party or parties  making such
payment,  such Senior  Indebtedness  shall be  reinstated  to the extent of such
payment and the  provisions  of this Article 10 shall be  applicable  as if such
payment were never made.

     The  provisions  of this  Article 10 are for the  benefit of the holders of
Senior Indebtedness, and each Holder of the Securities, by his purchase or other
acquisition of the  Securities,  hereby agrees for the benefit of each holder of
Senior  Indebtedness  that his  Securities are subject to the provisions of this
Article 10.

SECTION 10.2 PAYMENT OVER OF PROCEEDS UPON DISSOLUTION, ETC.

     In the event of (a) any insolvency or bankruptcy case or proceeding, or any
receivership,  liquidation,  reorganization or other similar case or proceeding,
relative to the Company or to its creditors,  as such, or to a substantial  part
of its assets,  or (b) any proceeding for the liquidation,  dissolution or other
winding up of the Company,  whether  voluntary or involuntary and whether or not
involving  insolvency or  bankruptcy,  or (c) any  assignment for the benefit of
creditors or any other  marshalling  of assets and  liabilities  of the Company,
then and in any such event the holders of Senior  Indebtedness shall be entitled
to receive  payment in full of all amounts due or to become due on or in respect
of all Senior  Indebtedness  (including,  without  limitation,  all  Allowed and
Disallowed  Post-Commencement Interest and Expenses), or provision shall be made
for such payment in cash or in a manner otherwise satisfactory to the holders of
Senior  Indebtedness,  before the  Holders of the  Securities  are  entitled  to
receive any Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 8 hereof),  and to that end the holders of Senior  Indebtedness shall be
entitled to receive,  for  application  to the payment  thereof,  any payment or
distribution of any kind or character,  whether in cash, property or securities,
including any such payment or  distribution  which may be payable or deliverable
by  reason  of the  payment  of any  other  indebtedness  of the  Company  being
subordinated  to the  payment  of  the  Securities,  which  may  be  payable  or
deliverable  in  respect  of  the  Securities  in  any  such  case,  proceeding,
dissolution, liquidation or other winding up or event.



                                      -34-



<PAGE>



     In the  event  that,  notwithstanding  the  foregoing  provisions  of  this
Section,  the  Trustee or the Holder of any  Security  shall have  received  any
Payment  or  Distribution  in  Respect  of  the  Securities  in any  such  case,
proceeding,  dissolution,  liquidation  or other winding up or event (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 8  hereof),  including  any such  payment or  distribution  which may be
payable or deliverable by reason of the payment of any other indebtedness of the
Company being  subordinated to the payment of the Securities,  before all Senior
Indebtedness  (including,   without  limitation,   all  Allowed  and  Disallowed
Post-Commencement  Interest  and  Expenses)  is paid in full or payment  thereof
provided for, and, if (i) subject to Section 10.8,  such fact shall, at or prior
to the  time of such  payment  or  distribution,  have  been  made  known to the
Trustee,  then and in such event such payment or distribution shall be paid over
or  delivered   forthwith  to  the  holders  of  Senior  Indebtedness  or  to  a
representative   duly  appointed  by  any  such  holder  or  holders  of  Senior
Indebtedness  unless otherwise  required by law or court order or (ii) such fact
shall  have been made  known to such  Holder  at any time  before or after  such
payment, then and in such event such Holder shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed  by any such  holder or holders  of such  Senior  Indebtedness  unless
otherwise required by law or court order, in either such case for application to
the payment of all Senior Indebtedness remaining unpaid, to the extent necessary
to pay all Senior Indebtedness (including,  without limitation,  all Allowed and
Disallowed  Post-  Commencement  Interest and  Expenses)  in full,  after giving
effect to any concurrent payment or distribution to or for the holders of Senior
Indebtedness.

     The  consolidation  of the Company with, or the merger of the Company into,
another Person or the  liquidation  or dissolution of the Company  following the
conveyance or transfer of its properties and assets substantially as an entirety
to another Person upon the terms and conditions set forth in Article 5 shall not
be deemed a dissolution, winding up, liquidation, reorganization, assignment for
the benefit of creditors or marshalling of assets and liabilities of the Company
for the purposes of this Section if the Person formed by such  consolidation  or
into which the  Company is merged or which  acquires by  conveyance  or transfer
such  properties and assets  substantially  as an entirety,  as the case may be,
shall, as a part of such consolidation,  merger,  conveyance or transfer, comply
with the conditions set forth in Article 5.

SECTION 10.3  PRIOR  PAYMENT  TO  SENIOR   INDEBTEDNESS   UPON  ACCELERATION  OF
              SECURITIES

     In the event that any  Securities are declared due and payable before their
Stated  Maturity,  then and in such  event the  holders  of Senior  Indebtedness
outstanding  at the time such  Securities  so become  due and  payable  shall be
entitled  to  receive  payment  in  full  in  cash,  or  in a  manner  otherwise
satisfactory to the holders of Senior Indebtedness,  of all amounts due on or in
respect of such Senior Indebtedness (including,  without limitation, all Allowed
and Disallowed  Post-Commencement  Interest and Expenses)  before the Holders of
the Securities are entitled to receive any Payment or Distribution in Respect of
the  Securities  (including  any  payment  which may be payable by reason of the
payment of any other  indebtedness  of the  Company  being  subordinated  to the
payment of the Securities),  other than payment of amounts previously  deposited
in accordance with the defeasance  provisions of Article 8 hereof, by or for the
account of the Company.

     In the event that,  notwithstanding  the foregoing,  the Company shall make
any Payment or  Distribution  in Respect of the Securities to the Trustee or the
Holder of any Security  prohibited by the foregoing  provisions of this Section,
then if (i) subject to Section 10.8, such fact shall,  prior to the time of such
payment, have been made known to the Trustee, then and in such event the Trustee
shall  forthwith pay over and deliver such payment to the holders of such Senior
Indebtedness or to a representative duly appointed by any such holder or holders
of such Senior Indebtedness or (ii) such fact shall have been made known to such
Holder at any time  before or after  such  payment,  then and in such event such
Holder  shall  forthwith  pay over and  deliver  such  payment to the holders of
Senior  Indebtedness or to a representative duly appointed by any such holder or
holders of such Senior Indebtedness,  in either such case for application to the
payment of all Senior  Indebtedness  then remaining unpaid  (including,  without
limitation, all Allowed and Disallowed Post-Commencement Interest and Expenses),
after giving  effect to any  concurrent  payment or  distribution  to or for the
benefit of holders of Senior Indebtedness.


                                      -35-



<PAGE>



     The  provisions of this Section shall not apply to any payment with respect
to which Section 10.2 is applicable.

SECTION 10.4  NO  PAYMENT   UPON  CERTAIN   DEFAULTS   WITH  RESPECT  TO  SENIOR
              INDEBTEDNESS

     (a) No Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts  previously  deposited  in  accordance  with the  defeasance
provisions  of  Article 8  hereof)  shall be made by or for the  account  of the
Company  upon the  occurrence  of any default in the payment of any Bank Debt or
any Senior  Indebtedness  (other than Bank Debt) in excess of $20 million beyond
any applicable grace period, unless and until such default is cured or waived or
ceases to exist or such Senior  Indebtedness  has been paid in full or provision
for such  payment in cash or in a manner  otherwise  satisfactory  to holders of
Senior Indebtedness has been made.

     (b) Upon any default  with  respect to the  financial  covenants  under the
Credit Agreement as specified therein,  or if any payment or distribution by the
Company with  respect to any Security  would,  immediately  after giving  effect
thereto,  result in such default,  no Payment or  Distribution in Respect of the
Securities  (other than payments of amounts  previously  deposited in accordance
with the defeasance provisions of Article 8 hereof), including any payment which
may be  payable  by  reason  of the  payment  of any  other  indebtedness  being
subordinated  to the  payment  of the  Securities,  shall  be made by or for the
account of the  Company  on  account of  principal  of or  premium,  if any,  or
interest on the  Securities or on account of the  purchase,  redemption or other
acquisition  of the  Securities  for the period  specified  below (the  "Payment
Blockage  Period").  The Payment Blockage Period shall commence upon the receipt
of notice by the Company or the Trustee from the Bank Agent and shall end on the
earlier of (i) 179 days  thereafter,  (ii) the date on which such  default  with
respect to the financial covenants under the Credit Agreement is cured or waived
or ceases to exist or on which such Bank Debt is paid in full or  provision  for
such  payment in money or money's  worth has been made,  (iii) the date on which
the maturity of any  Indebtedness  (other than Senior  Indebtedness)  shall have
been accelerated by virtue of such event, or (iv) the date on which such Payment
Blockage  Period  shall  have been  terminated  by notice to the  Company or the
Trustee  from the Bank  Agent,  after  which any and all  required  payments  in
respect of the Securities,  including any missed payments,  may resume. Only one
Payment  Blockage  Period may be commenced  during any period of 365 consecutive
days.  No default  with  respect  to the  financial  covenants  under the Credit
Agreement that existed or was continuing on the date of the  commencement of any
Payment  Blockage Period will be, or can be, made the basis for the commencement
of a second  Payment  Blockage  Period  whether  or not  within a period  of 365
consecutive  days,  unless such default has been cured or waived for a period of
not less than 90 consecutive  days. In no event will a Payment  Blockage  Period
extend beyond 179 days.

     (c) In the event that,  notwithstanding  the  foregoing,  the Company shall
make any payment to the Trustee or the Holder of any Security  prohibited by the
foregoing provisions of this Section,  then (i) subject to Section 10.8, if such
fact shall, at or prior to the time of such payment, have been made known to the
Trustee, then and in such event the Trustee shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed by any such holder or holders of such Senior Indebtedness or (ii) such
fact shall have been made known to such  Holder at any time before or after such
payment, then and in such event such Holder shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed by any such holder or holders of such Senior Indebtedness.

     The  provisions of this Section shall not apply to any payment with respect
to which Section 10.2 is applicable.

     SECTION 10.5 PAYMENT PERMITTED IF NO DEFAULT

     Nothing  contained in this Article or elsewhere in this Indenture or in any
of the Securities  shall prevent (a) the Company,  at any time except during the
pendency of any case, proceeding, dissolution,  liquidation or other winding up,
assignment  for the  benefit of  creditors  or other  marshalling  of assets and
liabilities  of the Company  referred to in Section 10.2 or under the conditions
described in Section 10.3 or Section 10.4, from making any Payment or


                                      -36-



<PAGE>



Distribution in Respect of the Securities, or (b) the application by the Trustee
of any  money  deposited  with it  hereunder  with  respect  to any  Payment  or
Distribution  in Respect of the  Securities  or the retention of such Payment or
Distribution  in Respect of the  Securities  by the Holders,  if, at the time of
such  application  by the Trustee,  it had not been notified in accordance  with
Section 10.8 that such payment was  prohibited by the provisions of this Article
10.

SECTION 10.6 SUBROGATION TO RIGHTS OF HOLDERS OF SENIOR INDEBTEDNESS

     Subject to the  payment in full in cash of all amounts due on or in respect
of  Senior  Indebtedness  (including,   without  limitation,   all  Allowed  and
Disallowed  Post-Commencement  Interest  and  Expenses,  except  to  the  extent
provided below), the Holders of the Securities shall be subrogated to the extent
of the payments or distributions made to the holders of such Senior Indebtedness
pursuant to the  provisions  of this  Article 10 (equally  and ratably  with the
holders  of all  indebtedness  of the  Company  which  by its  express  terms is
subordinated  to other  indebtedness  of the Company to  substantially  the same
extent as the  Securities  are  subordinated  and are entitled to like rights of
subrogation) to the rights of the holders of such Senior Indebtedness to receive
payments and  distributions of cash,  property and securities  applicable to the
Senior  Indebtedness until the principal of and premium, if any, and interest on
the  Securities  shall be paid in full.  For  purposes of such  subrogation,  no
payments or distributions to the holders of the Senior Indebtedness of any cash,
property or  securities  to which the Holders of the  Securities  or the Trustee
would be entitled  except for the provisions of this Article 10, and no payments
over  pursuant  to the  provisions  of this  Article  to the  holders  of Senior
Indebtedness  by Holders of the Securities or the Trustee,  shall,  as among the
Company, its creditors other than holders of Senior Indebtedness and the Holders
of the  Securities,  be deemed to be a payment or distribution by the Company to
or on account of the Senior Indebtedness.

     Notwithstanding  anything to the contrary in this Section 10.6, the Holders
of the  Securities  hereby  agree that they shall have no rights of  subrogation
with respect to amounts paid to the holders of Senior Indebtedness in payment of
any  interest,  reimbursements,  costs,  expenses  or  indemnities  that are not
allowed  claims  enforceable  against the Company in a case or proceeding  under
Bankruptcy Law.

SECTION 10.7 PROVISIONS SOLELY TO DEFINE RELATIVE RIGHTS

     The  provisions  of this  Article  10 are and are  intended  solely for the
purpose of defining the relative  rights of the Holders of the Securities on the
one hand and the  holders  of Senior  Indebtedness  on the other  hand.  Nothing
contained in this Article or elsewhere in this Indenture or in the Securities is
intended to or shall (a) impair, as among the Company,  its creditors other than
holders of Senior Indebtedness and the Holders of the Securities, the obligation
of the Company,  which is absolute and  unconditional,  to pay to the Holders of
the  Securities  the  principal  of and  premium,  if any,  and  interest on the
Securities as and when the same shall become due and payable in accordance  with
their  terms;  or (b) affect the  relative  rights  against  the  Company of the
Holders of the Securities and creditors of the Company other than the holders of
Senior  Indebtedness;  or (c) prevent the Trustee or the Holder of any  Security
from exercising all remedies otherwise  permitted by applicable law upon default
under this  Indenture,  subject to the rights,  if any, under this Article 10 of
the holders of Senior  Indebtedness  to receive  cash,  property and  securities
otherwise  payable or deliverable to the Trustee or such Holder.  The failure to
make a payment on account of principal of,  premium,  if any, or interest on, or
any other amounts then payable with respect to, the  Securities by any reason of
this Article 10 shall not be construed as preventing  the occurrence of an Event
of Default under Section 6.1.

SECTION 10.8 APPLICATION BY TRUSTEE OF MONIES DEPOSITED WITH IT

     Money and U.S. Government  Obligations  deposited in trust with the Trustee
pursuant to Section 8.2 and in compliance with Section 8.1 shall be for the sole
benefit  of the  Holders  and,  to the  extent  allocated  for  the  payment  of
Securities, shall not be subject to the subordination provisions of this Article
10.  Otherwise,  any  deposit of monies by the  Company  with the Trustee or any
Paying Agent  (whether or not in trust) for payment on account of principal  of,
premium, if any, and interest on the Securities or that otherwise  constitutes a
Payment or  Distribution  in Respect of the  Securities  shall be subject to the
provisions of Sections 10.1, 10.2, 10.3 and 10.4 except that, if at least


                                      -37-



<PAGE>



three  Business  Days prior to the date on which by the terms of this  Indenture
any  such  monies  may  become  payable  for  any  purpose  (including,  without
limitation, the payment of the principal of, premium, if any, or the interest on
any  Security)  the Trustee  shall not have received with respect to such monies
the notice provided for in Section 10.4(b) or 10.11, then the Trustee shall have
full power and  authority  to receive  such  monies and to apply the same to the
purpose for which they were received, and shall not be affected by any notice to
the  contrary  which may be received by it within  three  Business  Days of such
date. This Section shall be construed  solely for the benefit of the Trustee and
Paying  Agent and shall not  otherwise  affect  the  rights of holders of Senior
Indebtedness.

SECTION 10.9 TRUSTEE TO EFFECTUATE SUBORDINATION

     Each holder of a Security by his acceptance  thereof authorizes and directs
the Trustee on his behalf to take such action as may be necessary or appropriate
to  effectuate  the  subordination  provided in this  Article and  appoints  the
Trustee his attorney-in-fact for any and all such purposes.

SECTION 10.10 NO WAIVER OF SUBORDINATION PROVISIONS

     No right of any  present  or future  holder of any Senior  Indebtedness  to
enforce  subordination  as  herein  provided  shall  at any  time  in any way be
prejudiced  or  impaired by any act or failure to act on the part of the Company
or by any act or failure to act, in good faith,  by any such  holder,  or by any
noncompliance  by the Company with the terms,  provisions  and covenants of this
Indenture,  regardless of any  knowledge  thereof any such holder may have or be
otherwise charged with.

     Without in any way limiting the generality of the foregoing paragraph,  the
holders of Senior  Indebtedness may, at any time and from time to time,  without
the  consent  of or notice to the  Trustee  or the  Holders  of the  Securities,
without  incurring  responsibility  to the Holders of the Securities and without
impairing  or  releasing  the  subordination  provided  in this  Article  or the
obligations  hereunder of the Holders of the Securities to the holders of Senior
Indebtedness,  do any one or more of the following: (i) change the manner, place
or terms of  payment  or  extend  the time of  payment  of,  or renew or  alter,
compromise,  accelerate,  extend or refinance Senior Indebtedness,  or otherwise
amend  or  supplement  in any  manner  Senior  Indebtedness  or  any  instrument
evidencing  the  same  or any  agreement  under  which  Senior  Indebtedness  is
outstanding; (ii) sell, exchange, release, foreclose upon or otherwise deal with
any property pledged, mortgaged or otherwise securing Senior Indebtedness; (iii)
release any Person  liable in any manner for the payment or collection of Senior
Indebtedness;  (iv) exercise or refrain from  exercising  any rights against the
Company  and any other  Person;  (v)  increase or reduce the rate of interest or
amount  of  principal  payable  on any  Senior  Indebtedness;  (vi)  release  or
discharge  the  Company,  by  acceptance  of a deed  or  assignment  in  lieu of
foreclosure or otherwise,  as to all or any portion of the Senior  Indebtedness;
or (vii)  release,  substitute  or add any one or more  guarantors or endorsers,
accept  additional or  substituted  security for payment or  performance  of the
Senior  Indebtedness,  or release  or  subordinate  any  security  therefor.  No
exercise,  delay in  exercise or failure to exercise by any holder of any Senior
Indebtedness  of any right  hereby  given it, no  dealing  by any  holder of any
Senior  Indebtedness with the Company or any other guarantor,  endorser or other
person, no change, impairment or suspension of any right or remedy of any holder
of any Senior  Indebtedness,  and no act or thing  which but for this  provision
could  act as a  release  or  exoneration  of  the  Holders  of  the  Securities
hereunder,  shall in any way  affect,  decrease,  diminish  or impair any of the
obligations  of the  Holders of the  Securities  and the  Trustee or give to the
Holders  of the  Securities,  the  Trustee  or any other  person  or entity  any
recourse or defense against any holder of any Senior Indebtedness.

SECTION 10.11 NOTICE TO TRUSTEE

     The  Company  shall give prompt  written  notice to the Trustee of any fact
known to the Company which would prohibit the making of any payment to or by the
Trustee in respect of the  Securities.  Notwithstanding  the  provisions of this
Article or any other  provision  of this  Indenture,  the  Trustee  shall not be
charged with  knowledge of the  existence of any facts which would  prohibit the
making of any payment to or by the Trustee in respect of the Securities,  unless
and until the  Trustee  shall have  received  written  notice  thereof  from the
Company or a holder of


                                      -38-



<PAGE>



Senior Indebtedness or from any trustee or other representative  therefor;  and,
prior to the receipt of any such written  notice,  the  Trustee,  subject to the
provisions of Sections 7.1 and 7.2,  shall be entitled in all respects to assume
that no such facts exist.

     Subject to the  provisions  of Sections 7.1 and 7.2,  the Trustee  shall be
entitled  to  rely  on  the  delivery  to it of a  written  notice  by a  Person
representing  himself  to be a  holder  of  Senior  Indebtedness  (or a  trustee
therefor)  to  establish  that such  notice has been given by a holder of Senior
Indebtedness (or a trustee  therefor).  In the event that the Trustee determines
in good faith that further evidence is required with respect to the right of any
Person as a holder of Senior  Indebtedness  to  participate  in any  payment  or
distribution pursuant to this Article 10, the Trustee may request such Person to
furnish evidence to the reasonable  satisfaction of the Trustee as to the amount
of Senior  Indebtedness held by such Person,  the extent to which such Person is
entitled to  participate  in such  payment or  distribution  and any other facts
pertinent  to the  rights of such  Person  under  this  Article  10, and if such
evidence  is not  furnished,  the  Trustee  may defer any payment to such Person
pending  judicial  determination  as to the right of such Person to receive such
payment.

SECTION 10.12 RELIANCE ON JUDICIAL ORDER OR CERTIFICATE OF LIQUIDATING AGENT

     Upon any payment or  distribution  of assets of the Company  referred to in
this Article 10, the Trustee, subject to the provisions of Sections 7.1 and 7.2,
and the  Holders of the  Securities  shall be entitled to rely upon any order or
decree entered by any court of competent  jurisdiction in which such insolvency,
bankruptcy, receivership, liquidation,  reorganization,  dissolution, winding up
or similar case or  proceeding is pending,  or a  certificate  of the trustee in
bankruptcy,  receiver,  liquidating trustee, custodian, assignee for the benefit
of  creditors,  agent or other  person  making  such  payment  or  distribution,
delivered  to the  Trustee or to the Holders of  Securities,  for the purpose of
ascertaining   the  Persons   entitled  to   participate   in  such  payment  or
distribution,  the holders of the Senior  Indebtedness and other indebtedness of
the Company,  the amount thereof or payable thereon,  the amount or amounts paid
or distributed  thereon and all other facts pertinent thereto or to this Article
10.

SECTION 10.13 TRUSTEE NOT FIDUCIARY FOR HOLDERS OF SENIOR INDEBTEDNESS

     The Trustee shall not be deemed to owe any fiduciary duty to the holders of
Senior  Indebtedness  and shall not be liable to any such holders if it shall in
good faith  mistakenly pay over or distribute to Holders of Securities or to the
Company or to any other Person cash,  property or securities to which holders of
Senior Indebtedness shall be entitled by virtue of this Article 10 or otherwise.

SECTION 10.14 RIGHTS OF TRUSTEE AS HOLDER OF SENIOR  INDEBTEDNESS;  PRESERVATION
              OF TRUSTEE'S RIGHTS

     The Trustee in its individual  capacity shall be entitled to all the rights
set forth in this Article with respect to any Senior  Indebtedness  which may at
any  time be held by it,  to the same  extent  as any  other  holder  of  Senior
Indebtedness,  and nothing in this Indenture shall deprive the Trustee of any of
its rights as such holder.

     Nothing  in this  Article  shall  apply to claims of, or  payments  to, the
Trustee under or pursuant to Section 7.6.


                                   ARTICLE 11.

                                  MISCELLANEOUS

SECTION 11.1 TRUST INDENTURE ACT CONTROLS



                                      -39-



<PAGE>



     If any provision of this Indenture limits,  qualifies or conflicts with the
duties imposed by TIA ss. 318(c), the imposed duties shall control.

SECTION 11.2 NOTICES

     Any notice or  communication  by the Company or the Trustee to the other is
duly given if in writing and delivered in Person or mailed by  first-class  mail
(registered  or  certified,  return  receipt  requested),  telex,  telecopier or
overnight air courier guaranteeing next day delivery, to the other's address:

          If to the Company:

          Integrated Health Services, Inc.
          10065 Red Run Boulevard
          Owings Mills, Maryland  21117
          Attention:  President


          If to the Trustee:

          Signet Trust Company
          7 St. Paul Street
          Baltimore, Maryland  21202
          Attention:  Corporate Trust Department

     The Company or the Trustee by notice to the other may designate  additional
or different addresses for subsequent notices or communications.

     All notices and communications  shall be deemed to have been duly given: at
the time  delivered by hand, if personally  delivered;  five Business Days after
being deposited in the mail, postage prepaid,  if mailed; when answered back, if
telexed;  when receipt  acknowledged,  if telecopied;  and the next Business Day
after  timely  delivery  to the  courier,  if  sent  by  overnight  air  courier
guaranteeing next day delivery.

     Any notice or communication to a Holder shall be mailed by first-class mail
to the Holder's address shown on the register kept by the Registrar.  Failure to
mail a notice or  communication to a Holder or any defect in it shall not affect
its sufficiency with respect to other Holders.

     If a notice or  communication is mailed in the manner provided above within
the time prescribed, it is duly given, whether or not the addressee receives it.

     If the Company mails a notice or communication to Holders,  it shall mail a
copy to the Trustee and each Agent at the same time.

SECTION 11.3 CERTIFICATE AND OPINION AS TO CONDITIONS PRECEDENT

     Upon any request or  application  by the Company to the Trustee to take any
action under this Indenture, the Company shall furnish to the Trustee:

          (1) an Officers'  Certificate  (which shall include the statements set
     forth in Section 11.4)  stating  that,  in the opinion of the signers,  all
     conditions precedent and covenants,  if any, provided for in this Indenture
     relating to the proposed action have been complied with; and



                                      -40-



<PAGE>



          (2) an Opinion of Counsel  (which  shall  include the  statements  set
     forth in Section 11.4)  stating  that, in the opinion of such counsel,  all
     such conditions precedent and covenants have been complied with.

SECTION 11.4 STATEMENTS REQUIRED IN CERTIFICATE OR OPINION

     Each  certificate or opinion with respect to compliance with a condition or
covenant  provided  for in this  Indenture  (other than a  certificate  provided
pursuant to TIA ss. 314(a)(4)) shall include:

          (1) a statement that the Person making such certificate or opinion has
     read such covenant or condition;

          (2) a brief statement as to the nature and scope of the examination or
     investigation  upon which the  statements  or  opinions  contained  in such
     certificate or opinion are based;

          (3) a statement that, in the opinion of such Person,  he has made such
     examination  or  investigation  as is necessary to enable him to express an
     informed  opinion as to whether or not such  covenant or condition has been
     complied with; and

          (4) a statement  as to whether or not, in the opinion of such  Person,
     such condition or covenant has been complied with.

SECTION 11.5 RULES BY TRUSTEE AND AGENTS

     The  Trustee  may make  reasonable  rules for  action by or at a meeting of
Holders.  The  Registrar  or  Paying  Agent  may make  reasonable  rules and set
reasonable requirements for its functions.

SECTION 11.6 LEGAL HOLIDAYS

     A  "Legal  Holiday"  is a  Saturday,  a Sunday  or a day on  which  banking
institutions  in The  City of New  York  are  authorized  or  obligated  by law,
regulation  or executive  order to remain  closed.  If a payment date is a Legal
Holiday  at a place of  payment,  payment  may be made at that place on the next
succeeding day that is not a Legal Holiday, and no interest shall accrue for the
intervening period.

SECTION 11.7 NO RECOURSE AGAINST OTHERS

     A director, officer, employee or stockholder of the Company or the Trustee,
as such,  shall not have any liability for any  obligations of the Company under
the  Securities or this Indenture or for any claim based on, in respect of or by
reason  of such  obligations  or their  creation.  Each  Holder by  accepting  a
Security waives and releases all such liability.

SECTION 11.8 GOVERNING LAW

     THIS  INDENTURE  AND THE  SECURITIES  SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK,  WITHOUT REGARD TO PRINCIPLES
OF CONFLICTS OF LAW.

SECTION 11.9 NO ADVERSE INTERPRETATION OF OTHER AGREEMENTS

                  This Indenture may not be used to interpret another indenture,
loan or debt agreement of the Company or a Subsidiary.  Any such indenture, loan
or debt agreement may not be used to interpret this Indenture.


                                      -41-



<PAGE>



SECTION 11.10 SUCCESSORS

     All agreements of the Company in this  Indenture and the  Securities  shall
bind its successor.  All agreements of the Trustee in this Indenture  shall bind
its successor.

SECTION 11.11 SEVERABILITY

     In case any  provision  in this  Indenture  or in the  Securities  shall be
invalid, illegal or unenforceable,  the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby.

SECTION 11.12 COUNTERPART ORIGINALS

     The  parties may sign any number of copies of this  Indenture.  Each signed
copy  shall  be an  original,  but  all of  them  together  represent  the  same
agreement.

SECTION 11.13 TRUSTEE AS PAYING AGENT AND REGISTRAR

     The Company initially appoints the Trustee as Paying Agent and Registrar.

SECTION 11.14 TABLE OF CONTENTS, HEADINGS, ETC.

     The Table of Contents,  Cross-Reference  Table and Headings of the Articles
and Sections of this Indenture  have been inserted for  convenience of reference
only,  are not to be  considered  a part  hereof  and shall in no way  modify or
restrict any of the terms or provisions hereof.

SECTION 11.15 EFFECTIVE DATE

     This Amended and Restated  Supplemental  Indenture shall be effective,  and
the  effective  date shall be deemed to have  occurred,  upon the receipt by the
Trustee of a written notice from the Company that the conditions to the Offer to
Purchase the  Company's 10 3/4% Senior  Subordinated  Notes due 2004 and Consent
Solicitation dated May 1, 1997, have been satisfied or waived by the Company and
that the Acceptance Date (as defined therein) has occurred.

                            [Signatures on Next Page]


                                      -42-



<PAGE>



                                   SIGNATURES





Dated as of May 15, 1997
                                         (SEAL)

                                         INTEGRATED HEALTH SERVICES, INC.


                                         By: /s/
                                             --------------------------------
                                             Name:
                                             Title:

Attest:

/s/
- ---------------------------------


Dated as of May 15, 1997
                                         (SEAL)

                                         SIGNET TRUST COMPANY,
                                         as Trustee


                                         By  /s/
                                             --------------------------------
                                             Name:
                                             Title:

Attest:

/s/
- ---------------------------------



                                      -43-



<PAGE>



                                    EXHIBIT A

                   10 3/4% SENIOR SUBORDINATED NOTES DUE 2004


No.                                                                       $


INTEGRATED HEALTH SERVICES, INC.

promises to pay to



or registered assigns,

the principal sum of



Dollars  [or such  greater or lesser  amount as  indicated  on the  Schedule  of
Exchanges of Definitive Securities on the reverse hereof]1 on July 15, 2004

Interest Payment Dates:  January 15 and July 15

Record Dates:  December 31 and June 30



Authentication:                                           Dated:          , 1994

This is one of the Securities referred to in the within-mentioned Indenture.

SIGNET TRUST COMPANY,
as Trustee                                      INTEGRATED HEALTH SERVICES, INC.



By:_____________________________                By:_____________________________
         Authorized Officer


                                                By:_____________________________


                                                                          (SEAL)
- ----------

     1 This phrase  should be included  only if the Security is issued in global
form.

                                       A-1
<PAGE>

                   10 3/4% SENIOR SUBORDINATED NOTES DUE 2004

     1. INTEREST. INTERGRATED HEALTH SERVICES, INC., a Delaware corporation (the
"Company"), promises to pay interest on the principal amount of this Security at
10 3/4% per annum from the date this  Security  is issued  until  maturity.  The
Company will pay interest  semiannually  on January 15 and July 15 of each year,
or if any such day is not a Business  Day, on the next  succeeding  Business Day
(each an "Interest  Payment Date").  Interest on the Securities will accrue from
the most recent date on which interest has been paid or, if no interest has been
paid, from the date of issuance;  provided, that if there is no existing Default
in the payment of  interest,  and if this  Security is  authenticated  between a
record  date  referred to on the face  hereof and the next  succeeding  Interest
Payment Date,  interest shall accrue from such next succeeding  Interest Payment
Date; provided,  further,  that the first Interest Payment Date shall be January
15,  1995.  Interest  will be computed on the basis of a 360-day  year of twelve
30-day months.

     2.  METHOD OF  PAYMENT.  The Company  will pay  interest on the  Securities
(except  defaulted  interest)  to the  Persons  who are  registered  Holders  of
Securities  at the close of  business  on the  record  date next  preceding  the
Interest  Payment Date,  even if such  Securities are canceled after such record
date and on or before  such  Interest  Payment  Date.  In the case of a Security
which is called for redemption on a redemption date, or to be repurchased by the
Company in connection with a Change in Control Repurchase  pursuant to paragraph
6 or an Asset  Sale  Offer  pursuant  to  Paragraph  7, on or after an  interest
payment record date and prior to the next Interest  Payment Date, the registered
holder of such  Security as of such record date shall be entitled to accrued and
unpaid interest to the redemption  date or repurchase  date, as the case may be,
as provided in  paragraphs  5, 6 and 7 below.  The Holder  must  surrender  this
Security to a Paying Agent to collect principal  payments.  The Company will pay
the principal of,  premium,  if any, and interest on the  Securities in money of
the  United  States of America  that at the time of payment is legal  tender for
payment of public and private debts. The Company,  however, may pay such amounts
by check payable in such money mailed to a Holder's registered address.

     3. PAYING AGENT AND REGISTRAR. Initially, Signet Trust Company, the Trustee
under the  Indenture,  will act as Paying Agent and  Registrar.  The Company may
change any Paying Agent, Registrar or co-registrar without notice to any Holder.
The Company or any of its Subsidiaries may act in any such capacity.

     4. INDENTURE. The Company issued the Securities under an Indenture dated as
of July 1, 1994, as subsquently  supplemented by a Supplemental  Indenture dated
as of June 13,  1996  and  amended  and  restated  by an  Amended  and  Restated
Supplemental  Indenture  dated  as of May 15,  1997  ("Indenture")  between  the
Company and the Trustee. The terms of the Securities include those stated in the
Indenture  and  those  made  part of the  Indenture  by  reference  to the Trust
Indenture  Act of 1939,  as amended (15 U.S.  Code ss.ss.  77aaa-77bbbb),  as in
effect on the date of execution of the Indenture.  The Securities are subject to
all such terms,  and Holders are  referred to the  Indenture  and such Act for a
statement of such terms. The Securities are unsecured general obligations of the
Company limited to $100,000,000 in aggregate  principal amount, plus amounts, if
any,  sufficient  to pay  interest  on  outstanding  Securities  as set forth in
Paragraph 2 hereof.

     5. OPTIONAL REDEMPTION. The Company may redeem all or any of the Securities
at any  time on or  after  July  15,  1999 at the  following  redemption  prices
(expressed as percentages of principal  amount) plus accrued and unpaid interest
to the redemption date, if redeemed during the 12-month period beginning:



                                      A-2

<PAGE>



                                                      Optional
          Year                                    Redemption Price
          ----                                    ----------------
      July 15, 1999                                     105.375%
      July 15, 2000                                     103.583%
      July 15, 2001                                     101.792%
      July 15, 2002 and thereafter                      100%


     6. RIGHT TO REQUIRE  REPURCHASE.  Following the occurrence of any Change in
Control,  each Holder will have the right to require that the Company repurchase
(a "Change in Control  Repurchase") such Holder's Securities at a purchase price
equal to 101% of the aggregate principal amount of the Securities,  plus accrued
and unpaid interest thereon,  if any, to the date of repurchase.  Within 30 days
after any Change in  Control,  the  Company or, at the  Company's  request,  the
Trustee, shall cause to be mailed a notice to all Holders notifying such Holders
of the  occurrence of such Change in Control,  the Holder's  rights arising as a
result thereof and the procedures to be followed by Holders  wishing to exercise
such rights.

     A Holder  of  Securities  may  exercise  the  right to  require a Change in
Control  Repurchase  after  receipt of notice of the  existence of such right by
completing the form entitled  "OPTION OF HOLDER TO ELECT PURCHASE"  appearing on
this  Security  and by  complying  with the other  procedures  set forth in such
notice.  Any portion of  Securities  with respect to which the Holder  wishes to
exercise such right must be in integral multiples of $1,000.

     7. MANDATORY OFFER TO REPURCHASE. If the Company consummates any Asset Sale
(as such term is defined in the  Indenture),  the Company  will,  under  certain
circumstances,  be  required to utilize a portion of the net  proceeds  received
from such Asset Sale to offer to purchase  Securities at a purchase  price equal
to 100%  of the  aggregate  principal  amount  of the  Securities  plus  accrued
interest to the date fixed for redemption  (the "Asset Sale Offer").  Holders of
Securities  that are the subject of an offer to purchase  will  receive an Asset
Sale Offer from the Company or the  Trustee.  The Asset Sale Offer shall  remain
open for a period of 30 days  after its  commencement  unless a longer  offering
period is required by law (the  "Asset Sale Offer  Period").  On or prior to the
fifth Business Day following the termination of the Asset Sale Offer Period (the
"Asset Sale Payment Date"), the Company shall purchase,  or cause the Trustee to
purchase,  and mail or deliver payment for the amount of Securities  required to
be  purchased  pursuant  to the Asset  Sale Offer or, if less than the amount of
Securities  required to be  purchased  pursuant to the Asset Sale Offer has been
tendered, all Securities tendered in response to the Asset Sale Offer.

     A Holder of  Securities  may tender or refrain  from  tendering  all or any
portion of his  Securities at his  discretion  by  completing  the form entitled
"OPTION OF HOLDER TO ELECT PURCHASE" appearing on this Security.  Any portion of
Securities tendered must be in integral multiples of $1,000.

     8. NOTICE OF  REDEMPTION.  Notice of Redemption  will be mailed at least 30
days but not more than 60 days  before  the  redemption  date to each  Holder of
Securities to be redeemed at his registered address. Securities in denominations
larger  than  $1,000  may be  redeemed  in part but only in whole  multiples  of
$1,000, unless all of the Securities held by a Holder are to be redeemed. On and
after the  redemption  date interest  ceases to accrue on Securities or portions
thereof called for redemption.

     9.  SUBORDINATION.  The indebtedness  evidenced by this Security is, to the
extent provided in the Indenture, subordinate and subject in right of payment to
the  prior  payment  in full  of all  Senior  Indebtedness  (as  defined  in the
Indenture),  and this  Security  is  issued  subject  to the  provisions  of the
Indenture with respect thereto.  Each Holder of this Security,  by accepting the
same,  (a) agrees to and shall be bound by such  provisions,  (b) authorizes and
directs  the Trustee on his behalf to take such  action as may be  necessary  or
appropriate to effectuate the  subordination  so provided,  and (c) appoints the
Trustee his attorney-in-fact for any and all such purposes.




                                       A-3

<PAGE>



     10.  DENOMINATIONS,  TRANSFER,  EXCHANGE.  The Securities are in registered
form  without  coupons in  denominations  of $1,000 and  integral  multiples  of
$1,000.  The transfer of Securities  may be  registered  and  Securities  may be
exchanged  as  provided  in the  Indenture.  The  Registrar  and the Trustee may
require a Holder,  among other things, to furnish  appropriate  endorsements and
transfer documents and to pay any taxes and fees required by law or permitted by
the  Indenture.  The Registrar need not exchange or register the transfer of any
Security or portion of a Security  selected for  redemption.  Also,  it need not
exchange or register  the  transfer  of any  Securities  for a period of 15 days
before a selection of Securities to be redeemed.

     11.  PERSONS  DEEMED  OWNERS.  The  registered  Holder of a Security may be
treated as its owner for all purposes.

     12. AMENDMENTS AND WAIVERS. Subject to certain exceptions, the Indenture or
the Securities may be amended or supplemented with the consent of the Holders of
at least a majority in principal amount of the Securities then outstanding,  and
any existing  default under,  or compliance with any provision of, the Indenture
may be waived  (other  than any  continuing  Default  or Event of Default in the
payment of interest or premium, if any, on or the principal of the Securities or
in respect of a  provision  under the  Indenture  which  cannot be  modified  or
amended  without the consent of the Holder of each  Security  then  outstanding)
with the  consent  of the  Holders  of a  majority  in  principal  amount of the
Securities then outstanding.  Without the consent of any Holder, the Company and
the Trustee may amend or supplement  the Indenture or the Securities to cure any
ambiguity,  defect  or  inconsistency;  to  provide  for the  assumption  of the
Company's  obligations  to  Holders in the case of a merger or  acquisition;  to
evidence and provide for the acceptance of appointment of any successor  Trustee
under the Indenture; to make any change that does not adversely affect the legal
rights of any Holder;  or to comply with the requirements of the Trust Indenture
Act of 1939, as amended.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of the Indenture (and the obligation of the Company to
obtain any such consent  otherwise  required from such Holder) may be subject to
the  requirement  that such  Holder  shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of the Indenture.

     Without  the consent of each Holder  affected,  the Company may not,  among
other  things,  (i) change  the  Stated  Maturity  of the  principal  of, or any
installment of interest on, any Security,  (ii) reduce the principal  amount of,
or premium, if any, or interest on, any Security, (iii) modify the subordination
provisions of the Indenture in a manner adverse to the Holders,  (iv) change the
place of payment  where,  or the coin or currency in which,  any Security or any
premium  or  interest  thereon is  payable,  (v)  adversely  affect the right of
Holders to require the Company to make a Change in Control  Repurchase or modify
the  obligations  of the  Company  to make an Asset  Sale  Offer or  modify  the
redemption  provisions  of the  Indenture,  (vi) impair the right of a Holder to
institute  suit for the  enforcement of payment of the principal of and premium,
if any, and interest on any Security on or after the Stated Maturity thereof (or
in the case of a redemption,  on or after the  redemption  date) or (vii) reduce
the percentage in principal amount of Securities the consent of whose Holders is
required for any  modification or amendment of the Indenture,  or the consent of
whose Holders is required for any waiver of compliance  with certain  provisions
of the Indenture or certain Defaults or Events of Default thereunder.

     13.  DEFAULTS  AND  REMEDIES.  Events of Default  include:  (i)  default in
payment of  principal or premium on the  Securities;  (ii) default in payment of
interest on the Securities for 30 days; (iii) failure by the Company for 45 days
after notice to it to comply with any of its other  agreements  in the Indenture
or the Securities;  (iv) any  acceleration of Indebtedness of the Company or its
Subsidiaries having an outstanding  principal amount of $50 million or a failure
to pay such  Indebtedness  at its stated  maturity;  and (v)  certain  events of
bankruptcy or insolvency.  If an Event of Default occurs and is continuing,  the
Trustee  or  the  Holders  of at  least  25% in  principal  amount  of the  then
outstanding  Securities may declare all the Securities to be immediately due and
payable for an amount equal to 100% of the principal  amount of the  Securities,
and premium,  if any, plus accrued interest to the date of payment,  except that
in the case of an Event of Default  arising from certain events of bankruptcy or
insolvency, all outstanding Securities



                                       A-4

<PAGE>



become due and payable immediately without further action or notice. Holders may
not enforce the Indenture or the Securities except as provided in the Indenture.
The Trustee  may require  indemnity  satisfactory  to it before it enforces  the
Indenture  or the  Securities.  Subject  to  certain  limitations,  Holders of a
majority in principal amount of the then  outstanding  Securities may direct the
Trustee in its  exercise of any trust or power.  The Trustee may  withhold  from
Holders  notice  of any  continuing  default  (except a default  in  payment  of
principal or interest or that resulted from the failure of the Company to comply
with its obligations  with respect to Holders'  rights to require  repurchase of
Securities upon a Change in Control) if it determines that withholding notice is
in their interests. The Company must furnish an annual compliance certificate to
the Trustee.

     14. TRUSTEE  DEALINGS WITH COMPANY.  The Trustee,  in its individual or any
other capacity,  may make loans to, accept  deposits from, and perform  services
for the Company or its  Affiliates,  and may otherwise  deal with the Company or
its Affiliates, as if it were not Trustee.

     15.  NO  RECOURSE  AGAINST  OTHERS.  A  director,   officer,   employee  or
stockholder,  as such,  of the  Company  shall  not have any  liability  for any
obligations  of the Company  under the  Securities  or the  Indenture or for any
claim  based  on,  in  respect  of or by  reason  of such  obligations  or their
creation.  Each Holder by  accepting  a Security  waives and  releases  all such
liability. The waiver and release are part of the consideration for the issuance
of the Securities.

     16. AUTHENTICATION. This Security shall not be valid until authenticated by
the manual signature of the Trustee or an authenticating agent.

     17.  ABBREVIATIONS.  Customary  abbreviations  may be used in the name of a
Holder  or an  assignee,  such  as:  TEN  COM  (--tenants  in  common),  TEN ENT
(--tenants  by  the   entireties),   JT  TEN  (--joint  tenants  with  right  of
survivorship  and not as tenants in  common),  CUST  (--Custodian),  and U/G/M/A
(--Uniform Gifts to Minors Act).



                                       A-5

<PAGE>



     The Company  will  furnish to any Holder upon  written  request and without
charge a copy of the Indenture. Request may be made to:

           Integrated Health Services, Inc.
           10065 Red Run Boulevard
           Owings Mills, Maryland  21117
           Attention:  Secretary




                                       A-6

<PAGE>



                                 ASSIGNMENT FORM



To assign this Security, fill in the form below: (I) or (we) assign and transfer
this Security to

- ----------------------------------------------------------------
(Insert assignee's Soc. Sec. or Tax I.D. no.)

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

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

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

- ----------------------------------------------------------------
(Print or type assignee's name, address and zip code)

and  irrevocably  appoint  ________________________________________  to transfer
this Security on the books of the Company.  The agent may substitute  another to
act for him.


Date:  ______________

                                   Your Signature:
                                                  ------------------------------
                                            (Sign exactly as your name appears
                                             on the face of this Security)






Signature Guarantee:____________________________




                                       A-7

<PAGE>



                       OPTION OF HOLDER TO ELECT PURCHASE



     If you  want to  elect  to have  this  Security  purchased  by the  Company
pursuant to Section 3.8 or 4.7 of the Indenture, check the appropriate box:

                 [ ] Section 3.8           [ ] Section 4.7

     If you want to elect to have only  part of the  Security  purchased  by the
Company  pursuant to Section 3.8 or 4.7 of the  Indenture,  state the amount you
elect to have purchased: $_______________.


Date:  ______________

                                   Your Signature:
                                                  ------------------------------
                                            (Sign exactly as your name appears
                                             on the face of this Security)


Signature Guarantee:_______________________________




                                       A-8

<PAGE>



            [FORM OF SCHEDULE OF EXCHANGES OF DEFINITIVE SECURITIES2]


     The following  exchanges of a part of this Global  Security for  Definitive
Securities have been made.

<TABLE>
<CAPTION>
                       Amount of              Amount of             Principal Amount of
                       decrease in            increase in           this Global Security
                       Principal Amount       Principal Amount      following such           Signature of autho-
   Date of             of this Global         of this Global        decrease (or             rized officer of
   Exchange            Security               Security              increase)                Trustee
   --------            ----------------       ----------------      --------------------     ------------------
<S>                    <C>                    <C>                   <C>                      <C>
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.
</TABLE>

- --------
     2 This schedule should be included only if the Security is issued in global
form.



                                       A-9



















                        INTEGRATED HEALTH SERVICES, INC.,

                             A DELAWARE CORPORATION,

                                    AS ISSUER


                                       TO

                      FIRST UNION NATIONAL BANK OF VIRGINIA

                                   AS TRUSTEE


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


                                    INDENTURE


                            Dated as of May 30, 1997


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



                                  $450,000,000


                    9 1/2% Senior Subordinated Notes due 2007









<PAGE>



                              CROSS REFERENCE TABLE*

Trust Indenture  
Act Section                                          Indenture Section

31 (a)(1)             .............................                7.9
    (a)(2)            .............................                7.9
    (a)(3)            .............................     Not Applicable
    (a)(4)            .............................     Not Applicable
    (a)(5)            .............................                7.9
    (b)               .............................                7.9
    (c)               .............................     Not Applicable
311(a)                .............................                 **
    (b)               .............................                 **
    (c)               .............................     Not Applicable
312                   .............................                 **
313(a)                .............................                 **
    (b)(1)            .............................     Not Applicable
    (b)(2)            .............................                 **
    (c)               .............................                 **
    (d)               .............................                 **
314(a)                .............................            4.3,4.4
    (b)               .............................     Not Applicable
    (c)(1)            .............................               11.3
    (c)(2)            .............................               11.3
    (c)(3)            .............................     Not Applicable
    (d)               .............................     Not Applicable
    (e)               .............................               11.4
    (f)               .............................     Not Applicable
315(a)                .............................                7.1(2)
    (b)               .............................           7.5,11.2
    (c)               .............................                7.1(1)
    (d)               .............................                7.1(3)
    (e)               .............................                6.11
316(a)(last sentence) .............................                2.8
    (a)(1)(A)         .............................                6.5
    (a)(1)(B)         .............................                6.4
    (a)(2)            .............................     Not Applicable
    (b)               .............................                6.7
    (c)               .............................                9.4
317(a)(1)             .............................                6.8
    (a)(2)            .............................                6.9
    (b)               .............................                2.4
318(a)                .............................               11.1

- ----------
*    This Cross-Reference Table is not part of the Indenture.

**   Included pursuant to Section 318(c) of the Trust Indenture Act of 1939.




<PAGE>


                                TABLE OF CONTENTS

                                                                            Page

                                   ARTICLE 1.

                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

Section 1.1   Definitions....................................................  1
Section 1.2   Other Definitions.............................................. 11
Section 1.3   Incorporation by Reference of Trust Indenture Act.............. 11
Section 1.4   Rules of Construction.......................................... 12

                                   ARTICLE 2.

                                 THE SECURITIES

Section 2.1   Form and Dating................................................ 12
Section 2.2   Execution and Authentication................................... 13
Section 2.3   Registrar and Paying Agent..................................... 13
Section 2.4   Paying Agent to Hold Money in Trust............................ 13
Section 2.5   Registration of Transfer and Exchange.......................... 13
Section 2.6   Replacement Securities......................................... 17
Section 2.7   Outstanding Securities......................................... 17
Section 2.8   Treasury Securities............................................ 17
Section 2.9   Temporary Securities........................................... 18
Section 2.10  Cancellation................................................... 18
Section 2.11  Defaulted Interest............................................. 18
Section 2.12  Securities Issuable in the Form of a Global Security........... 20

                                   ARTICLE 3.

                    OPTIONAL REDEMPTION AND ASSET SALE OFFER

Section 3.1   Notices to Trustee............................................. 19
Section 3.2   Selection of Securities to Be Redeemed or Purchased............ 20
Section 3.3   Notices to Holders............................................. 20
Section 3.4   Effect of Notice of Redemption................................. 21
Section 3.5   Deposit of Redemption Price or Purchase Price.................. 22
Section 3.6   Securities Redeemed or Purchased in Part....................... 22
Section 3.7   Optional Redemption............................................ 22
Section 3.8   Asset Sale Offer............................................... 23

                                   ARTICLE 4.

                                    COVENANTS

Section 4.1   Payment of Securities.......................................... 24
Section 4.2   Maintenance of Office or Agency................................ 24
Section 4.3   SEC Reports.................................................... 24
Section 4.4   Compliance Certificate......................................... 25
Section 4.5   Corporate Existence, Taxes, etc................................ 25
Section 4.6   Stay, Extension and Usury Laws................................. 25
Section 4.7   Limitations on Restricted Payments............................. 25
Section 4.8   Limitations on Restrictions on Distributions from Subsidiaries. 26
Section 4.9   Limitations on Additional Indebtedness......................... 26

                                       i

<PAGE>

Section 4.10  Change in Control.............................................. 27
Section 4.11  Limitations on Asset Sales..................................... 28
Section 4.12  Limitations on Transactions with Affiliates.................... 29
Section 4.13  Limitations on Liens........................................... 29
Section 4.14  Limitations on Subsidiary Preferred Stock...................... 30
Section 4.15  Limitations on Certain Other Subordinated Indebtedness......... 30
Section 4.16  Limitations on Subsidiaries and Unrestricted Subsidiaries...... 30

                                   ARTICLE 5.

                                   SUCCESSORS

Section 5.1   Limitations on Mergers and Consolidations...................... 31
Section 5.2   Successor Corporation Substituted.............................. 31

                                   ARTICLE 6.

                              DEFAULTS AND REMEDIES

Section 6.1   Events of Default.............................................. 31
Section 6.2   Acceleration................................................... 33
Section 6.3   Other Remedies................................................. 33
Section 6.4   Waiver of Past Defaults........................................ 33
Section 6.5   Control by Majority............................................ 33
Section 6.6   Limitations on Suits........................................... 33
Section 6.7   Rights of Holders to Receive Payment........................... 34
Section 6.8   Collection Suit by Trustee..................................... 34
Section 6.9   Trustee May File Proofs of Claim............................... 34
Section 6.10  Priorities..................................................... 34
Section 6.11  Undertaking for Costs.......................................... 35

                                   ARTICLE 7.

                                     TRUSTEE

Section 7.1   Duties of Trustee.............................................. 35
Section 7.2   Rights of Trustee.............................................. 36
Section 7.3   Individual Rights of Trustee................................... 36
Section 7.4   Trustee's Disclaimer........................................... 36
Section 7.5   Notice of Defaults............................................. 36
Section 7.6   Compensation and Indemnity..................................... 36
Section 7.7   Replacement of Trustee......................................... 37
Section 7.8   Successor Trustee by Merger, etc............................... 38
Section 7.9   Eligibility; Disqualification.................................. 38

                                   ARTICLE 8.

                             DISCHARGE OF INDENTURE

Section 8.1   Termination of Company's Obligations........................... 38
Section 8.2   Application of Trust Money..................................... 40
Section 8.3   Repayment to the Company....................................... 40
Section 8.4   Reinstatement.................................................. 40

                                       ii

<PAGE>

                                   ARTICLE 9.

                                   AMENDMENTS

Section 9.1   Without Consent of Holders..................................... 40
Section 9.2   With Consent of Holders........................................ 41
Section 9.3   Compliance with Trust Indenture Act............................ 42
Section 9.4   Revocation and Effect of Consents.............................. 42
Section 9.5   Notation on or Exchange of Securities.......................... 43
Section 9.6   Trustee to Sign Amendments, etc................................ 43

                                   ARTICLE 10.

                                  SUBORDINATION

Section 10.1  Securities Subordinated to Senior Indebtedness................. 43
Section 10.2  Payment Over of Proceeds Upon Dissolution, Etc................. 43
Section 10.3  Prior Payment to Senior Indebtedness Upon Acceleration
of Securities................................................................ 44
Section 10.4  No Payment Upon Certain Defaults with Respect to Senior
Indebtedness................................................................. 44
Section 10.5  Payment Permitted If No Default................................ 46
Section 10.6  Subrogation to Rights of Holders of Senior Indebtedness........ 46
Section 10.7  Provisions Solely to Define Relative Rights.................... 46
Section 10.8  Application by Trustee of Monies Deposited With It............. 47
Section 10.9  Trustee to Effectuate Subordination............................ 47
Section 10.10 No Waiver of Subordination Provisions.......................... 47
Section 10.11 Notice to Trustee.............................................. 48
Section 10.12 Reliance on Judicial Order or Certificate of Liquidating Agent. 48
Section 10.13 Trustee Not Fiduciary for Holders of Senior Indebtedness....... 48
Section 10.14 Rights of Trustee as Holder of Senior Indebtedness;
Preservation of Trustee's Rights............................................. 48

                                   ARTICLE 11.

                                  MISCELLANEOUS

Section 11.1  Trust Indenture Act Controls................................... 49
Section 11.2  Notices........................................................ 49
Section 11.3  Certificate and Opinion as to Conditions Precedent............. 49
Section 11.4  Statements Required in Certificate or Opinion.................. 50
Section 11.5  Rules by Trustee and Agents.................................... 50
Section 11.6  Legal Holidays................................................. 50
Section 11.7  No Recourse Against Others..................................... 50
Section 11.8  Governing Law.................................................. 50
Section 11.9  No Adverse Interpretation of Other Agreements.................. 50
Section 11.10 Successors..................................................... 51
Section 11.11 Severability................................................... 51
Section 11.12 Counterpart Originals.......................................... 51
Section 11.13 Trustee as Paying Agent and Registrar.......................... 51
Section 11.14 Table of Contents, Headings, etc............................... 51
SIGNATURES................................................................... 52

EXHIBIT A     FORM OF RULE 144A NOTE
EXHIBIT B     FORM OF EXCHANGE NOTE
EXHIBIT C     TRANSFER CERTIFICATION

                                      iii


<PAGE>

     INDENTURE dated as of May 30, 1997,  between  INTEGRATED  HEALTH  SERVICES,
INC., a Delaware  corporation (the "Company"),  and FIRST UNION NATIONAL BANK OF
VIRGINIA, a national banking association  organized under the laws of the United
States, as Trustee (the "Trustee").

     Each party  agrees as follows for the benefit of the other  parties and for
the equal and  ratable  benefit  of the  Holders  of the Rule 144A Notes and the
Exchange Notes (each as defined below):


                                   ARTICLE 1.

                          DEFINITIONS AND INCORPORATION
                                  BY REFERENCE

Section 1.1 Definitions

     "Acquired  Indebtedness" means (a) with respect to any Person (including an
Unrestricted Subsidiary) that becomes a Subsidiary of the Company after the date
hereof,  Indebtedness of such Person and its  Subsidiaries  existing at the time
such  Person  becomes a  Subsidiary  of the  Company  that was not  incurred  in
connection  with, or in  contemplation  of, such Person becoming a Subsidiary of
the Company and (b) with respect to the Company or any of its Subsidiaries,  any
Indebtedness  assumed by the Company or any of its  Subsidiaries  in  connection
with the  acquisition  of an asset from another  Person that was not incurred by
such other Person in connection with, or in contemplation  of, such acquisition.
Acquired  Indebtedness  shall be deemed to be  incurred  on the date such person
becomes a Subsidiary or the date of the related asset acquisition.

     "Affiliate"  of any  specified  Person means any other  Person  directly or
indirectly controlling, controlled by or under direct or indirect common control
with such specified Person. For purposes of this definition, "control" when used
with respect to any  specified  Person means the power to direct the  management
and  policies  of such  Person,  directly  or  indirectly,  whether  through the
ownership  of  voting  securities,  by  contract  or  otherwise,  and the  terms
"controlling" and "controlled" have meanings correlative to the foregoing.

     "Agent" means any Registrar or Paying Agent.

     "Allowed and Disallowed  Post-Commencement Interest and Expenses" means all
interest,  at  the  rate  provided  in  the  applicable  document  or  documents
(including  any rate  applicable  upon any default or event of  default,  to the
extent lawful), and all reimbursements,  costs, expenses and indemnities, to the
extent provided in the applicable document or documents,  accruing or claimed at
any time after  commencement of any insolvency or bankruptcy case or proceeding,
or any  receivership,  liquidation,  reorganization,  dissolution,  winding  up,
assignment for the benefit of creditors,  marshalling of assets and  liabilities
or  other   similar  case  or   proceeding,   whether  or  not  such   interest,
reimbursement,  cost or expense  is an allowed  claim  enforceable  against  the
Company in a case or proceeding  under  Bankruptcy Law or in any other such case
or proceeding.

     "Asset  Sale" for any Person  means the sale,  lease,  conveyance  or other
disposition  (including,  without  limitation,  by merger or consolidation,  and
whether  by  operation  of law or  otherwise)  of any of  that  Person's  assets
(including,  without limitation,  the sale or other disposition of Capital Stock
of any Subsidiary of such Person, whether by such Person or by such Subsidiary),
whether owned on the date hereof or subsequently acquired, in one transaction or
a series of related  transactions,  in which such Person and/or its Subsidiaries
sell, lease,  convey or otherwise dispose of (i) all or substantially all of the
Capital Stock of any of such Person's Subsidiaries, (ii) assets which constitute
substantially  all of an operating unit or business of such Person or any of its
Subsidiaries,  or (iii) any health care facility;  provided,  however,  that the
following  shall not  constitute  Asset Sales:  (i) a  transaction  or series of
related  transactions  that  results in a Change in Control,  (ii)  transactions
between  the  Company  and any of its Wholly  Owned  Subsidiaries  or among such
Wholly  Owned  Subsidiaries  or  (iii) a  transaction  or a  series  of  related
transactions in which either (x) the fair market value of the asset(s)  disposed
of does not exceed 2.5% of the  Consolidated  Tangible  Assets of the Company or
(y) the Consolidated EBITDA of the company associated with the asset disposed of
does not exceed 2.5% of the Consolidated EBITDA of the Company.

     "Attributable  Indebtedness,"  when  used  with  respect  to any  Sale  and
Leaseback  Transaction  or an

<PAGE>

operating  lease with respect to a health care facility means, as at the time of
determination,  the  present  value  (discounted  at a  rate  equivalent  to the
interest rate implicit in the lease,  compounded on a semi-annual  basis) of the
total obligations of the lessee for rental payments, after excluding all amounts
required to be paid on account of  maintenance  and repairs,  insurance,  taxes,
utilities and other similar expenses payable by the lessee pursuant to the terms
of the lease,  during the remaining  term of the lease included in any such Sale
and Leaseback  Transaction or such operating lease or until the earliest date on
which the lessee may terminate  such lease without  penalty or upon payment of a
penalty  (in  which  case the  rental  payments  shall  include  such  penalty);
provided,  that  the  Attributable  Indebtedness  with  respect  to a  Sale  and
Leaseback  Transaction  shall  be no less  than  the  fair  market  value of the
property subject to such Sale and Leaseback Transaction.

     "Bank Agent" means Citibank, N.A., as Administrative Agent under the Credit
Agreement or any successor Administrative Agent thereunder.

     "Bank Debt" means all obligations of the Company and its Subsidiaries,  now
or  hereafter  existing  under the  Credit  Agreement,  whether  for  principal,
interest, reimbursement of amounts drawn under letters of credit issued pursuant
thereto, guarantees in respect thereof, fees, expenses, premiums, indemnities or
otherwise,   including  such   obligations   incurred  by  the  Company  or  its
Subsidiaries in connection  with any extension,  refunding or refinancing of the
Credit Agreement.

     "Bankruptcy  Law" means Title 11, U.S. Code or any similar federal or state
law for the relief of debtors.

     "Board of  Directors"  means the Board of  Directors  of the Company or any
authorized committee of the Board of Directors of the Company.

     "Business Day" means any day other than a Legal Holiday.

     "Capital Stock" of any Person means any and all shares, rights to purchase,
warrants or options  (whether or not currently  exercisable),  participation  or
other equivalents of or interests in (however designated) the equity (including,
without  limitation,  common stock,  preferred  stock and  partnership and joint
venture  interests)  of such Person.  Solely for  purposes of clause  (ii)(2) of
Section 4.7 hereof,  "the Company's  Capital Stock" shall include  Capital Stock
(other than  Disqualified  Stock)  issued by a  subsidiary  trust of the Company
which is not conducting  business  operations,  provided,  that the  calculation
pursuant  to clause  (ii)(2) of Section  4.7 hereof  shall not  include  (i) the
subsequent  issuance of Capital  Stock of the  Company in  exchange  for or upon
conversion  of such  subsidiary  trust's  Capital  Stock  or (ii)  any  proceeds
received by the subsidiary trust from the sale of Capital Stock by such trust to
the Company or any Subsidiary or Affiliate of the Company,  and provided further
that to the extent the subsidiary trust uses the proceeds of its sale of Capital
Stock to purchase debt  securities of the Company,  (i) such debt securities are
subordinated in right of payment to the Securities and (ii) distributions on the
Capital  Stock of the  subsidiary  trust may be  suspended  at the option of the
Company or the subsidiary  trust for a period extending up to the lesser of five
years or the maturity of the  underlying  debt security of the Company issued to
the subsidiary trust.

     "Capitalized  Lease  Obligation" of any Person means the obligation of such
Person  to pay  rent or  other  amounts  under a lease  that is  required  to be
capitalized  for financial  reporting  purposes in accordance with GAAP, and the
amount of such obligation shall be the capitalized  amount thereof determined in
accordance with GAAP.

     "Cash  Equivalents"  means,  at any time, (i) any evidence of  Indebtedness
with a maturity of 180 days or less issued or directly and fully  guaranteed  or
insured by the United States of America or any agency or instrumentality thereof
(provided  that the full  faith and  credit of the  United  States of America is
pledged in support  thereof);  (ii) certificates of deposit or acceptance with a
maturity of 180 days or less of any  financial  institution  that is a member of
the Federal  Reserve  System having  combined  capital and surplus and undivided
profits of not less than $500.0 million or (iii) commercial paper,  maturing not
more than 180 days  after  the date of  acquisition,  issued by any  corporation
(other than an Affiliate or  Subsidiary  of the Company)  organized and existing
under the laws of the United States of America with a rating,  at the time as of
which any investment  therein is made, of "P-1" (or higher) according to Moody's
Investor  Service,  Inc. or any successor  rating  agency,  or "A-1" (or higher)
according to Standard and Poor's Corporation or any successor rating agency.

     "Change in Control"  means any of the following:  (i) all or  substantially
all of the  Company's  assets


                                      -2-
<PAGE>


are sold, leased,  conveyed or disposed of as an entirety or substantially as an
entirety,  to any Person or related  "group" of Persons  (other than a Permitted
Holder); (ii) stockholders of the Company shall approve any plan or proposal for
the liquidation or dissolution of the Company;  (iii) there shall be consummated
any  consolidation  or merger of the Company (A) in which the Company is not the
continuing or surviving corporation (other than a consolidation or merger with a
Wholly  Owned  Subsidiary  of the  Company in which all  shares of Common  Stock
outstanding  immediately prior to the effectiveness  thereof are changed into or
exchanged for the same  consideration) or (B) pursuant to which the Common Stock
would be converted into cash,  securities or other property,  in each case other
than a consolidation or merger of the Company in which the holders of the Common
Stock  immediately  prior to the  consolidation  or  merger  have,  directly  or
indirectly,  at  least a  majority  of the  common  stock of the  continuing  or
surviving  corporation  immediately after such  consolidation or merger; or (iv)
any Person,  or any Persons acting together which would constitute a "group" for
purposes of Section  13(d) of the Exchange Act (other than a Permitted  Holder),
together with any affiliates  thereof shall beneficially own (as defined in Rule
13d-3  under the  Exchange  Act) at least 50% of the total  voting  power of all
classes  of capital  stock of the  Company  entitled  to vote  generally  in the
election of directors of the Company.

     "Common  Equity" of any Person means all Capital  Stock of such Person that
is generally entitled to (i) vote in the election of directors of such Person or
(ii) if such Person is not a corporation,  vote or otherwise  participate in the
selection of the governing body, partners,  managers or others that will control
the management and policies of such Person.

     "Company"  means  (i)  Integrated   Health   Services,   Inc.,  a  Delaware
corporation, and (ii) any successor of Integrated Health Services, Inc.

     "Consolidated  Amortization Expense" of any Person for any period means the
amortization expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated  Coverage  Ratio" with respect to the Company means the ratio
of (i)  Consolidated  EBITDA  of the  Company  to (ii) the  aggregate  amount of
Consolidated  Interest  Expense of the Company for the four full fiscal quarters
immediately  preceding  the date of the  transaction  giving rise to the need to
calculate the Consolidated  Coverage Ratio and for which such quarters financial
results have been reported;  provided,  however,  that if any calculation of the
Company's  Consolidated  Coverage Ratio requires the use of any quarter prior to
the date of the Indenture,  such calculation shall be made on a pro forma basis,
giving effect to the issuance of the  Securities and the use of the net proceeds
therefrom  as if the same had  occurred  at the  beginning  of the  four-quarter
period used to make such  calculation;  and  provided  further that if any Asset
Sale was  consummated  or any  acquisition  of a  hospital  or other  healthcare
facility or any assets  purchased  outside the  ordinary  course of business was
effected by the  Company or any of its  Subsidiaries  during  such four  quarter
period or on any later  date on or prior to the date of the  transaction  giving
rise to the need to calculate the Consolidated  Coverage Ratio, such calculation
shall be made on a pro forma  basis,  giving  effect to each such  Asset Sale or
acquisition  (including  the  Consolidated  EBITDA  relating  to  the  hospital,
healthcare  facility or other assets acquired),  as the case may be, and the use
of any proceeds  therefrom,  as if the same had occurred at the beginning of the
four-quarter   period  used  to  make  such  calculation  (except  that  if  any
calculation of the  Consolidated  Coverage Ratio requires the use of any quarter
prior to the acquisition of First American Health Care of Georgia,  Inc. ("First
American"), then the results of operations for First American shall be reflected
in such  calculation  from the date of the  acquisition of First American (on an
annualized  basis for the four quarter period following the acquisition) and pro
forma  effect  shall not be given to such  results of  operations  (but shall be
given effect to any  financing,  including the  incurrence of  Indebtedness,  in
connection with such  acquisition) as if it had occurred at the beginning of the
four-quarter  period  used to make such  calculation).  The  calculation  of the
Consolidated  Coverage  Ratio  shall  also  give  pro  forma  effect  to (i) the
incurrence,  repayment or retirement of any other Indebtedness, and the issuance
or redemption of any Preferred  Stock, by the Company and its  Subsidiaries  and
(ii) the  discontinuance  of any operations by the Company and its Subsidiaries,
in any case occurring during such four quarter period or on any later date on or
prior to the date of the  transaction  giving rise to the need to calculate  the
Consolidated  Coverage  Ratio as if such  Indebtedness  was incurred,  repaid or
retired or such Preferred  Stock was issued or redeemed at the beginning of such
four-quarter  period.  For purposes of  calculating  the  Consolidated  Coverage
Ratio,  (i) the Consolidated  Interest  Expense  attributable to interest on any
Indebtedness  computed on a pro forma basis and (A) bearing a floating  interest
rate shall be  computed as if the average  rate over the  applicable  period had
been the applicable rate for the entire period and (B) which was not outstanding
during the period for which the  computation  is being made but which bears,  at
the  option of the  Company,  a fixed or  floating  rate of  interest,  shall be
computed by  applying at the option of the Company  either the fixed or floating
rate and (ii) in making such calculation,  the Consolidated  Interest Expense of
the  Company


                                      -3-
<PAGE>

attributable to interest on any  Indebtedness  under a revolving credit facility
computed on a pro forma basis  shall be  computed  based upon the average  daily
balance of such Indebtedness during the applicable period.

     "Consolidated  Depreciation Expense" of any Person for any period means the
depreciation expense of such Person and its Subsidiaries for such period (to the
extent included in the  computation of Consolidated  Net Income of such Person),
determined on a consolidated basis in accordance with GAAP.

     "Consolidated   EBITDA"  of  any  Person   means,   with   respect  to  any
determination  date,  Consolidated Net Income,  plus (i) Consolidated Income Tax
Expense,  plus (ii) Consolidated  Depreciation  Expense, plus (iii) Consolidated
Amortization  Expense,  plus (iv)  Consolidated  Interest Expense (to the extent
reducing  Consolidated  Net Income),  plus (v) all other non-cash items reducing
Consolidated  Net Income of such Person and its  Subsidiaries,  determined  on a
consolidated  basis  in  accordance  with  GAAP,  and less  all  non-cash  items
increasing  Consolidated  Net  Income  of  such  Person  and  its  Subsidiaries,
determined on a  consolidated  basis in accordance  with GAAP, in each case, for
such Person's prior four full fiscal quarters for which  financial  results have
been reported immediately preceding the determination date.

     "Consolidated Income Tax Expense" means, for any Person for any period, the
provision  for  taxes  based  on  income  and  profits  of such  Person  and its
Subsidiaries  to the extent such income or profits  were  included in  computing
Consolidated Net Income of such Person for such period.

     "Consolidated  Interest  Expense"  of any Person  for any period  means the
Interest Expense of such Person and its Subsidiaries for such period, determined
on a consolidated  basis in accordance with GAAP, plus any dividends accrued for
such period on any Preferred  Stock of any Subsidiary not held by the Company or
any Wholly Owned Subsidiary of the Company.

     "Consolidated Net Income" of any Person for any period means the net income
(or loss) of such Person and its  Subsidiaries  for such period  determined on a
consolidated  basis in accordance with GAAP,  without giving effect to dividends
on any series of preferred  stock of any  Subsidiary of such Person,  whether or
not in cash,  to the extent such  consolidated  net income was reduced  thereby;
provided  that  there  shall be  excluded  from such net  income  (to the extent
otherwise included therein),  without duplication:  (i) the net income (or loss)
of any Person  (other than a  Subsidiary  of the  referent  Person) in which any
Person other than the referent Person has an ownership  interest,  except to the
extent that any such income has actually been received by the referent Person or
any of its Subsidiaries in the form of dividends or similar distributions during
such period; (ii) except to the extent includible in the consolidated net income
of the referent Person pursuant to the foregoing  clause (i), the net income (or
loss) of any Person that accrued prior to the date that (a) such Person  becomes
a Subsidiary of the referent Person or is merged into or  consolidated  with the
referent Person or any of its  Subsidiaries or (b) the assets of such Person are
acquired by the referent Person or any of its Subsidiaries; (iii) the net income
of any Subsidiary of the referent Person (other than a Wholly Owned  Subsidiary)
to  the  extent  that  the  declaration  or  payment  of  dividends  or  similar
distributions by such Subsidiary of that income is not permitted by operation of
the terms of its charter or any agreement,  instrument, judgment, decree, order,
statute,  rule or governmental  regulation  applicable to that Subsidiary during
such period;  (iv) any gain or loss,  together with any related  provisions  for
taxes on any such gain or loss,  realized  during  such  period by the  referent
Person or any of its Subsidiaries upon (a) the acquisition of any securities, or
the  extinguishment  of any  Indebtedness,  of the referent Person or any of its
Subsidiaries  or (b)  any  Asset  Sale  by  the  referent  Person  or any of its
Subsidiaries;  (v) any  extraordinary  gain or loss,  together  with any related
provision  for taxes on any such  extraordinary  gain or loss,  realized  by the
referent Person or any of its Subsidiaries  during such period; (vi) any unusual
or  nonrecurring   non-cash  charge  which  is  not,  under  generally  accepted
accounting  principles,  an  extraordinary  item;  and  (vii)  in the  case of a
successor to such Person by consolidation, merger or transfer of its assets, any
earnings of the  successor  prior to such merger,  consolidation  or transfer of
assets.

     "Consolidated   Net  Worth"  of  any  Person  as  of  any  date  means  the
stockholders' equity (including any preferred stock that is classified as equity
under GAAP, other than  Disqualified  Stock) of such Person and its Subsidiaries
(excluding any equity adjustment for foreign currency translation for any period
subsequent to the date of this Indenture) on a consolidated  basis at such date,
as determined in accordance with GAAP, less all write-ups  (other than write-ups
in connection with acquisitions) subsequent to the date of this Indenture in the
book value of any asset owned by such Person or any of its Subsidiaries.

     "Consolidated Tangible Assets" of any Person as of any date means the total
assets of such Person


                                      -4-
<PAGE>


and  its  Subsidiaries  (excluding  any  assets  that  would  be  classified  as
"intangible  assets"  under  GAAP)  on a  consolidated  basis at such  date,  as
determined in accordance with GAAP, less all write-ups  (other than write-ups in
connection  with  acquisitions)  subsequent to the date of this Indenture in the
book value of any asset (except any such intangible assets) owned by such Person
or any of its Subsidiaries.

     "Corporate  Trust  Office of the  Trustee"  shall be at the  address of the
Trustee  specified in Section 11.2 or such other address as the Trustee may give
notice to the Company.

     "Credit  Agreement"  means the Revolving  Credit  Agreement,  dated May 15,
1996, among the Company,  the Bank Agent,  and the other financial  institutions
signatory  thereto,  together  with the related  documents  thereto,  including,
without  limitation,  any security  documents  and all  exhibits  and  schedules
thereto,  and any agreement or agreements relating to any extension,  refunding,
refinancing,  successor or  replacement  facility,  whether or not with the same
lenders,  and whether or not the principal amount or amount of letters of credit
outstanding  thereunder or the interest rate payable in respect thereof shall be
thereby increased, in each case as amended and in effect from time to time.

     "Credit  Facility"  means the Credit  Agreement  and one or more  borrowing
arrangements to be entered into by and between the Company and/or one or more of
its Subsidiaries and a commercial bank or other institutional lender,  including
any related notes,  security  documentation,  guarantees,  collateral documents,
instruments  and agreements  executed in connection  therewith,  in each case as
amended, modified,  supplemented,  restructured,  renewed,  restated,  refunded,
replaced or refinanced or extended from time to time on one or more occasions.

     "Default" means any event, act or condition that is, or after notice or the
passage of time or both would be, an Event of Default.

     "Definitive Securities" means any Securities other than a Global Security.

     "Depositary"  means, with respect to Securities issuable or issued in whole
or in part in global form hereunder,  unless otherwise  specified by the Company
pursuant to Section 2.12, The Depository  Trust Company,  New York, New York, or
any successor thereto  registered as a clearing agency under the Exchange Act or
other applicable statute or regulation.

     "Disqualified  Stock" means any Capital Stock that, by its terms (or by the
terms  of  any  security  into  which  it is  convertible  or  for  which  it is
exchangeable),  or upon the  happening of any event,  matures or is  mandatorily
redeemable, pursuant to a sinking fund obligation or otherwise, or is redeemable
at the option of the  holder  thereof,  in whole or in part,  on or prior to the
final maturity date of the  Securities  for cash or debt  securities at any time
prior to any such final maturity,  or is convertible  into or  exchangeable  for
debt securities at any time prior to any such final maturity.

     "Eligible  Investments"  of any Person means  Investments of such Person in
(i)  securities  issued or fully  guaranteed  or insured  by the  United  States
Government or any agency  thereof and backed by the full faith and credit of the
United States maturing not more than one year from the date of acquisition; (ii)
certificates  of deposit,  time deposits,  Eurodollar  time  deposits,  bankers'
acceptances or deposit accounts having in each case a remaining term to maturity
of not more than one year,  which are  either (a) fully  insured by the  Federal
Deposit  Insurance  Corporation or (b) issued by any lender or by any commercial
bank under the laws of any State or any national  banking  association  that has
combined capital and surplus of not less than  $500,000,000 and whose short-term
securities  are rated at least A-1 by S&P or P-1 by  Moody's;  (iii)  commercial
paper that is rated at least A-1 by S&P or P-1 by  Moody's,  issued by a company
that is  incorporated  under the laws of the  United  States or of any State and
directly issues its own commercial  paper,  and has a remaining term to maturity
of not more than one year;  (iv) a repurchase  agreement with (A) any commercial
bank  that is  organized  under the laws of any  State or any  national  banking
association  and that has  total  assets  of at least  $500,000,000,  or (B) any
investment bank that is organized under the laws of any state and that has total
assets of at least  $500,000,000,  which agreement is secured by any one or more
of the  securities  and  obligations  described in clauses (i), (ii) or (iii) of
this  definition  of  Eligible  Investments,  which  shall  have a market  value
(exclusive  of accrued  interest and valued at least  monthly) at least equal to
the  principal  amount  of  such  investment;  (v) any  money  market  or  other
investment fund the investments of which are limited to investments described in
clauses (i), (ii), (iii) and (iv) of this definition of Eligible Investments and
which is managed by (A) a commercial  bank that is  organized  under the laws of
any State or any national  banking  association  and that has total assets of at
least $500,000,000,  or (B) any investment bank that is organized under the laws
of  any  State  and  that  has  total  assets  of at  least  $500,000,000;  (vi)
obligations,


                                      -5-
<PAGE>

debentures, notes, bonds or other evidences of indebtedness rated at least A- by
Moody's or A3 by S&P;  provided that the aggregate  amount of investments by any
Person permitted under this clause (vi) shall not exceed 25% of the total amount
invested by such Person in eligible investments; (vii) investments in investment
grade  auction rate and  adjustable  rate  preferred  equities for issuers whose
actual or implied senior long-term debt is rated at least A- by Moody's or A3 by
S&P; (viii)  investments in investment  grade fixed rate preferred  equities for
issuers whose actual or implied  senior  long-term  debt is rated at least A- by
Moody's or A3 by S&P;  provided that the aggregate  amount of investments by any
Person  permitted  under this  clause  (viii)  shall not exceed 10% of the total
amount  invested by such Person in Eligible  Investments;  (ix)  adjustable rate
mortgage-backed  securities  rated at least AA by S&P or Aa by Moody's;  and (x)
fixed rate mortgage-backed securities rated at least AA by S&P or Aa by Moody's,
provided that the aggregate  amount of investments by any Person permitted under
this clause (x) shall not exceed 25% of the total amount invested by such Person
in Eligible Investments.

     "Equity Interest" means, with respect to any Person,  any and all shares or
other equivalents (however designated) of capital stock,  partnership  interests
or any other participation,  right or other interests in the nature of an equity
interest  in such Person or any option,  warrant or other  security  convertible
into or exchangeable for the foregoing.

     "Exchange Act" means the Securities Exchange Act of 1934, as amended.

     "Exchange  Notes" means Notes having terms  substantially  identical in all
respects  to the Rule  144A  Notes  for which  they are to be  exchanged  in the
Exchange  Offer,  except that (i) the Exchange  Notes will have been  registered
under the Securities Act and,  therefore,  will not bear legends restricting the
transfer  thereof,  and (ii)  Holders of Exchange  Notes will not be entitled to
certain  rights of  holders  of Rule 144A Notes  under the  Registration  Rights
Agreement.

     "Exchange  Offer"  means the offer the  Company is to make  pursuant to the
Registration Rights Agreement to exchange Rule 144A Notes for Exchange Notes.

     "Existing  Indebtedness"  means all of the  Indebtedness of the Company and
its Subsidiaries that is outstanding on the date hereof.

     "GAAP" means  generally  accepted  accounting  principles  set forth in the
opinions and  pronouncements of the Accounting  Principles Board of the American
Institute of Certified Public  Accountants and statements and  pronouncements of
the Financial  Accounting  Standards  Board or in such other  statements by such
other  entity as may be  approved  by a  significant  segment of the  accounting
profession of the United States, as in effect from time to time.

     "Global  Security"  means a Security  which is  executed by the Company and
authenticated  and delivered by the Trustee to the Depositary or pursuant to the
Depositary's instruction,  all in accordance with this Indenture and pursuant to
a written  order of the Company,  which shall be  registered  in the name of the
Depositary or its nominee and which shall represent, and shall be denominated in
an amount equal to the aggregate  principal  amount of, all of the Securities or
any  portion  thereof,  but not  including  any  Securities  that are no  longer
outstanding,  and having the same terms, including, without limitation, the same
original  issue  date,  date or  dates on which  principal  is due,  and rate of
interest.

     "Guarantee" by any Person means any obligation, contingent or otherwise, of
such Person  directly  or  indirectly  guaranteeing  any  Indebtedness  or other
obligation  of any other  Person and,  without  limiting the  generality  of the
foregoing, any obligation,  direct or indirect, contingent or otherwise, of such
Person (i) to purchase or pay (or  advance or supply  funds for the  purchase or
payment of) such  Indebtedness or other obligation of such other Person (whether
arising by virtue of  partnership  arrangements,  by agreement  to keepwell,  to
purchase assets, goods,  securities or services, to take-or-pay,  or to maintain
financial  statement  conditions  or  otherwise)  or (ii)  entered  into for the
purpose of assuring  in any other  manner the  obligee of such  Indebtedness  or
other  obligation of the payment thereof or to protect such obligee against loss
in respect thereof (in whole or in part); provided that the term Guarantee shall
not include  endorsements  for  collection or deposit in the ordinary  course of
business. The term "Guarantee" used as a verb has a corresponding meaning.

     "Hedging  Obligations"  of any Person means the  obligations of such Person
pursuant  to  any  interest  rate  swap  agreement,  foreign  currency  exchange
agreement,  interest rate collar agreement,  option or futures contract or


                                      -6-
<PAGE>

other similar  agreement or  arrangement  relating to interest  rates or foreign
exchange rates.

     "Holder" means a Person in whose name a Security is registered.

     "Indebtedness" of any Person at any date means,  without  duplication:  (i)
all Bank Debt;  (ii) all other  indebtedness  of such Person for borrowed  money
(whether  or not  recourse  of the  lender is to the whole of the assets of such
Person  or only to a portion  thereof);  (iii) all  obligations  of such  Person
evidenced by bonds,  debentures,  notes or other similar  instruments;  (iv) all
obligations  of such  Person in respect  of  letters of credit or other  similar
instruments  (or  reimbursement  obligations  with  respect  thereto);  (v)  all
obligations of such Person with respect to Hedging Obligations (other than those
that fix the interest rate on variable rate indebtedness  otherwise permitted by
this  Indenture  or that  protect the Company  and/or its  Subsidiaries  against
changes in foreign exchange  rates);  (vi) all obligations of such Person to pay
the deferred  and unpaid  purchase  price of property or services,  except trade
payables and accrued expenses incurred in the ordinary course of business; (vii)
all Capitalized  Lease  Obligations of such Person;  (viii) all  Indebtedness of
others  secured  by a Lien on any  asset  of such  Person,  whether  or not such
Indebtedness  is  assumed  by such  Person;  (ix)  all  Indebtedness  of  others
guaranteed  by  such  Person  to the  extent  of  such  guarantee;  and  (x) all
Attributable Indebtedness.  The amount of Indebtedness of any Person at any date
shall be the outstanding  balance at such date of all unconditional  obligations
as  described  above;  and in the case of  clauses  (iv) and (ix),  the  maximum
liability of such Person for any such  contingent  obligations at such date, and
in the case of clause (viii), the amount of the Indebtedness secured.

     "Indenture" means this Indenture, as amended from time to time.

     "Interest  Expense" of any Person for any period means the aggregate amount
of interest which,  in accordance  with GAAP,  would be set opposite the caption
"interest  expense" or any like caption on an income  statement  for such Person
(including,  without  limitation or duplication,  imputed  interest  included in
Capitalized  Lease  Obligations,  all commissions,  discounts and other fees and
charges  owed  with  respect  to  letters  of  credit  and  bankers'  acceptance
financing,  the net costs associated with Hedging  Obligations,  amortization of
financing  fees and  expenses,  the  interest  portion of any  deferred  payment
obligation, amortization of discount and all other non-cash interest expense).

     "Interest Payment Date" shall have the meaning assigned to such term in the
Securities.

     "Investments" of any Person means (i) all investments by such Person in any
other Person in the form of loans, advances or capital contributions  (excluding
commission,  travel and similar  advances to officers and employees  made in the
ordinary  course of  business),  (ii) all  guarantees of  Indebtedness  or other
obligations  of any other Person by such Person,  (iii) all  purchases (or other
acquisitions for consideration) by such Person of Indebtedness, Capital Stock or
other  securities  of any other  Person  and (iv) all other  items that would be
classified as investments  (including,  without limitation,  purchases of assets
outside  the  ordinary  course of  business)  on a balance  sheet of such Person
prepared in accordance with GAAP.

     "Lien"  means,  with  respect to any asset,  any  mortgage,  lien,  pledge,
charge, security interest or other similar encumbrance of any kind in respect of
such  asset,  whether  or not  filed,  recorded  or  otherwise  perfected  under
applicable law (including,  without  limitation,  any conditional  sale or other
title  retention  agreement,  any  financing  lease in the nature  thereof,  any
agreement  to sell,  and any  filing of, or  agreement  to give,  any  financing
statement  (other than notice filings not perfecting a security  interest) under
the Uniform Commercial Code (or equivalent statutes) of any jurisdiction).

     "Net  Proceeds"  with  respect  to any Asset  Sale  means (i) cash (in U.S.
dollars or freely  convertible into U.S. dollars) received by the Company or any
of its Subsidiaries from such Asset Sale (including,  without  limitation,  cash
received as  consideration  for the  assumption  or  incurrence  of  liabilities
incurred in connection with or in  anticipation  of such Asset Sale),  after (a)
provision for all income or other taxes measured by or resulting from such Asset
Sale or the transfer of the proceeds of such Asset Sale to the Company or any of
its Subsidiaries,  (b) payment of all brokerage commissions and the underwriting
and other fees and expenses  related to such Asset Sale and (c)  deduction of an
appropriate amount to be provided by the Company or any of its Subsidiaries as a
reserve,  in accordance with GAAP,  against any liabilities  associated with the
assets  sold or  otherwise  disposed  of in such Asset Sale and  retained by the
Company or any of its  Subsidiaries  after such Asset Sale  (including,  without
limitation,   pension  and  other   post-employment   benefit   liabilities  and
liabilities  related to  environmental  matters) or against any  indemnification
obligations  associated with the sale or other disposition of the assets sold or
otherwise  disposed  of in such Asset Sale


                                      -7-
<PAGE>


and  (ii) all  non-cash  consideration  received  by the  Company  or any of its
Subsidiaries  from such Asset Sale upon the  liquidation  or  conversion of such
consideration into cash.

     "Officer" means the Chief Executive  Officer,  the Chief Financial Officer,
the  Treasurer,  any  Assistant  Treasurer,  Controller,  Secretary  or any Vice
President of the Company.

     "Officers'  Certificate" means a certificate signed by two Officers, one of
whom must be the Company's Chief Executive Officer or Chief Financial Officer.

     "Opinion of Counsel"  means an opinion from legal counsel who is acceptable
to the  Trustee in its sole  discretion.  The  counsel  may be an employee of or
counsel to the Company or the Trustee.

     "Payment or Distribution in Respect of the Securities"  means, for purposes
of Article 10 hereof,  any  payment or  distribution  of any kind or  character,
whether in cash,  property  or  securities,  on  account  of the  payment of the
principal  of and  premium,  if  any,  and  interest  on any of the  Securities,
including,  without limitation,  any redemption or repurchase price paid for any
optional or mandatory redemption, Asset Sale Offer, Change in Control Repurchase
or other  repurchase  or  retirement  of the  Securities or any other payment on
account of the Securities  (including payments with respect to claims related to
the issuance of the Securities);  provided,  however,  that the exchange of Rule
144A Notes for a like amount of Exchange Notes shall not constitute a Payment or
Distribution in Respect of the Securities.  For purposes of this definition, the
words "cash,  property or securities" shall not be deemed to include  securities
of the Company as reorganized or readjusted, or securities of the Company or any
other corporation provided for by a plan of reorganization or readjustment which
are  subordinated  in right of payment to all Senior  Indebtedness  which may be
outstanding  to  substantially  the same extent as, or to a greater extent than,
the  Securities  are so  subordinated  as  provided  in  Article  10  and  which
securities  are not  subject to maturity or  mandatory  prepayment  prior to the
maturity of any Senior Indebtedness then outstanding.

     "Permitted Holder" means Robert N. Elkins and any group (within the meaning
of Section  13(d)(3) of the Exchange  Act) of which Mr.  Elkins is a member;  so
long as, with respect to any group,  Mr.  Elkins owns more than 20% of the total
voting power of all classes of Capital Stock of the acquiring entity entitled to
vote generally in the election of directors of the acquiring entity.

     "Permitted Investment" means (i) capital  contributions,  advances or loans
to the Company by any Subsidiary, by the Company to a Wholly Owned Subsidiary or
by a Subsidiary to a Wholly Owned Subsidiary; (ii) the acquisition or holding by
the  Company  or any  Subsidiary  of  receivables  owing to the  Company or such
Subsidiary,  if created or  acquired  in the  ordinary  course of  business  and
payable or  dischargeable  in accordance with customary  trade terms;  (iii) the
acquisition  or holding by the Company or any  Subsidiary  of cash and  Eligible
Investments;  (iv) the  Company and its  Subsidiaries  may make  Investments  in
Persons at least a majority of whose  revenues  result from  healthcare  related
businesses  or  facilities;  (v)  Investments  acquired or retained from another
Person  in  connection  with  any  sale,  conveyance,  transfer,  lease or other
disposition  of any  properties or assets to such Person in accordance  with the
covenant  described in Section 4.11 hereof;  and (vi)  Investments not otherwise
permitted by clauses (i) through (v) above in an aggregate  amount not exceeding
$10 million.

     "Person" means any  individual,  corporation,  partnership,  joint venture,
incorporated  or  unincorporated   association,   joint-stock  company,   trust,
unincorporated   organization   or  government  or  other  agency  or  political
subdivision thereof or other entity of any kind.

     "Preferred  Stock"  means with  respect to any Person all Capital  Stock of
such Person which has a preference in liquidation  or a preference  with respect
to the payment of dividends.

     "Public Equity  Offering"  means a public offering by the Company of shares
of its common stock  (however  designated  and whether  voting or non-voting but
excluding  Disqualified  Stock) and any and all  rights,  warrants or options to
acquire such common stock pursuant to a registration  statement registered under
the Securities Act.

     "Refinancing  Indebtedness" means Indebtedness that refunds,  refinances or
extends any Existing Indebtedness or other Indebtedness permitted to be incurred
under  the  Indenture  (other  than  Existing   Indebtedness  under  the  Credit
Agreement); provided that: (i) the Refinancing Indebtedness is the obligation of
the same Person as was


                                      -8-
<PAGE>

obligated on the  Indebtedness  being  refinanced  and has a ranking in priority
relative to the Securities equal to or junior to that of the Indebtedness  being
refunded, refinanced or extended; (ii) the Refinancing Indebtedness is scheduled
to mature  no  earlier  than the  Indebtedness  being  refunded,  refinanced  or
extended;  (iii) the  Refinancing  Indebtedness  has a Weighted  Average Life to
Maturity at the time such Refinancing  Indebtedness is incurred that is equal to
or greater  than the  Weighted  Average  Life to  Maturity of the portion of the
Indebtedness  being  refunded,  refinanced  or  extended;  (iv) the  Refinancing
Indebtedness  is secured  only to the extent,  if at all, and by the assets that
the Indebtedness being refunded, refinanced or extended is secured; and (v) such
Refinancing Indebtedness is in an aggregate principal amount that is equal to or
less than the aggregate principal amount then outstanding under the Indebtedness
being refunded,  refinanced or extended (except for issuance costs and increases
in  Attributable  Indebtedness  due solely to  increases  in the  present  value
calculations  resulting  from  renewals  or  extensions  of  the  terms  of  the
underlying leases in effect on the date of this Indenture).

     "Registration  Rights  Agreement" means the  Registration  Rights Agreement
dated as of May 22,  1997 by and between  the  Company  and Smith  Barney  Inc.,
Donaldson,  Lufkin &  Jenrette  Securities  Corporation,  Morgan  Stanley  & Co.
Incorporated and Salomon Brothers Inc, as Initial Purchasers,  as such agreement
may be amended, modified or supplemented from time to time.

     "Restricted Payment" means, with respect to any Person: (i) the declaration
of any  dividend  or the making of any other  payment or  distribution  of cash,
securities or other property or assets in respect of such Person's Capital Stock
(except that a dividend payable solely in Capital Stock (other than Disqualified
Stock) of such Person  shall not  constitute  a  Restricted  Payment);  (ii) any
payment on account of the purchase, redemption,  retirement or other acquisition
for value of such Person's Capital Stock or options, warrants or other rights to
acquire such Capital Stock, or any other payment or distribution made in respect
thereof,  either  directly  or  indirectly;  (iii) the making of any  payment of
principal,  premium or interest  on, or any payment on account of the  purchase,
redemption,  retirement, defeasance or other acquisition for value (prior to any
scheduled  maturity,  scheduled  repayment,  scheduled  sinking  fund payment or
scheduled  interest  payment  date)  of,  Indebtedness  of  the  Company  or its
Subsidiaries which is pari passu with or subordinated in right of payment to the
Securities and has a scheduled  maturity date  subsequent to the maturity of the
Securities;  or (iv) the making of any  Investment  in any  Person  other than a
Permitted  Investment;  provided,  however,  with respect to the Company and its
Subsidiaries,  Restricted  Payments shall not include (I) any payment  described
(a) in clause  (i),  (ii) or (iii)  above made (1) to the  Company or any of its
Wholly Owned  Subsidiaries  by any of the Company's  Subsidiaries  or (2) by the
Company to any of its Wholly  Owned  Subsidiaries  or (b) in clause  (iii) above
made with the Net Proceeds from any Asset Sale remaining after completion of the
Asset Sale Offer made in connection  with such Asset Sale,  all as  contemplated
under Section 4.11 hereof,  (II) any payment  described in clause (i) above made
by a Subsidiary that is not a Wholly Owned  Subsidiary to all holders of Capital
Stock of such  Subsidiary  on a pro rata  basis or  (III)  the  purchase  by the
Company of up to an  aggregate  of $50 million of the  Company's  Capital  Stock
pursuant  to  one  or  more  stock  repurchase  programs.   Notwithstanding  the
foregoing,  the following  shall not  constitute  Restricted  Payments:  (X) the
retirement,  repurchase,  redemption or other acquisition of Indebtedness of the
Company or any Subsidiary out of the net proceeds of a substantially  concurrent
sale (other than to a  Subsidiary  of the  Company) of new  Indebtedness  of the
Company;  provided (a) the principal  amount of such new  Indebtedness  does not
exceed the principal amount of Indebtedness so retired, repurchased, redeemed or
otherwise  acquired  (plus the  amount  of any  premium  required  to be paid in
connection with such retirement,  repurchase,  redemption or  acquisition),  (b)
such  Indebtedness has a ranking in priority relative to the Securities equal to
or junior to that of the  Indebtedness  so  retired,  repurchased,  redeemed  or
otherwise  acquired,  (c) such  Indebtedness has a Stated Maturity for its final
scheduled  principal  payment  later  than the  Stated  Maturity  for the  final
scheduled  principal  payment of the Securities and (d) such  Indebtedness has a
Weighted  Average  Life to  Maturity  equal to or  greater  than  the  remaining
Weighted  Average Life to Maturity of the  Securities;  and (Y) the  retirement,
repurchase,  redemption or other  acquisition of shares of the Company's Capital
Stock or  Indebtedness  of the Company or a Subsidiary of the Company out of the
proceeds of a  substantially  concurrent sale (other than to a Subsidiary of the
Company) of shares of the  Company's  Capital  Stock  (other  than  Disqualified
Stock);  provided,  however,  that the proceeds of such a sale of Capital  Stock
shall not be included in the calculation of aggregate net cash proceeds from the
issuance and sale of the Company's  Capital Stock  pursuant to clause (ii)(2) of
Section 4.7 hereof.

     "Rule 144 A Notes" means the Company's 9 1/2% Senior Subordinated Notes due
2007, as initially issued under this Indenture.

     "Sale and  Leaseback  Transaction"  means,  with respect to any Person,  an
arrangement with any bank,  insurance  company or other lender or investor or to
which such  lender or  investor  is a party,  providing  for the leasing by


                                      -9-
<PAGE>


such Person or any of its  Subsidiaries  of any property or asset of such Person
or any of its  Subsidiaries  which has been or is being sold or  transferred  by
such  Person or such  Subsidiary  to such lender or investor or to any Person to
whom funds have been or are to be  advanced  by such  lender or  investor on the
security of such property or asset.

     "SEC" means the Securities and Exchange Commission.

     "Securities" means the Rule 144A Notes and Exchange Notes issued under this
Indenture.

     "Securities Act" means the Securities Act of 1933, as amended.

     "Senior  Indebtedness"  means the  principal  of and  premium,  if any, and
interest on and other amounts due on or in connection  with any  Indebtedness of
the Company permitted under Section 4.9 hereof (including,  without  limitation,
all Allowed and Disallowed Post-Commencement Interest and Expenses in respect of
such Indebtedness) and any amounts with respect to Hedging  Obligations that fix
the interest  rate on variable  rate  indebtedness  otherwise  permitted by this
Indenture,  other than the Securities, the Company's 10 1/4% Senior Subordinated
Notes due 2006, the Company's 9-5/8% Senior  Subordinated Notes due 2002, Series
A (to the extent  outstanding  upon  completion  of the tender  offer being made
therefor by the Company  pursuant to the Company's Offer to Purchase and Consent
Solicitation  Statement  dated  May 1,  1997),  the  Company's  10  3/4%  Senior
Subordinated  Notes due 2004 (to the extent  outstanding  upon completion of the
tender offer being made therefor by the Company  pursuant to the Company's Offer
to Purchase and Consent Solicitation Statement dated May 1, 1997), the Company's
5 3/4% Convertible Senior Subordinated  Debentures due 2001 and the Company's 6%
Convertible Subordinated Debentures due 2003, whether outstanding on the date of
this Indenture or thereafter created,  incurred or assumed,  unless, in the case
of any particular  Indebtedness,  the instrument creating or evidencing the same
or  pursuant  to which  the same is  outstanding  expressly  provides  that such
Indebtedness shall not be senior in right of payment to the Securities; provided
that Senior  Indebtedness  will not include (i) any  Indebtedness,  liability or
obligation of the Company to (A) any of its Subsidiaries, (B) trade creditors or
(C) any person  arising  out of any  lawsuit  against  the Company or any of its
Subsidiaries  or any  settlement  thereof  (other than any lawsuit or settlement
thereof respecting amounts payable with regard to Senior Indebtedness), (ii) any
redemption or other payments on Preferred Stock, (iii) any Indebtedness incurred
in violation of the  provisions  of this  Indenture or (iv) amounts  owing under
leases (other than Capitalized Lease Obligations).

     "Shelf  Registration  Statement"  means  the  Registration  Statement  with
respect to the Securities  which the Company is required to file pursuant to the
Registration Rights Agreement.

     "Significant  Subsidiary" has the meaning ascribed to it under Regulation C
promulgated under the Securities Act of 1933, as amended.

     "Stated  Maturity"  means,  when used with  respect to any  security or any
installment  of interest  thereon,  that date  specified in such security as the
fixed  date on which the  principal  of such  security  or such  installment  of
interest is due and payable.

     "Subsidiary" of any Person means (i) any corporation of which Common Equity
having  ordinary  voting  power to elect a  majority  of the  directors  of such
corporation  is owned by such  Person  directly  or  through  one or more  other
Subsidiaries  of such Person,  and (ii) any entity other than a  corporation  in
which such  Person,  directly  or  indirectly,  owns at least a majority  of the
Common Equity of such entity.  Notwithstanding  the foregoing,  an  Unrestricted
Subsidiary  shall not be  deemed a  Subsidiary  of the  Company  other  than for
purposes of the definition of Unrestricted Subsidiary,  unless the Company shall
have designated such Unrestricted Subsidiary as a "Subsidiary" by written notice
to the Trustee. An Unrestricted  Subsidiary may be designated as a Subsidiary at
any time by the Company by written  notice to the  Trustee;  provided,  however,
that (i) no Default or Event of Default shall have occurred and be continuing or
would arise therefrom and (ii) if such Unrestricted  Subsidiary is an obligor of
any Indebtedness, any such designation shall be deemed to be an incurrence as of
the date of such designation by the Company of such Indebtedness and immediately
after  giving  effect to such  designation,  the  Company  could  incur $1.00 of
additional Indebtedness pursuant to clause (a) of Section 4.9 hereof.

     "TIA" means the Trust  Indenture Act of 1939, as amended (15 U.S.C.  ss.ss.
77aaa-77bbbb),  as in effect on the date hereof (unless  otherwise  specifically
provided herein).

     "Transfer Restricted Securities" means Securities that bear or are required
to bear the legend set forth


                                      -10-
<PAGE>

in Section 2.5 hereof.

     "Trustee" means the party named as such above until a successor replaces it
in accordance  with the  applicable  provisions of this Indenture and thereafter
means the successor serving hereunder.

     "Trust  Officer"  means any  officer or  assistant  officer of the  Trustee
assigned by the Trustee to administer its corporate trust matters.

     "U.S. Government Obligations" means direct obligations of the United States
of  America  for the  payment  of which the full  faith and credit of the United
States of America is pledged.

     "Unrestricted  Subsidiary"  means any Subsidiary of the Company which shall
have been  designated  as an  Unrestricted  Subsidiary  in  accordance  with the
Indenture.  An  Unrestricted  Subsidiary  may be designated as a Subsidiary at a
later date in the manner provided in the definition of "Subsidiary" above.

     "Weighted Average Life to Maturity" means, when applied to any Indebtedness
or portion thereof at any date, the number of years obtained by dividing (i) the
then outstanding  principal  amount of such  Indebtedness or portion thereof (if
applicable)  into (ii) the sum of the products  obtained by multiplying  (a) the
amount of each then  remaining  installment,  sinking fund,  serial  maturity or
other required  payment of principal,  including  payment at final maturity,  in
respect  thereof,  by (b)  the  number  of  years  (calculated  to  the  nearest
one-twelfth) that will elapse between such date and the making of such payment.

     "Wholly  Owned  Subsidiary"  of any Person means (i) a Subsidiary  of which
100% of the Common Equity  (except for directors'  qualifying  shares or certain
minority  interests owned by other Persons solely due to local law  requirements
that there be more than one stockholder,  but which interest is not in excess of
what is required for such  purpose) is owned  directly by such Person or through
one or more other Wholly Owned  Subsidiaries  of such Person and (ii) any entity
other than a corporation in which such Person, directly or indirectly,  owns all
of the Common Equity of such entity.


Section 1.2 Other Definitions

                                                                      Defined
Term                                                                 in Section
- ----                                                                 ----------

"Affiliate Transaction"...........................................     4.12
"Asset Sale Offer"................................................     4.11
"Asset Sale Offer Period".........................................     3.8
"Custodian".......................................................     6.1
"Change in Control Repurchase"....................................     4.10
"Event of Default"................................................     6.1
"incur"...........................................................     4.9(a)
"Legal Holiday"...................................................    11.6
"Payment Blockage Period".........................................    10.4
"Paying Agent"....................................................     2.3
"Payment Account".................................................     4.1
"Registrar".......................................................     2.3
"Repurchase Date".................................................     4.10
"Successor".......................................................     5.1


Section 1.3 Incorporation by Reference of Trust Indenture Act

     Whenever this Indenture  refers to a provision of the TIA, the provision is
incorporated by reference in and made a part of this Indenture.

     All terms used in this  Indenture  that are defined by the TIA,  defined by
TIA  reference to another  statute or defined by SEC rule under the TIA have the
meanings so assigned to them.


                                      -11-
<PAGE>

Section 1.4 Rules of Construction

      Unless the context otherwise requires:

     (1) a term has the meaning assigned to it;

     (2) an accounting term not otherwise defined has the meaning assigned to it
     in accordance with GAAP;

     (3) "or" is not exclusive;

     (4) words in the singular include the plural, and in the plural include the
     singular;

     (5) provisions apply to successive events and transactions;

     (6) any amount may be negative; and

     (7)  "herein",  "hereof"  and other words of similar  import  refer to this
     Indenture  as a  whole  and  not  to any  particular  Article,  Section  or
     Subdivision.


                                   ARTICLE 2.

                                 THE SECURITIES

Section 2.1 Form and Dating

     The Rule 144A Notes and the Trustee's  certificate of authentication  shall
be substantially in the form of Exhibit A. Subject to Section 2.6, the Rule 144A
Notes shall be in an aggregate  principal  amount no greater than  $450,000,000;
provided,  that if Exchange Notes are issued hereunder  pursuant to the Exchange
Offer,  the  aggregate  maximum  principal  amount of Rule 144A  Notes  shall be
reduced by the principal amount of Exchange Notes so issued. The Exchange Notes,
when and if issued,  and the Trustee's  certificate of  authentication  shall be
substantially  in the form of Exhibit B.  Subject to Section  2.6,  the Exchange
Notes shall be in an aggregate  principal  amount no greater  than  $450,000,000
less the  principal  amount of Rule 144A Notes not  exchanged  for the  Exchange
Notes in the Exchange  Offer.  The  Securities  may have  notations,  legends or
endorsements  required by law, stock exchange rule or usage. Each Security shall
be  dated  the  date  of  its   authentication.   The  Securities  shall  be  in
denominations of $1,000 and integral multiples thereof.

     The  Securities  may be  initially  issued  either  in the form of a Global
Security or Securities or in the form of Definitive Securities or both. A Global
Security  shall  represent  such  of the  outstanding  Securities  as  shall  be
specified therein and shall provide that it shall represent the aggregate amount
of  outstanding  Securities  from  time to time  endorsed  thereon  and that the
aggregate amount of outstanding  Securities represented thereby may from time to
time  be  reduced  or  increased,  as  appropriate,  to  reflect  exchanges  and
redemptions.  Any  endorsement of a Global Security to reflect the amount of any
increase or decrease in the amount of outstanding Securities represented thereby
shall  be made by the  Trustee  or an Agent  thereof,  at the  direction  of the
Trustee,  in accordance with written  instructions  given by the Holder thereof.
Definitive Securities shall be printed,  lithographed or engraved or produced by
any combination of these methods on steel engraved borders or may be produced in
any other manner permitted by the rules of any securities  exchange on which the
Securities  may be listed,  all as  determined  by the officers  executing  such
Securities, as evidenced by their execution of such Securities.

     The terms and provisions contained in the Securities shall constitute,  and
are  hereby  expressly  made,  a part  of  this  Indenture  and  to  the  extent
applicable, the Company and the Trustee, by their execution and delivery of this
Indenture, expressly agree to such terms and provisions and to be bound thereby.


                                      -12-
<PAGE>

Section 2.2 Execution and Authentication

     Two  Officers  shall  sign the  Securities  for the  Company  by  manual or
facsimile  signature.  The Company's  seal shall be reproduced on the Securities
and may be in facsimile form.

     If an Officer whose  signature is on a Security no longer holds that office
at the time the Security is authenticated,  the Security  nevertheless  shall be
valid.

     A Security shall not be valid until  authenticated  by the manual signature
of the Trustee. The signature shall be conclusive evidence that the Security has
been authenticated under this Indenture.

     The Trustee  shall  authenticate  Securities  for original  issue up to the
aggregate  principal  amount  stated in  paragraph 4 of the  Securities,  upon a
written  order of the Company  signed by two Officers.  The aggregate  principal
amount of Securities  outstanding  at any time may not exceed such amount except
as provided in Section 2.6.

     The Trustee may appoint an  authenticating  agent acceptable to the Company
to authenticate Securities.  An authenticating agent may authenticate Securities
whenever  the  Trustee  may  do  so.  Each   reference  in  this   Indenture  to
authentication  by  the  Trustee  includes  authentication  by  such  agent.  An
authenticating agent has the same rights as an Agent to deal with the Company or
an Affiliate.

Section 2.3 Registrar and Paying Agent

     The Company shall maintain or cause to be maintained through the Trustee or
such  other  Person as may be  appointed  hereunder  an  office or agency  where
Securities  may be  presented  for  registration  of  transfer  or for  exchange
("Registrar")  and an office or agency where  Securities  may be  presented  for
payment ("Paying Agent").  The Registrar shall keep a register of the Securities
and of  their  transfer  and  exchange.  The  Company  may  appoint  one or more
co-registrars  and one or more additional  paying agents.  The term  "Registrar"
includes any  co-registrar  and the term "Paying Agent"  includes any additional
paying  agent.  The Company  may change any Paying  Agent or  Registrar  without
notice to any  Holder.  The Company  shall  notify the Trustee in writing of the
name and address of any Agent not a party to this Indenture,  such  notification
to be delivered,  together  with a  certificate  of such Agent that it agrees to
perform its duties in accordance with the procedures  established by the Trustee
and with the  terms of this  Indenture,  to the  Trustee  prior to the date such
Agent assumes its duties hereunder.  If the Company fails to appoint or maintain
another entity as Registrar or Paying Agent,  the Trustee shall act as such. The
Company or any of its Subsidiaries may act as Paying Agent or Registrar.

Section 2.4 Paying Agent to Hold Money in Trust

     The Company shall require each Paying Agent other than the Trustee to agree
in  writing  that the  Paying  Agent  will hold in trust for the  benefit of the
Holders or the  Trustee  all money held by the Paying  Agent for the  payment of
principal of or premium, if any, or interest on the Securities,  and will notify
the Trustee of any default by the Company in making any such payment.  While any
such default continues,  the Trustee may require a Paying Agent to pay all money
held by it to the Trustee. The Company at any time may require a Paying Agent to
pay all money held by it to the Trustee.  Upon payment over to the Trustee,  the
Paying Agent (if other than the Company or a  Subsidiary)  shall have no further
liability for the money. If the Company or a Subsidiary acts as Paying Agent, it
shall segregate and hold in a separate trust fund for the benefit of the Holders
all money held by it as Paying Agent.

Section 2.5 Registration of Transfer and Exchange

     (a) With respect to the transfer  and  exchange of  Definitive  Securities:
when Definitive  Securities are presented to the Trustee with the request (x) to
register  the  transfer of the  Definitive  Securities  or (y) to exchange  such
Definitive  Securities for an equal principal amount of Definitive Securities of
other authorized denominations,  the Trustee shall register the transfer or make
the exchange as requested if its  requirements  for such  transactions  are met;
provided,  however,  that the Definitive Securities presented or surrendered for
register of transfer or exchange:

          (i) shall be duly endorsed or accompanied by a written  instruction of
     transfer in form


                                      -13-
<PAGE>


     satisfactory  to the Trustee duly executed by the Holder  thereof or by its
     attorney, duly authorized in writing; and

          (ii) shall,  in the case of Transfer  Restricted  Securities  that are
     Definitive  Securities,  except if  exchanged  for an Exchange  Note in the
     Exchange Offer, be accompanied by the following additional  information and
     documents, as applicable

               (A) if such Transfer  Restricted  Security is being  delivered to
          the Registrar by a Holder for registration in the name of such Holder,
          without transfer,  a certification from such Holder to that effect (in
          substantially the form of Exhibit C hereto); or

               (B) if such Transfer  Restricted Security is being transferred to
          a "qualified  institutional  buyer" (as defined in Rule 144A under the
          Securities  Act) in reliance on Rule 144A under the  Securities Act or
          pursuant to an exemption from registration in accordance with Rule 144
          under the  Securities  Act or  pursuant to an  effective  registration
          statement under the Securities Act, a certification to that effect (in
          substantially the form of Exhibit C hereto); or

               (C) if such Transfer  Restricted Security is being transferred in
          reliance on another  exemption from the  registration  requirements of
          the Securities Act, a certification  to that effect (in  substantially
          the form of Exhibit C hereto)  and an  opinion  of counsel  reasonably
          acceptable to the Company and to the Registrar to the effect that such
          transfer is in compliance with the Securities Act.

     (b) The  following  restrictions  apply  to any  transfer  of a  Definitive
Security for a beneficial  interest in a Global Security.  A Definitive Security
may not be exchanged for a beneficial interest in a Global Security except until
and upon  satisfaction of the requirements set forth below.  Upon receipt by the
Trustee of a Definitive  Security,  duly endorsed or  accompanied by appropriate
instruments of transfer, in form satisfactory to the Trustee, together with:

          (i) if such Definitive  Security is a Transfer Restricted Security and
     such  transfer is not being made in  connection  with the  Exchange  Offer,
     certification,  substantially  in the form of  Exhibit C hereto,  that such
     Definitive  Security is being  transferred  to a  "qualified  institutional
     buyer" (as  defined in Rule 144A under the  Securities  Act) in  accordance
     with Rule 144A under the Securities Act; and

          (ii) whether or not such Definitive  Security is a Transfer Restricted
     Security, written instructions directing the Trustee to make an endorsement
     on the Global  Security to reflect an increase in the  aggregate  principal
     amount of the Securities represented by the Global Security,

then the Trustee shall cancel such Definitive  Security and cause, in accordance
with the  standing  instructions  and  procedures  existing  between  it and the
Depositary,  the aggregate  principal  amount of Securities  represented  by the
Global Security to be increased  accordingly.  If no Global  Securities are then
outstanding,   the  Company   shall  issue  and,   upon  receipt  of  a  written
authentication order in the form of an Officers' Certificate,  the Trustee shall
authenticate a new Global Security in the appropriate principal amount.

     (c) The transfer and exchange of Global Securities or beneficial  interests
therein  shall be  effected  through the  Depositary,  in  accordance  with this
Indenture  (including  the  restrictions  on transfer set forth  herein) and the
procedures of the Depositary therefor.

     (d) With  respect to the  transfer  of a  beneficial  interest  in a Global
Security for a Definitive Security:

          (i) Any person having a beneficial  interest in a Global  Security may
     upon request exchange such beneficial  interest for a Definitive  Security.
     Upon receipt by the Trustee of written  instructions  or such other form of
     instructions as is customary for the Depositary or its nominee on behalf of
     any person having a beneficial interest in a Global Security constituting a
     Transfer


                                      -14-
<PAGE>

     Restricted  Security only,  except if exchanged for an Exchange Note in the
     Exchange Offer, the following additional  information and documents (all of
     which may be submitted by facsimile):

               (A) if such  beneficial  interest  is  being  transferred  to the
          person  designated by the Depositary as being the beneficial  owner, a
          certification  from such person to that effect (in  substantially  the
          form of Exhibit C hereto); or ---------

               (B)  if  such  beneficial  interest  is  being  transferred  to a
          "qualified  institutional  buyer"  (as  defined in Rule 144A under the
          Securities  Act) in accordance with Rule 144A under the Securities Act
          or pursuant to an exemption from  registration in accordance with Rule
          144 under the Securities Act or pursuant to an effective  registration
          statement  under the Securities  Act, a  certification  to that effect
          from the transferor (in  substantially  the form of Exhibit C hereto);
          or

               (C) if such beneficial  interest is being transferred in reliance
          on  another  exemption  from  the  registration  requirements  of  the
          Securities Act, a certification  to that effect from the transferee or
          transferor  (in  substantially  the form of  Exhibit C hereto)  and an
          opinion  of  counsel  from the  transferee  or  transferor  reasonably
          acceptable to the Company and to the Registrar to the effect that such
          transfer is in compliance with the Securities Act,

then the Trustee will cause,  in accordance with the standing  instructions  and
procedures  existing  between it and the  Depositary,  the  aggregate  principal
amount of the Global Security to be reduced and,  following such reduction,  the
Company will execute and, upon receipt of a written  authentication order in the
form of an Officers'  Certificate,  the Trustee will authenticate and deliver to
the transferee a Definitive Security.

          (ii)  Definitive  Securities  issued  in  exchange  for  a  beneficial
     interest  in a  Global  Security  pursuant  to this  Section  2.5  shall be
     registered  in such  names  and in  such  authorized  denominations  as the
     Depositary,   pursuant  to   instructions   from  its  direct  or  indirect
     participants  or  otherwise,  shall in writing  instruct the  Trustee.  The
     Trustee  shall deliver such  Definitive  Securities to the persons in whose
     name such Securities are so registered.

     (e)  Notwithstanding any other provisions of this Indenture (other than the
provisions set forth in subsection  (f) of this Section 2.5), a Global  Security
may not be  transferred  as a whole except by the Depositary to a nominee of the
Depositary  or by a nominee  of the  Depositary  to the  Depositary  or  another
nominee  of  the  Depositary  or by the  Depositary  or any  such  nominee  to a
successor Depositary or a nominee of such successor Depositary.

     (f) The following relates to the authentication of Definitive Securities in
the  absence  of the  Depositary.  If at any time:  (i) the  Depositary  for the
Securities  notifies the Company that the  Depositary  is unwilling or unable to
continue as Depositary for the Global Securities and a successor  Depositary for
the Global  Securities  is not  appointed  by the  Company  within 90 days after
delivery of such notice; or (ii) the Company,  at its sole discretion,  notifies
the  Trustee  in  writing  that it elects to cause the  issuance  of  Definitive
Securities under this Indenture, then the Company will execute, and the Trustee,
upon  receipt  of a  written  order  in the  form  of an  Officers'  Certificate
requesting  the  authentication  and  delivery of  Definitive  Securities,  will
authenticate and deliver Definitive Securities, in an aggregate principal amount
equal to the  principal  amount of the Global  Securities,  in exchange for such
Global Securities.

     (g) (i) Except as otherwise  agreed to by the Company,  the Trustee and the
Holder thereof or as permitted by the following  paragraph  (ii), each Rule 144A
Note certificate  evidencing the Global Securities and the Definitive Securities
(and all  Securities  other than Exchange  Notes issued in exchange  therefor or
substitution thereof) shall bear a legend in substantially the following form:

     THIS SECURITY HAS NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS
     AMENDED (THE "SECURITIES  ACT"), OR ANY STATE SECURITIES LAWS. NEITHER THIS
     SECURITY NOR ANY INTEREST OR PARTICIPATION  HEREIN MAY BE REOFFERED,  SOLD,
     ASSIGNED, TRANSFERRED,  PLEDGED, ENCUMBERED OR OTHERWISE DISPOSED OF IN THE
     ABSENCE OF SUCH  REGISTRATION OR UNLESS SUCH TRANSACTION IS EXEMPT FROM, OR
     NOT SUBJECT TO, REGISTRATION UNDER SUCH LAWS.


                                      -15-
<PAGE>


     THE HOLDER OF THIS SECURITY BY ITS  ACCEPTANCE  HERETO AGREES NOT TO OFFER,
     SELL OR OTHERWISE  TRANSFER SUCH  SECURITY,  PRIOR TO THE DATE (THE "RESALE
     RESTRICTION  TERMINATION  DATE")  WHICH IS TWO YEARS AFTER THE LATER OF THE
     ORIGINAL  ISSUE DATE  HEREOF AND THE LAST DATE ON WHICH THE  COMPANY OR ANY
     AFFILIATED PERSON OF THE COMPANY WAS THE OWNER OF THIS SECURITY UNLESS SUCH
     OFFER,  SALE OR OTHER  TRANSFER IS (A) TO THE  COMPANY,  (B)  PURSUANT TO A
     REGISTRATION   STATEMENT  WHICH  HAS  BEEN  DECLARED  EFFECTIVE  UNDER  THE
     SECURITIES  ACT, (C) FOR SO LONG AS THE  SECURITIES ARE ELIGIBLE FOR RESALE
     PURSUANT  TO RULE 144A,  TO A PERSON THE HOLDER  REASONABLY  BELIEVES  IS A
     "QUALIFIED   INSTITUTIONAL  BUYER"  AS  DEFINED  IN  RULE  144A  UNDER  THE
     SECURITIES  ACT THAT  PURCHASES FOR ITS OWN ACCOUNT OR FOR THE ACCOUNT OF A
     QUALIFIED  INSTITUTIONAL BUYER TO WHOM NOTICE IS GIVEN THAT THE TRANSFER IS
     BEING MADE IN RELIANCE ON RULE 144A,  (D) TO AN  INSTITUTIONAL  "ACCREDITED
     INVESTOR"  WITHIN THE MEANING OF  SUBPARAGRAPH  (a)(1),  (a)(2),  (a)(3) OR
     (a)(7) OF RULE 501 UNDER THE  SECURITIES ACT THAT IS ACQUIRING THE SECURITY
     FOR  ITS  OWN  ACCOUNT,  OR  FOR  THE  ACCOUNT  OF  SUCH  AN  INSTITUTIONAL
     "ACCREDITED  INVESTOR," FOR INVESTMENT  PURPOSES AND NOT WITH A VIEW TO, OR
     FOR OFFER OR SALE IN CONNECTION  WITH, ANY DISTRIBUTION IN VIOLATION OF THE
     SECURITIES  ACT, OR (E) PURSUANT TO ANOTHER  AVAILABLE  EXEMPTION  FROM THE
     REGISTRATION  REQUIREMENTS  OF  THE  SECURITIES  ACT,  AND IN  EACH  OF THE
     FOREGOING  CASES SUCH OFFER,  SALE OR OTHER TRANSFER IS IN COMPLIANCE  WITH
     ANY  APPLICABLE  STATE  SECURITIES  LAWS,  SUBJECT TO THE COMPANY'S AND THE
     TRUSTEE'S  RIGHT  PRIOR TO ANY SUCH  OFFER,  SALE OR  TRANSFER  PURSUANT TO
     CLAUSES  (D) OR (E) TO REQUIRE  THE  DELIVERY  OF AN  OPINION  OF  COUNSEL,
     CERTIFICATION AND/OR OTHER INFORMATION SATISFACTORY TO EACH OF THEM, AND IN
     EACH  OF THE  FOREGOING  CASES,  A  CERTIFICATE  OF  TRANSFER  IN THE  FORM
     CONTAINED IN THE INDENTURE IS COMPLETED AND DELIVERED BY THE  TRANSFEROR TO
     THE  TRUSTEE.  THIS  LEGEND  WILL BE REMOVED  UPON THE  REQUEST OF THE THEN
     HOLDER OF THIS SECURITY AFTER THE RESALE RESTRICTION  TERMINATION DATE. ANY
     TRANSFEREE OF THIS SECURITY SHALL BE DEEMED TO HAVE REPRESENTED  EITHER (A)
     THAT IT IS NOT USING THE ASSETS OF AN EMPLOYEE  BENEFIT PLAN SUBJECT TO THE
     EMPLOYEE  RETIREMENT  INCOME SECURITY ACT ("ERISA") OR THE INTERNAL REVENUE
     CODE (THE  "CODE") TO PURCHASE  THIS  SECURITY OR (B) THAT ITS PURCHASE AND
     CONTINUED  HOLDING OF THE SECURITY WILL BE COVERED BY A U.S.  DEPARTMENT OF
     LABOR  CLASS  EXEMPTION  (WITH  RESPECT TO  PROHIBITED  TRANSACTIONS  UNDER
     SECTION 406(a) OF ERISA).

               (ii) Upon any sale or transfer of a Transfer  Restricted Security
          (including any Transfer  Restricted  Security  represented by a Global
          Security)  pursuant  to  Rule  144  under  the  Securities  Act  or an
          effective  registration  statement under the Securities Act (including
          the Shelf Registration Statement):

                    (A) in the case of any Transfer  Restricted Security that is
               a  Definitive  Security,  the  Registrar  shall permit the Holder
               thereof to  exchange  such  Transfer  Restricted  Security  for a
               Definitive Security that does not bear the legend set forth above
               and  rescind any  restriction  on the  transfer of such  Transfer
               Restricted Security; and

                    (B) any such Transfer Restricted  Security  represented by a
               Global  Security shall not be subject to the provisions set forth
               in (i) above (such sales or transfers  being  subject only to the
               provisions of Section 2.5(c)  hereof);  provided,  however,  that
               with  respect  to any  request  for  an  exchange  of a  Transfer
               Restricted  Security that is represented by a Global Security for
               a Definitive Security that does not bear a legend,  which request
               is made in reliance  upon Rule 144 or an  effective  registration
               statement,  the Holder  thereof  shall  certify in writing to the
               Registrar that such request is being made pursuant to Rule 144 or
               an effective  registration  statement (such  certification  to be
               substantially in the form of Exhibit C hereto.)


                                      -16-
<PAGE>


     (h) At such time as all  beneficial  interests  in a Global  Security  have
either been  exchanged  for  Definitive  Securities,  redeemed,  repurchased  or
cancelled,  such Global  Security shall be returned to or retained and cancelled
by the  Trustee.  At any time  prior  to such  cancellation,  if any  beneficial
interest in a Global Security is exchanged for Definitive Securities,  redeemed,
repurchased or cancelled, the principal amount of Securities represented by such
Global Security shall be reduced and an endorsement shall be made on such Global
Security,  by the Trustee or the Securities  Custodian,  at the direction of the
Trustee, to reflect such reduction.

     (i) All  Definitive  Securities  and  Global  Securities  issued  upon  any
registration  of  transfer  or  exchange  of  Definitive  Securities  or  Global
Securities  shall be the valid  obligations of the Company,  evidencing the same
debt, and entitled to the same benefits under this Indenture,  as the Definitive
Securities or Global  Securities  surrendered upon such registration of transfer
or exchange.

     No  service  charge  shall  be made to a  Holder  for any  registration  of
transfer or exchange (except as otherwise expressly  permitted herein),  but the
Company may require  payment of a sum  sufficient  to cover any  transfer tax or
similar  governmental  charge payable and any other expenses (including the fees
and expenses of the Trustee) in connection  therewith  (other than such transfer
tax or similar  governmental  charge payable upon exchanges  pursuant to Section
2.6 or 9.5).

Section 2.6 Replacement Securities

     If any mutilated Security is surrendered to the Trustee, or the Company and
the Trustee receive evidence to their  satisfaction of the destruction,  loss or
theft of any Security, the Company shall issue and the Trustee, upon the written
order of the Company  signed by two Officers,  shall  authenticate a replacement
Security if the  Trustee's  requirements  are met. If required by the Trustee or
the Company, an indemnity bond must be supplied by the Holder that is sufficient
in the  judgment of the Trustee  and the  Company to protect  the  Company,  the
Trustee,  the Agent or any authenticating  agent from any loss which any of them
may suffer if a Security is replaced. The Company and the Trustee may charge for
their expenses in replacing a Security.

     Every replacement Security is an additional obligation of the Company.

Section 2.7 Outstanding Securities

     The Securities outstanding at any time are all the Securities authenticated
by the  Trustee  except for those  canceled  by it,  those  delivered  to it for
cancellation and those described in this Section 2.7 as not outstanding.

     If a  Security  is  replaced  pursuant  to  Section  2.6,  it  ceases to be
outstanding  unless  the  Trustee  receives  proof  satisfactory  to it that the
replaced Security is held by a bona fide purchaser.

     If the principal  amount of any Security is  considered  paid under Section
4.1, it ceases to be  outstanding  and interest on it ceases to accrue as of the
date it is deemed paid. Upon a "legal defeasance"  pursuant to Section 8.1(b) or
a "covenant  defeasance"  pursuant to Section  8.1(c),  the Securities  shall be
deemed to be  outstanding  or not  outstanding  as  provided  in the  applicable
Section 8.1(b) or 8.1(c).

     Except  as set  forth in  Section  2.8,  a  Security  does not  cease to be
outstanding because the Company or an Affiliate holds the Security.

Section 2.8 Treasury Securities

     In  determining  whether the Holders of the  required  principal  amount of
Securities have concurred in any direction,  waiver or consent, Securities owned
by the Company or by any Person directly or indirectly controlling or controlled
by or  under  direct  or  indirect  common  control  with the  Company  shall be
considered  as  though  not  outstanding,   except  that  for  the  purposes  of
determining  whether  the  Trustee  shall be  protected  in  relying on any such
direction,  waiver or consent,  only Securities which the Trustee actually knows
are so owned shall be so disregarded.


                                      -17-
<PAGE>


Section 2.9 Temporary Securities

     Until definitive Securities are ready for delivery, the Company may prepare
and the Trustee shall authenticate  temporary  Securities.  Temporary Securities
shall  be  substantially  in the  form of  definitive  Securities  but may  have
variations  that the Company  considers  appropriate  for temporary  Securities.
Without  unreasonable  delay,  the Company  shall  prepare and the Trustee shall
authenticate definitive Securities in exchange for temporary Securities.

Section 2.10 Cancellation

     The  Company  at  any  time  may  deliver  Securities  to the  Trustee  for
cancellation.  The  Registrar  and Paying Agent shall forward to the Trustee any
Securities  surrendered  to them  for  registration  of  transfer,  exchange  or
payment. The Trustee shall cancel all Securities surrendered for registration of
transfer, exchange, payment,  replacement or cancellation,  and, upon request of
the  Company,  certification  of their  destruction  shall be  delivered  to the
Company  unless,  by a written order signed by two  Officers,  the Company shall
direct that canceled Securities be returned to it. The Company may not issue new
Securities to replace Securities that it has paid or that have been delivered to
the Trustee for cancellation.

Section 2.11 Defaulted Interest

     If the Company  defaults in a payment of  interest  on the  Securities,  it
shall pay the  defaulted  interest  in any  lawful  manner  plus,  to the extent
lawful,  interest  payable on the  defaulted  interest,  to the  Persons who are
Holders on a subsequent  special  record date, in each case at the rate provided
in the Securities.  The Company, with the consent of the Trustee, shall fix each
such special  record date and payment  date. At least 15 days before the special
record date, the Company (or, upon written request of the Company,  the Trustee,
in the name of and at the expense of the Company) shall mail to Holders a notice
that states the special record date, the related  payment date and the amount of
such interest to be paid.

Section 2.12 Securities Issuable in the Form of a Global Security

     (a) If the Company shall  establish that the Securities are to be issued in
whole or in part in the form of one or more Global Securities,  then the Company
shall execute and the Trustee or an agent  thereof  shall,  in  accordance  with
Section 2.2 and the written order of the Company delivered to the Trustee or its
agent  thereunder,  authenticate and deliver such Global Security or Securities,
which (i) shall  represent,  and shall be  denominated in an amount equal to the
aggregate  principal  amount of the outstanding  Securities to be represented by
such Global Security or Securities, or such portion thereof as the Company shall
specify in a written order of the Company signed by two Officers,  (ii) shall be
registered in the name of the Depositary for such Global  Security or Securities
or its  nominee,  (iii)  shall be  delivered  by the Trustee or its agent to the
Depositary  or pursuant to the  Depositary's  instruction  and (iv) shall bear a
legend substantially to the following effect:  "Unless and until it is exchanged
in whole or in part for securities in definitive  form, this security may not be
transferred  except as a whole by the  Depositary to a nominee of the Depositary
or by a nominee of the  Depositary to the  Depositary or another  nominee of the
Depositary or by the Depositary or any such nominee to a successor Depositary or
a nominee of such successor Depositary.  Unless this certificate is presented by
an authorized  representative  of the Depositary to the Company or its agent for
registration of transfer,  exchange,  or payment,  and any certificate issued is
registered in the name of the nominee of the Depositary or in such other name as
is requested by an authorized  representative of the Depositary (and any payment
is made to the nominee of the Depositary or to such other entity as is requested
by an authorized  representative  of the Depositary),  ANY TRANSFER,  PLEDGE, OR
OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch
as the registered owner hereof,  the nominee of the Depositary,  has an interest
herein."

     (b)  Notwithstanding any other provision of this Section 2.12 or of Section
2.5, and subject to the provisions of paragraph (c) below, a Global Security may
be  transferred,  in whole but not in part and in the manner provided in Section
2.5, only to a nominee of the  Depositary  for such Global  Security,  or to the
Depositary,  or a  successor  Depositary  for such Global  Security  selected or
approved by the Company, or to a nominee of such successor Depositary.

     (c) (i) If at any time the  Depositary for a Global  Security  notifies the
Company that it is


                                      -18-
<PAGE>


unwilling or unable to continue as Depositary for such Global  Security or if at
any time the  Depositary  for the  Securities  shall no longer be eligible or in
good  standing  under  the  Exchange  Act or any  other  applicable  statute  or
regulation,  the Company  shall appoint a successor  Depositary  with respect to
such Global Security.  If a successor Depositary for such Global Security is not
appointed by the Company  within 90 days after the Company  receives such notice
or becomes  aware of such  ineligibility,  the  Company  will  execute,  and the
Trustee or an agent  thereof,  upon  receipt of a written  order of the  Company
signed  by two  Officers  for the  authentication  and  delivery  of  individual
Definitive  Securities in exchange for such Global Security,  will  authenticate
and  deliver,  individual  Definitive  Securities  of like tenor and terms in an
aggregate  principal amount equal to the principal amount of the Global Security
in exchange for such Global Security.

          (ii) The Company may at any time and in its sole discretion  determine
     that the  Securities  issued in the form of one or more  Global  Securities
     shall no longer be  represented by such Global  Security or Securities.  In
     such event the Company will  execute,  and the  Trustee,  upon receipt of a
     written order of the Company signed by two Officers for the  authentication
     and delivery of individual Definitive Securities in exchange in whole or in
     part for such Global Security,  will  authenticate  and deliver  individual
     Definitive  Securities  of like tenor and terms in an  aggregate  principal
     amount equal to the principal  amount of such Global Security or Securities
     in exchange for such Global Security or Securities.

          (iii) If specified by the Company  pursuant to a written  order of the
     Company signed by two Officers,  the  Depositary for a Global  Security may
     surrender  such  Global  Security  in  exchange  in  whole  or in part  for
     individual  Definitive  Securities of like tenor and terms on such terms as
     are  acceptable to the Company and such  Depositary.  Thereupon the Company
     shall execute, and the Trustee or an agent thereof, upon a written order of
     the Company signed by two Officers, shall authenticate and deliver, without
     service  charge,  (1) to each Person  specified  by such  Depositary  a new
     Definitive  Security  or  Securities  of like  tenor  and  terms and of any
     authorized  denomination  as  requested  by  such  Person  in an  aggregate
     principal  amount  equal to and in exchange  for such  Person's  beneficial
     interest as specified by such Depositary in the Global Security; and (2) to
     such  Depositary  a new Global  Security  of like tenor and terms and in an
     authorized  denomination  equal  to the  difference,  if any,  between  the
     principal  amount of the  surrendered  Global  Security  and the  aggregate
     principal amount of Definitive Securities delivered to Holders thereof.

          (iv) In any  exchange  provided  for in (i),  (ii)  or  (iii)  of this
     paragraph (c), the Company will execute and the Trustee or an agent thereof
     will  authenticate  and  deliver   individual   Definitive   Securities  in
     registered  form in  authorized  denominations.  Upon the  exchange  of the
     entire  principal  amount of a Global  Security for  individual  Definitive
     Securities,  such Global Securities shall be cancelled by the Trustee or an
     agent  thereof.  Except as provided in (iii) above,  Definitive  Securities
     issued in exchange for a Global Security  pursuant to this Section shall be
     registered  in such  names  and in  such  authorized  denominations  as the
     Depositary  for such Global  Security,  pursuant to  instructions  from its
     direct or indirect  participants  or otherwise,  shall instruct  either the
     Trustee or the Registrar.  Such Trustee or the Registrar shall deliver such
     Definitive  Securities to the Persons in whose names such Securities are so
     registered.


                                   ARTICLE 3.

                    OPTIONAL REDEMPTION AND ASSET SALE OFFER

Section 3.1 Notices to Trustee

     (a) If the Company  elects to redeem  Securities  pursuant to the  optional
redemption  provisions of Section 3.7, it shall furnish to the Trustee, at least
45 days but not  more  than 60 days  before  a  redemption  date,  an  Officers'
Certificate  stating  that the  Company  has  exercised  its  option  to  redeem
Securities  pursuant to Section 3.7 and setting forth the  redemption  date, the
principal amount of Securities to be redeemed and the redemption price.

     (b) If the Company offers to purchase Securities pursuant to the provisions
of Section  3.8,  it shall  furnish to the  Trustee,  on or before the fifth day
preceding  the  commencement  of  an  Asset  Sale  Offer  Period,  an  Officers'
Certificate  stating that the Company is making an Asset Sale Offer  pursuant to
Section 3.8 and setting forth the Asset Sale Payment Date, the principal  amount
of Securities the Company is offering to purchase and the purchase price of such
Securities,  and further  setting  forth a statement  to the effect that (a) the
Company has  consummated  an Asset Sale and (b) the  conditions set forth in the
first sentence of Section 4.11 have been satisfied.


    
                                  -19-
<PAGE>

Section 3.2 Selection of Securities to Be Redeemed or Purchased

     (a) If less  than all of the  Securities  are to be  redeemed  pursuant  to
Section 3.7, the Trustee  shall  select the  Securities  to be redeemed on a pro
rata basis,  by lot or in such other  manner as the Trustee  shall deem fair and
equitable;  provided,  however,  that in the  case of a  partial  redemption  of
Securities made with the proceeds of a Public Equity Offering,  selection of the
Securities for redemption shall be made on a pro rata basis,  unless such method
is otherwise  prohibited (in which case the Securities to be purchased  shall be
selected  by lot or in such  other  manner as the  Trustee  shall  deem fair and
equitable).  The particular Securities to be redeemed shall be selected,  unless
otherwise provided herein, prior to the date notice of redemption is required to
be sent by the Trustee,  from the outstanding  Securities not previously  called
for redemption.

     The Trustee  promptly shall notify the Company in writing of the Securities
selected for  redemption  and, in the case of any Security  selected for partial
redemption, the principal amount thereof to be redeemed. Securities and portions
of them selected shall be in amounts of $1,000 or integral  multiples of $1,000.
Provisions of this Indenture that apply to Securities called for redemption also
apply to portions of Securities called for redemption.

     (b) If less than all of the  Securities  are to be  purchased  pursuant  to
Section 3.8, the Trustee  shall select the  Securities  to be purchased on a pro
rata  basis,  unless  such  method is  otherwise  prohibited  (in which case the
Securities  to be purchased  shall be selected by lot or in such other manner as
the Trustee  shall deem fair and  equitable).  The  particular  Securities to be
purchased shall be selected, unless otherwise provided herein, prior to the date
notice of purchase is required to be sent by the Trustee,  from the  outstanding
Securities tendered pursuant to the Asset Sale Offer.

     The Trustee  promptly shall notify the Company in writing of the Securities
selected  for  purchase  and, in the case of any  Security  selected for partial
purchase, the principal amount thereof to be purchased.  Securities and portions
of them selected shall be in amounts of $1,000 or integral  multiples of $1,000.
Provisions of this Indenture  that apply to Securities  called for purchase also
apply to portions of Securities called for purchase.


Section 3.3 Notices to Holders

     (a) At least 30 days but not more than 60 days  before a  redemption  date,
the  Company  shall  mail a notice to each  Holder  whose  Securities  are to be
redeemed.

     The notice shall identify the Securities to be redeemed and shall state:

          (1) the redemption date;

          (2) the redemption price;

          (3) if any  Security  is being  redeemed  in part,  the portion of the
     principal  amount of such  Security  to be  redeemed  and  that,  after the
     redemption  date,  upon  surrender  of such  Security,  a new  Security  or
     Securities  in  principal  amount equal to the  unredeemed  portion will be
     issued;

          (4) the name and address of the Paying Agent;

          (5) that  Securities  called for redemption must be surrendered to the
     Paying  Agent at the  address  specified  in such  notice  to  collect  the
     redemption price;

          (6) that interest on Securities called for redemption ceases to accrue
     on and after the  redemption  date  (unless  the  Company  defaults  on its
     obligation to repurchase Securities);

          (7) the paragraph of the  Securities  pursuant to which the Securities
     are being redeemed; and

          (8) the  aggregate  principal  amount  of  Securities  that are  being
     redeemed.


    
                                  -20-
<PAGE>


     (b) If the  Company  determines  to make an Asset Sale Offer as provided in
Section 3.8, the Company shall promptly mail a notice to each Holder.

     The Notice shall state:

          (1) that an Asset Sale Offer is being made pursuant to Section 3.8 and
     the length of time the Asset Sale Offer will remain open;

          (2) the purchase price and the Asset Sale Payment Date;

          (3) the  aggregate  principal  amount of  Securities  the  Company  is
     offering to purchase;

          (4) that any  Security  not  tendered  or accepted  for  payment  will
     continue to accrue interest;

          (5) that any Security  accepted for payment pursuant to the Asset Sale
     Offer shall cease to accrue interest on the Asset Sale Payment Date;

          (6) that Holders electing to have a Security purchased pursuant to any
     Asset Sale Offer will be required to surrender the Security,  with the form
     entitled  "Option of Holder to Elect  Purchase"  on the reverse side of the
     Security  completed,  to the  Company,  a  depositary,  if appointed by the
     Company,  or a Paying Agent at the address specified in the notice prior to
     expiration of the Asset Sale Offer Period;

          (7) that  Holders will be entitled to withdraw  their  election if the
     Company,  depositary or Paying  Agent,  as the case may be,  receives,  not
     later than the  expiration of the Asset Sale Offer  Period,  or such longer
     period as may be required by law, a telegram, telex, facsimile transmission
     or letter setting forth the name of the Holder, the principal amount of the
     Security the Holder delivered for purchase and a statement that such Holder
     is withdrawing his election to have the Security purchased;

          (8) that, if the aggregate principal amount of Securities  surrendered
     by Holders exceeds the aggregate  principal amount of Securities offered to
     be purchased,  the Trustee shall select the Securities to be purchased on a
     pro rata basis,  unless such method is otherwise  prohibited (in which case
     the  Securities  to be purchased  shall be selected by lot or in such other
     manner as the Trustee shall deem fair and equitable); and

          (9) that Holders whose  Securities  are purchased only in part will be
     issued new Securities equal in principal amount to the unpurchased  portion
     of the Securities surrendered.


     (c) At the Company's request, the Trustee shall give the notice required in
Section  3.3(a) or 3.3(b) in the  Company's  name and at its expense;  provided,
however,  that the Company shall deliver to the Trustee,  at least 45 days prior
to  the  redemption  date  or  not  later  than  the  fifth  day  preceding  the
commencement  of an Asset Sale Offer  Period,  as the case may be, an  Officers'
Certificate  requesting  that the Trustee give such notice and setting forth the
information to be stated in such notice as provided in Section 3.3(a) or 3.3(b).

Section 3.4 Effect of Notice of Redemption

     Once notice of redemption  under Section 3.7 is mailed,  Securities  called
for redemption  become due and payable on the redemption  date at the redemption
price.  However,  if a redemption date is on or before an Interest  Payment Date
and on or after the related record date, any interest  accrued and unpaid to the
redemption  date shall be paid on such  Interest  Payment  Date to the person in
whose name the  Security is  registered  at the close of business on


    
                                  -21-
<PAGE>

such  record  date and the only  remaining  right of the  Holders of  Securities
called for redemption  shall be to receive the redemption  price (excluding such
interest) upon surrender of such Securities to the Paying Agent.

Section 3.5 Deposit of Redemption Price or Purchase Price

     One  Business  Day prior to the  redemption  date or the Asset Sale Payment
Date, as the case may be, the Company shall deposit with the Trustee or with the
Paying Agent money  sufficient to pay the redemption price or the purchase price
of, and accrued  interest on, all Securities to be redeemed or purchased on that
date.  The Trustee or the Paying Agent shall return to the Company any money not
required for that purpose.

     If the  Company  complies  with the  preceding  paragraph,  interest on the
Securities  or portions  thereof to be redeemed or  purchased  (in the case of a
redemption, whether or not such Securities are presented for payment) will cease
to accrue on the applicable  redemption  date or Asset Sale Payment Date, as the
case may be. If any  Security  called for  redemption  shall not be so paid upon
surrender,  or if any Security to be purchased shall not be so paid on the Asset
Sale  Payment  Date,  because of the  failure of the  Company to comply with the
preceding paragraph, then interest will be paid on the unpaid principal from the
redemption  date or the Asset Sale Payment  Date, as the case may be, until such
principal is paid and on any interest not paid on such unpaid principal, in each
case, at the rate provided in the Securities and in Section 4.1.

Section 3.6 Securities Redeemed or Purchased in Part

     Upon  surrender of a Security  that is redeemed or  purchased in part,  the
Company shall issue,  and the Trustee shall  authenticate  for the Holder at the
expense  of the  Company,  a new  Security  equal  in  principal  amount  to the
unredeemed portion or the portion not purchased of the Security surrendered.

Section 3.7 Optional Redemption

     The Company may redeem all or any of the Securities at any time on or after
September 15, 2002, at the following redemption prices (expressed as percentages
of principal amount), plus accrued and unpaid interest to the redemption date:










                                      -22-
<PAGE>


      If Redeemed During                   
the 12-month Period Commencing                   Redemption Price
- -------------------------------                  ----------------

 September 15, 2002                                  104.750%
 September 15, 2003                                  103.167%
 September 15, 2004                                  101.583%
 September 15, 2005 and thereafter                     100%


     Notwithstanding  the foregoing,  the Company may redeem in the aggregate up
to $150,000,000 principal amount of Securities at any time and from time to time
prior to  September  15,  2000 at a  redemption  price  equal to 108.500% of the
aggregate principal amount so redeemed,  plus accrued interest to the redemption
date,  out of the net cash  proceeds  of one or more  Public  Equity  Offerings;
provided that at least  $300,000,000  aggregate  principal  amount of Securities
originally  issued  remains   outstanding  after  the  occurrence  of  any  such
redemption  and that any such  redemption  occurs  within 60 days  following the
closing of any such Public Equity Offering.

     Any  redemption  pursuant to this Section 3.7 shall be made,  to the extent
applicable, in accordance with the provisions of Sections 3.1 through 3.6.

Section 3.8 Asset Sale Offer

     If the Company  determines  to make an Asset Sale Offer,  the Company shall
promptly  mail  (with  notice to the  Trustee)  or shall  cause the  Trustee  to
promptly mail (in the Company's name and at its expense) notice of an Asset Sale
Offer to each Holder of  Securities  as set forth in Section  3.3(b).  The Asset
Sale Offer  shall be deemed to have  commenced  on the date of such  mailing and
shall terminate 30 days after its  commencement  unless a longer offering period
is required by law (the  "Asset  Sale Offer  Period").  On or prior to the fifth
Business  Day  following  the  termination  of the Asset Sale Offer  Period (the
"Asset Sale Payment Date"), the Company shall purchase,  or cause the Trustee to
purchase,  and mail or deliver  payment  for,  as  selected  on a pro rata basis
(unless such method is otherwise prohibited,  in which case the Securities to be
purchased  shall be  selected  by lot,  with such  adjustments  as may be deemed
appropriate by the Company so that only Securities in denominations of $1,000 or
integral  multiples  thereof shall be purchased,  or in such other manner as the
Trustee shall deem fair and equitable) from Holders  tendering their  Securities
pursuant  to the Asset Sale  Offer,  the  amount of  Securities  required  to be
purchased  pursuant to Section  4.11.  If the Asset Sale  Payment  Date is on or
after an interest  payment  record  date and on or before the  related  interest
payment  date,  any accrued  interest will be paid to the person in whose name a
Security is  registered  at the close of business  on such record  date,  and no
additional interest will be payable to Holders who tender Securities pursuant to
the Asset Sale Offer. Any Asset Sale Offer shall be conducted in compliance with
applicable  tender offer rules,  including Section 14(e) of the Exchange Act and
Rule 14e-1 thereunder.

     On or before  any Asset  Sale  Payment  Date,  the  Company,  to the extent
lawful,  shall (i) accept for payment,  as selected on a pro rata basis  (unless
such  method  is  otherwise  prohibited,  in  which  case the  Securities  to be
purchased  shall be  selected  by lot,  with  such  adjustment  as may be deemed
appropriate by the Company so that only Securities in denominations of $1,000 or
integral  multiples  thereof shall be purchased,  or in such other manner as the
Trustee shall deem fair and equitable),  Securities or portions thereof tendered
pursuant to the Asset Sale Offer,  (ii) if the Company  appoints a depositary or
Paying Agent,  deposit with such depositary or Paying Agent money  sufficient to
pay  the  purchase  price  (including  all  accrued  interest  on the  purchased
Securities) of all Securities or portions thereof so accepted,  (iii) deliver or
cause the  depositary  or Paying Agent to deliver to the Trustee  Securities  so
accepted and (iv) deliver an Officers' Certificate identifying the Securities or
portions  thereof  accepted  for payment by the Company in  accordance  with the
terms of this Section 3.8. The depositary,  the Paying Agent or the Company,  as
the case may be,  promptly  shall mail or deliver  to each  tendering  Holder an
amount  equal to the  purchase  price  (including  all  accrued  interest on the
purchased  Securities) of the Securities tendered by such Holder and accepted by
the Company for purchase,  and the Trustee promptly shall  authenticate and mail
or deliver  to such  Holders a new  Security  equal in  principal  amount to any
unpurchased portion of the Security surrendered.  Any Securities not so accepted
promptly shall be mailed or delivered by the Company to the Holder thereof.  The
Company will publicly  announce the results of the Asset Sale Offer on the Asset
Sale Payment Date.


                                      -23-
<PAGE>


     Other than as  specifically  provided  in this  Section  3.8,  any offer to
purchase  Securities  pursuant to this  Section 3.8 shall be made in  accordance
with the other provisions of this Indenture.

                                   ARTICLE 4.

                                    COVENANTS

Section 4.1 Payment of Securities

     The Company shall pay the principal of and premium, if any, and interest on
the  Securities  on the  dates and in the  manner  provided  in the  Securities.
Principal,  premium,  if any, and interest shall be considered  paid on the date
due if the Paying Agent,  other than the Company or a Subsidiary of the Company,
holds on that date money deposited by the Company  designated for and sufficient
to pay all principal, premium, if any, and interest then due.

     The Company  shall pay interest  (including  post-petition  interest in any
proceeding  under any Bankruptcy Law) on overdue  principal at the rate equal to
the interest rate on the Securities to the extent lawful;  it shall pay interest
on overdue  payments of premium,  if any, or installments  of interest  (without
regard to any applicable grace period) at the same rate to the extent lawful.

     On or prior to the  effective  date of this  Indenture,  the Trustee  shall
establish  a  segregated   non-interest-bearing  corporate  trust  account  (the
"Payment Account") maintained by the Trustee for the benefit of Holders in which
all amounts  paid in respect of the  Securities  will be held and from which the
Trustee shall make payments to the Holders in accordance with this Indenture and
the  Securities.  The Trustee and any Agent of the Trustee shall have  exclusive
control and sole right of withdrawal with respect to the Payment Account for the
purpose  of making  deposits  in and  withdrawals  from the  Payment  Account in
accordance with this Indenture.  All monies and other property deposited or held
from time to time in the  Payment  Account  shall be held by the  Trustee in the
Payment  Account  for  the  exclusive   benefit  of  the  Holders,   subject  to
subordination to Senior Indebtedness in accordance with Article 10 hereof.

Section 4.2 Maintenance of Office or Agency

     The Company  will  maintain  an office or agency  where  Securities  may be
surrendered  for  registration  of transfer or  exchange  and where  notices and
demands to or upon the Company with respect of the Securities and this Indenture
may be served  pursuant  to Section  2.3.  The  Company  hereby  designates  the
Corporate Trust Office of the Trustee as such office or agency of the Company.

     The Company also from time to time may  designate one or more other offices
or agencies where the Securities may be presented or surrendered  for any or all
such purposes and from time to time may rescind such  designations.  The Company
will give  prompt  written  notice to the  Trustee  of any such  designation  or
rescission and of any change in the location of any such other office or agency.

Section 4.3 SEC Reports

     (a) The Company  shall  remain  subject to the  reporting  requirements  of
Section 13 or Section 15(d) of the Exchange Act and shall  continue to file with
the SEC such annual  reports and such  information,  documents and other reports
which are specified in Sections 13 and 15(d) of the Exchange Act.

     (b) The Company shall file with the Trustee and cause to be provided to the
Holders,  within 15 days  after it files  the same  with the SEC,  copies of its
annual reports and of the information, documents and other reports (or copies of
such  portions of any of the  foregoing as the SEC may by rules and  regulations
prescribe)  which the  Company or any  subsidiary  of the Company is required to
file with the SEC  pursuant  to Section  13 or 15(d) of the  Exchange  Act.  The
Company shall cause any annual report  furnished to its  stockholders  generally
and any quarterly or other financial reports furnished by it to its stockholders
generally  to be filed  with the  Trustee  and  mailed to the  Holders  at their
addresses  appearing in the register of Securities  maintained by the Registrar.
The Company will cause to be disclosed in an Officers' Certificate  accompanying
any annual  report  filed with the Trustee  and mailed to Holders or  comparable
information as of the date of the most recent financial  statements in each such
report or comparable  information the amount available for payments  pursuant to
Section 4.7. The Trustee shall have no obligation to furnish such information to
the Holders unless instructed to do so by the Company or requested by a Holder.


                                      -24-
<PAGE>

Section 4.4 Compliance Certificate

     (a) The Company shall deliver to the Trustee, within 120 days after the end
of each fiscal year of the  Company,  an  Officers'  Certificate  stating that a
review  of the  activities  of the  Company  and  its  Subsidiaries  during  the
preceding  fiscal  year has been  made  under  the  supervision  of the  signing
Officers  with a view to  determining  whether the  Company has kept,  observed,
performed  and  fulfilled  its  obligations  under this  Indenture,  and further
stating,  as to each such Officer signing such certificate,  that to the best of
his knowledge  the Company has kept,  observed,  performed  and  fulfilled  each
covenant contained in this Indenture and is not in default in the performance or
observance  of any of the terms,  provisions  and  conditions  hereof  (or, if a
Default or Event of Default shall have occurred, describing all such Defaults or
Events of Default of which he may have  knowledge and what action the Company is
taking or proposes  to take with  respect  thereto)  and that to the best of his
knowledge  no event has  occurred  and remains in  existence  by reason of which
payments on account of the principal of or premium, if any, or interest, if any,
on the Securities  are prohibited or, if such event has occurred,  a description
of the event and what  action  the  Company is taking or  proposes  to take with
respect thereto.

     (b) So long as (i) not contrary to the then current  recommendations of the
American  Institute  of  Certified  Public  Accountants  or (ii)  the  Company's
independent  public  accountants  do not have in  effect a  policy,  of  general
applicability  with respect to their  clients,  that such  accountants  will not
prepare  statements  on the subjects  specified  below,  the year-end  financial
statements  delivered  pursuant to Section 4.3 shall be accompanied by a written
statement of the Company's  independent  public accountants (who shall be a firm
of established national reputation) that in making the examination necessary for
certification of such financial  statements  nothing has come to their attention
that would lead them to believe that the Company has violated any  provisions of
Article 4 or 5 or, if any such violation has occurred, specifying the nature and
period of existence thereof, it being understood that such accountants shall not
be liable  directly  or  indirectly  to any  Person  for any  failure  to obtain
knowledge of any such violation.

     (c) The Company,  so long as any of the  Securities are  outstanding,  will
deliver to the Trustee, forthwith upon any Officer becoming aware of any Default
or Event of Default under this Indenture,  an Officers'  Certificate  specifying
such  Default  or Event of  Default  and what  action  the  Company is taking or
proposes to take with respect thereto.

Section 4.5 Corporate Existence, Taxes, etc.

     Subject to the  provisions of Section 5.1, the Company shall do or cause to
be done all things  necessary  to preserve and keep in full force and effect its
rights (charter and statutory), licenses and franchises; provided, however, that
the Company shall not be required to preserve any such right or franchise if the
Board of Directors  shall determine that the  preservation  thereof is no longer
desirable  in the conduct of the business of the Company and the loss thereof is
not disadvantageous in any material respect to the Holders.

Section 4.6 Stay, Extension and Usury Laws

     The Company  covenants  (to the extent that it may  lawfully do so) that it
will not at any time insist  upon,  plead or in any manner  whatsoever  claim or
take the  benefit or  advantage  of any stay,  extension  or usury law  wherever
enacted,  now or at any time  hereafter in force,  that may affect the Company's
obligation  to pay the  Securities;  and the  Company (to the extent that it may
lawfully do so) hereby expressly waives all benefit or advantage of any such law
insofar as such law applies to the  Securities,  and covenants that it will not,
by resort to any such law,  hinder,  delay or impede the execution of any power,
right or remedy  herein  granted to the Trustee,  but will suffer and permit the
execution  of every such  power,  right or remedy as though no such law has been
enacted.

Section 4.7 Limitations on Restricted Payments

     The  Company  shall  not,  and shall not  permit  any of its  Subsidiaries,
directly or indirectly,  to make any  Restricted  Payment if at the time of such
Restricted Payment:

     (i) a Default or Event of Default  shall have occurred and be continuing or
shall occur as a consequence thereof;


    
                                  -25-
<PAGE>

     (ii) after giving effect to the proposed Restricted Payment,  the amount of
such Restricted  Payment,  when added to the aggregate  amount of all Restricted
Payments  made after May 15, 1996,  exceeds the sum of (1) 50% of the  Company's
Consolidated  Net Income  accrued  during the period (taken as a single  period)
commencing  May 15, 1996, to and including the most recent fiscal  quarter ended
immediately prior to the date of such Restricted Payment and for which financial
results have been reported (or, if such aggregate  Consolidated Net Income shall
be a deficit,  minus 100% of such aggregate deficit);  (2) the net cash proceeds
from the  issuance  and sale of the  Company's  (a)  Capital  Stock  that is not
Disqualified  Stock,  including net cash proceeds  received upon the exercise of
any  options  or  warrants  to  purchase  shares of  Capital  Stock  other  than
Disqualified  Stock  (other than to a  Subsidiary  of the  Company) and (b) debt
securities  or  other   securities   that  are  convertible  or  exercisable  or
exchangeable for such Capital Stock that is not Disqualified Stock and that have
been so converted or exercised or exchanged,  after May 15, 1996;  (3) aggregate
net cash  proceeds  received by the Company  after the date of the  Indenture as
capital contributions to the Company; and (4) $20.0 million; or

     (iii)  the  Company  would  not be able to  incur  an  additional  $1.00 of
Indebtedness under the Consolidated Coverage Ratio test in Section 4.9(a).

     Notwithstanding the foregoing, the provisions of this Section 4.7 shall not
prevent  the  following  Restricted  Payments  (provided,   however,  that  such
Restricted  Payments  shall be included for purposes of computing  the amount of
Restricted   Payments  previously  made  under  clause  (ii)  of  the  preceding
paragraph):  (x) the  payment of any  dividend  within 60 days after the date of
declaration  thereof  if the  payment  thereof  would  have  complied  with  the
limitations of this covenant on the date of declaration  and (y) the purchase of
stock held by officers,  directors or employees of the Company whose  employment
or term with the Company has been terminated or who have died or become disabled
in an aggregate amount not to exceed $5.0 million in any fiscal year.

Section 4.8 Limitations on Restrictions on Distributions from Subsidiaries

     The Company  shall not,  and shall not permit any of its  Subsidiaries  to,
create or otherwise cause or suffer to exist or become  effective any consensual
encumbrance or restriction  (other than encumbrances or restrictions  imposed by
law or by  judicial or  regulatory  action or by  provisions  in leases or other
agreements  that  restrict  the  assignability  thereof)  on the  ability of any
Subsidiary of the Company to (i) pay  dividends or make any other  distributions
on its Capital Stock or any other interest or participation  in, or measured by,
its  profits,  owned by the  Company  or any of its other  Subsidiaries,  or pay
interest on or principal of any  Indebtedness  owed to the Company or any of its
other  Subsidiaries,  (ii) make loans or  advances  to the Company or any of its
other  Subsidiaries  or (iii)  transfer any of its  properties  or assets to the
Company  or  any  of  its  other   Subsidiaries,   except  for  encumbrances  or
restrictions  existing  under or by reason of (a)  applicable  law, (b) Existing
Indebtedness,  (c) any restrictions under any agreement  evidencing any Acquired
Indebtedness that was permitted to be incurred pursuant to Section 4.9, provided
that such  restrictions and encumbrances  only apply to assets that were subject
to such restrictions and encumbrances prior to the acquisition of such assets by
the Company or its  Subsidiaries,  (d)  restrictions or  encumbrances  replacing
those  permitted  by clause  (b) or (c)  which,  taken as a whole,  are not more
restrictive, (e) this Indenture, (f) any restrictions or encumbrances arising in
connection with  Refinancing  Indebtedness,  provided that any  restrictions and
encumbrances  of the type  described  in this  Section 4.8 that arise under such
Refinancing  Indebtedness are not, taken as a whole, more restrictive than those
under the agreement  creating or evidencing the  Indebtedness  being refunded or
refinanced,  (g) any  restrictions  with respect to a Subsidiary  of the Company
imposed  pursuant to an  agreement  that has been  entered  into for the sale or
other  disposition of all or substantially all of the Capital Stock or assets of
such Subsidiary,  (h) any agreement restricting the sale or other disposition of
property securing Indebtedness if such agreement does not expressly restrict the
ability  of a  Subsidiary  of the  Company  to pay  dividends  or make  loans or
advances  and (i)  customary  restrictions  in  purchase  money  debt or  leases
relating to the property covered thereby.

Section 4.9       Limitations on Additional Indebtedness

     (a) After the date hereof,  the Company shall not, and shall not permit any
of its Subsidiaries to, directly or indirectly,  create,  incur, issue,  assume,
guarantee,  extend the maturity of, or otherwise  become  liable with respect to
(collectively,   "incur"),  any  Indebtedness  (including,  without  limitation,
Acquired  Indebtedness),  unless  after giving  effect  thereto,  the  Company's
Consolidated Coverage Ratio on the date thereof would be at least:

          (i) 2.00 to 1, if such date is on or prior to March 31, 1998,


                                      -26-
<PAGE>
          (ii) 2.25 to 1, if such date is after  March 31,  1998 and on or prior
     to March 31, 1999, and

          (iii) 2.50 to 1, if such date is after March 31, 1999,

in each  case  determined  on a pro  forma  basis as if the  incurrence  of such
additional  Indebtedness and the application of the net proceeds therefrom,  had
occurred at the  beginning  of the  four-quarter  period used to  calculate  the
Company's Consolidated Coverage Ratio.

     (b) Notwithstanding the foregoing: (a) the Company and its Subsidiaries may
(i) incur  Indebtedness under one or more Credit Facilities not to exceed $700.0
million at any one time outstanding; (ii) incur Refinancing Indebtedness;  (iii)
incur any  Indebtedness of the Company to any Wholly Owned  Subsidiary or of any
Subsidiary  to the  Company or to any Wholly  Owned  Subsidiary;  (iv) incur any
Indebtedness  evidenced  by  letters  of credit  which are used in the  ordinary
course of  business  of the  Company  and its  Subsidiaries  to secure  workers'
compensation  and other insurance  coverages;  and (v) incur  Capitalized  Lease
Obligations  of the  Company  and  its  Subsidiaries  such  that  the  aggregate
principal  amount  of  Capitalized  Lease  Obligations  of the  Company  and its
Subsidiaries then  outstanding,  when added to the Capitalized Lease Obligations
to be incurred,  does not exceed 5% of Consolidated Tangible Assets; and (b) the
Company  and its  Subsidiaries  may  incur  additional  Indebtedness  (including
additional  Indebtedness  under any Credit  Facility  that is designated in such
Credit Facility as incurred under this clause (b)),  provided that the aggregate
principal  amount of any such  additional  Indebtedness  outstanding  under this
clause (b) at any time,  together  with the aggregate  liquidation  value of any
outstanding  Preferred  Stock  issued by a Subsidiary  of the Company,  does not
exceed $75.0 million.

     No  Subsidiary  of the Company  shall  Guarantee  any  Indebtedness  of the
Company (including by way of a pledge of assets) that is subordinate in right of
payment to any Senior  Indebtedness  unless such  Subsidiary also guarantees the
Securities  and waives,  and will not claim or take  advantage of, any rights of
reimbursement,  indemnity or subrogation  against the Company as a result of any
payment by such Subsidiary under its Guarantee of the Securities.  If such other
Indebtedness  of the  Company  is (1)  pari  passu  with  the  Securities,  such
Guarantee of such pari passu  Indebtedness shall be pari passu with or expressly
subordinated to such Guarantee of the Securities,  or (2)  subordinated in right
of payment to the Securities,  such Guarantee of such subordinated  Indebtedness
shall be expressly subordinated to such Guarantee of the Securities, at least to
the extent that such subordinated  Indebtedness is subordinated or junior to the
Securities.  Notwithstanding the foregoing, any Guarantee of the Securities by a
Subsidiary   of  the  Company  may  provide  by  its  terms  that  it  shall  be
automatically  and  unconditionally  released and discharged upon the release or
discharge of the Guarantee  which  resulted in the creation of such Guarantee of
the Securities, except a discharge or release by or as a result of payment under
such  Guarantee of such other  Indebtedness  or if any other  Guarantee of other
Indebtedness is outstanding.

Section 4.10 Change in Control

     (a)  Following the  occurrence  of any Change in Control,  each Holder will
have the right, at such Holder's option, to require that the Company purchase (a
"Change  in Control  Repurchase"),  and upon the  exercise  of such  right,  the
Company shall, subject to the provisions of Section 10.3 hereof,  purchase,  all
or any part of such Holder's  Securities on a date (the "Repurchase  Date") that
is no  earlier  than 30 days nor later  than 60 days after the date on which the
Company  gives  notice  of a Change in  Control  as  provided  in (b) below at a
purchase  price  equal  to  101%  of  the  aggregate  principal  amount  of  the
Securities,  plus accrued and unpaid interest thereon, if any, to the Repurchase
Date.

     (b) Within 30 days after any Change in Control, the Company (with notice to
the Trustee),  or the Trustee at the Company's request, will mail or cause to be
mailed  to all  Holders  on the date of the  Change  in  Control a notice of the
occurrence  of such Change in Control and of the  Holders'  rights  arising as a
result  thereof.  Such  notice,  which  shall  govern the terms of the Change in
Control Repurchase, shall state:

          (1) that a Change in Control has occurred and that such Holder has the
     right to require the Company to  repurchase  such  Holder's  Securities  in
     cash;

          (2) the  Repurchase  Date (which  will be no earlier  than 30 days nor
     later than 60 days from the date such notice is mailed);


                                      -27-
<PAGE>

          (3) the purchase price for the repurchase;

          (4) the date by which the repurchase right must be exercised; and

          (5) the instructions  determined by the Company,  consistent with this
     Section  4.10,  that a Holder must  follow in order to have its  Securities
     repurchased.

     (c) To exercise a repurchase  right,  a Holder shall deliver to the Company
(or a depositary  or Paying Agent  designated by the Company for such purpose in
the notice referred to in (b) above),  on or before the close of business on the
Repurchase Date, the Security or Securities with respect to which the repurchase
right is being  exercised,  duly endorsed for transfer to the Company,  with the
form  entitled  "Option  of Holder to Elect  Purchase"  on the  reverse  of each
Security so delivered  completed.  Holders  shall be entitled to withdraw  their
election if the Company (or the  depositary  or Paying Agent  designated  by the
Company for the purpose of receiving  such  election)  receives,  not later than
five Business Days prior to the Repurchase  Date, a telegram,  telex,  facsimile
transmission  or letter  setting  forth the name of the  Holder,  the  principal
amount of the Security or  Securities  the Holder  delivered  for purchase and a
statement that such Holder is withdrawing  its election to the have the Security
or Securities purchased.

     (d) In the event a repurchase  right shall be exercised in accordance  with
the terms  hereof,  subject to  Article  10, the  Company  shall on or  promptly
following  the  Repurchase  Date pay or  cause to be paid in cash to the  Holder
thereof  the  repurchase  price of the  Security or  Securities  as to which the
repurchase  right has been exercised.  In the event that the repurchase right is
exercised with respect to less than the entire principal amount of a surrendered
Security,  the Company  shall execute and deliver to the Trustee and the Trustee
shall  authenticate  for  issuance  in the name of the Holder a new  Security or
Securities in the aggregate  principal  amount of the  unrepurchased  portion of
such surrendered security.

     (e) If the Repurchase Date is on or before an Interest  Payment Date and on
or after the  related  record  date,  any  interest  accrued  and  unpaid to the
Repurchase  Date  will be paid to the  Person  in  whose  name the  Security  is
registered  at the close of  business  on such record  date,  and no  additional
interest will be payable to Holders who exercise their repurchase right pursuant
to this Section 4.10.

     (f) Any Change in Control  Repurchase shall be conducted in compliance with
applicable  tender offer rules,  including Section 14(e) of the Exchange Act and
Rule 14(e)(1)  thereunder.  The Change in Control Repurchase may not be modified
or conditioned by the Company in any manner.

Section 4.11 Limitations on Asset Sales

     The Company  shall not,  and shall not permit any of its  Subsidiaries  to,
consummate  any Asset Sale  unless (i) the Company or its  Subsidiaries  receive
consideration  at the time of such Asset Sale at least  equal to the fair market
value of the assets or Capital Stock  included in such Asset Sale (as determined
in good faith by the Board of Directors, whose determination shall be conclusive
and  evidenced  by a board  resolution)  and  (ii)  not  less  than  50% of such
consideration  is in the form of cash or Cash  Equivalents  (provided,  however,
that this clause (ii) shall not be applicable to a transaction  involving assets
acquired and  designated as held for sale,  which assets  represent in aggregate
since the date of the Indenture 5% or less of the net tangible assets previously
acquired by the Company or a Subsidiary  pursuant to acquisitions since the date
of the  Indenture  and  which  assets  are  disposed  of no later  than one year
following  their  initial  acquisition).  The Net Proceeds of Asset Sales shall,
within 360 days of receipt  thereof,  (a) be reinvested in the lines of business
of the Company or any of its Subsidiaries  immediately prior to such investment;
(b) be applied to the  payment of the  principal  of, and  interest  on,  Senior
Indebtedness;  (c) be  utilized  to make  any  Investment  in any  other  Person
permitted  under this  Indenture;  or (d) be applied to an offer (an "Asset Sale
Offer") to purchase  outstanding  Securities.  In any such Asset Sale Offer, the
Company  shall offer to purchase  Securities  on a pro rata basis  (unless  such
method is otherwise  prohibited,  in which case the  Securities  to be purchased
shall be selected by lot, with such adjustments as may be deemed  appropriate by
the  Company so that only  Securities  in  denominations  of $1,000 or  integral
multiples  thereof  shall be  purchased,  or in such other manner as the Trustee
shall  deem  fair  and  equitable),  at a  purchase  price  equal to 100% of the
aggregate  principal amount of the Securities,  plus accrued and unpaid interest
to the date of purchase,  in the manner set forth in this  Indenture.  Any Asset
Sale Offer will be conducted in compliance with  applicable  tender offer rules,
including Section 14(e) of the Exchange Act and Rule 14e-1  thereunder.  Any Net
Proceeds remaining  immediately after the completion of any Asset Sale Offer may
be used by the Company or its Subsidiaries for any purpose not inconsistent with
the other provisions of this Indenture.


                                      -28-
<PAGE>


     Notwithstanding the provisions of the immediately preceding paragraph,  the
Company and its  Subsidiaries  may, in the ordinary  course of business  (or, if
otherwise than in the ordinary  course of business,  upon receipt of a favorable
written opinion from an independent  financial advisor of national reputation as
to the fairness from a financial point of view to the Company or such Subsidiary
of the  proposed  transaction),  exchange  all  or a  portion  of its  property,
businesses or assets for  property,  businesses or assets that, or Capital Stock
of a Person all or  substantially  all of whose assets,  are of a type used in a
healthcare related business,  or a combination of any such property,  businesses
or  assets,  or  Capital  Stock of such a Person  and cash or Cash  Equivalents;
provided that (i) there shall not exist immediately prior or subsequent  thereto
a Default or an Event of Default,  (ii) a majority of the disinterested  members
of the Board of Directors of the Company shall have approved a resolution of the
Board of Directors that such exchange is fair to the Company or such Subsidiary,
as the case may be, and (iii) any cash or Cash Equivalents  received pursuant to
any such exchange  shall be applied in the manner  applicable to Net Proceeds of
Asset Sales as set forth pursuant to the provisions of the immediately preceding
paragraph; and provided, further, that any Capital Stock of a Person received in
such an  exchange  pursuant  to this  paragraph  shall be owned  directly by the
Company or a Subsidiary of the Company and, when combined with the Capital Stock
of such person already owned by the Company and its  Subsidiaries,  shall result
in such Person becoming a Wholly Owned Subsidiary of the Company.

Section 4.12 Limitations on Transactions with Affiliates

     Neither  the  Company  nor any of its  Subsidiaries  shall  make any  loan,
advance,  guarantee or capital  contribution to, or for the benefit of, or sell,
lease,  transfer or otherwise  dispose of any of its properties or assets to, or
for the benefit of, or purchase or lease any property or assets  from,  or enter
into or amend any contract,  agreement or understanding with, or for the benefit
of, any  Affiliate of the Company or any of its  Subsidiaries  or any Person (or
any  Affiliate of such Person)  holding 10% or more of the Common  Equity of the
Company or any of its Subsidiaries (each an "Affiliate  Transaction") unless (i)
such  Affiliate   Transactions   are  between  or  among  the  Company  and  its
Subsidiaries;  (ii) such Affiliate  Transactions  are in the ordinary  course of
business and consistent with past practice; or (iii) the terms of such Affiliate
Transactions are fair and reasonable to the Company or such  Subsidiary,  as the
case may be, and are at least as  favorable as the terms which could be obtained
by the  Company  or  such  Subsidiary,  as the  case  may  be,  in a  comparable
transaction made on an arm's-length basis between  unaffiliated  parties. In the
event of any transaction or series of transactions  occurring  subsequent to the
date of this  Indenture  with an Affiliate of the Company which is not permitted
under  clauses  (i) or (ii) above and  involves in excess of $5.0  million,  the
terms  of  such  transaction   shall  be  in  writing  and  a  majority  of  the
disinterested  members of the Board of Directors  shall by resolution  determine
that such business or  transaction  meets the criteria set forth in clause (iii)
above.

Section 4.13 Limitations on Liens

     The Company shall not, and shall not permit any Subsidiary to,  directly or
indirectly,  create,  incur  or  affirm  any  Lien  of  any  kind  securing  any
Indebtedness  which is pari  passu or  subordinate  in right of  payment  to the
Securities (including any assumption,  guarantee or other liability with respect
thereto  by  any  Subsidiary)  upon  any  property  or  assets   (including  any
intercompany notes) of the Company or any Subsidiary owned on the date hereof or
hereafter  acquired,  or any income or profits therefrom,  unless the Securities
are directly  secured  equally and ratably with (or, in the case of subordinated
Indebtedness,  prior or senior thereto,  with the same relative  priority as the
Securities  shall  have with  respect  to such  subordinated  Indebtedness)  the
obligation  or liability  secured by such Lien except for Liens (A) securing any
Indebtedness which became Indebtedness pursuant to a transaction permitted under
Section 5.1 hereof or securing Acquired  Indebtedness  which, in each case, were
created prior to (and not created in connection  with, or in  contemplation  of)
the incurrence of such pari passu  Indebtedness or subordinated  Indebtedness by
the Company or any  Subsidiary  and which  Indebtedness  is permitted  under the
provisions  of Section 5.1 hereof,  (B)  securing any  Indebtedness  incurred in
connection with any refinancing,  renewal,  substitutions or replacements of any
such  Indebtedness  described  in  clause  (A) or (C)  created  in  favor of the
Company;  provided,  however,  that in the case of clauses (A) and (B), any such
Lien only  extends to the assets that were  subject to such Lien  securing  such
Indebtedness   prior  to  the  related   acquisition   by  the  Company  or  its
Subsidiaries.


                                      -29-
<PAGE>

Section 4.14 Limitations on Subsidiary Preferred Stock

     The Company shall not permit any of its Subsidiaries to issue any Preferred
Stock  (other than to the Company or a Wholly  Owned  Subsidiary)  or permit any
Person (other than the Company or a Wholly Owned  Subsidiary) to own or hold any
interest in any Preferred  Stock of any such  Subsidiary  (other than  Preferred
Stock issued prior to the date of this  Indenture),  unless the Subsidiary would
be permitted to incur  Indebtedness  pursuant to the  provisions  of Section 4.9
hereof in the  aggregate  principal  amount equal to the  aggregate  liquidation
value of such Preferred Stock.

Section 4.15 Limitations on Certain Other Subordinated Indebtedness

     The  Company  shall  not  create,  incur,  assume  or  suffer  to exist any
Indebtedness that is subordinate in right of payment to any Senior  Indebtedness
unless such Indebtedness by its terms or the terms of the instrument creating or
evidencing  such  Indebtedness  is  subordinate in right of payment to, or ranks
pari passu with, the Securities.

Section 4.16 Limitations on Subsidiaries and Unrestricted Subsidiaries

     The Company may, by written notice to the Trustee, designate any Subsidiary
(including a newly acquired or a newly formed  Subsidiary) to be an Unrestricted
Subsidiary;  provided,  however,  that (i) no Default or Event of Default  shall
have occurred and be continuing or would arise therefrom, (ii) such designation,
when  considered as an Investment as described in the next sentence,  is at that
time permitted  under the covenant  described under Section 4.7 hereof and (iii)
immediately  after giving  effect to such  designation,  the Company could incur
$1.00 of additional  Indebtedness  pursuant to clause (a) of Section 4.9 hereof.
For purposes of Section 4.7 hereof,  (i) an "Investment" shall be deemed to have
been made at the time any Subsidiary is designated as an Unrestricted Subsidiary
in an amount  (proportionate to the Company's percentage Equity Interest in such
Subsidiary)  equal to the net  worth of such  Subsidiary  at the time  that such
Subsidiary  is designated as an  Unrestricted  Subsidiary;  (ii) at any date the
aggregate  amount of all Restricted  Payments made as Investments  since May 15,
1996 shall exclude and be reduced by an amount  (proportionate  to the Company's
percentage  Equity  Interest in such  Subsidiary)  equal to the net worth of any
Unrestricted   Subsidiary  from  and  after  the  date  that  such  Unrestricted
Subsidiary is designated a  Subsidiary,  not to exceed,  in the case of any such
redesignation  of an  Unrestricted  Subsidiary  as a  Subsidiary,  the amount of
Investments  previously  made  by the  Company  and  its  Subsidiaries  in  such
Unrestricted  Subsidiary (in the case of either clauses (i) or (ii) above,  "net
worth" to be  calculated  based upon the fair market value of the assets of such
Subsidiary  as of  any  such  date  of  designation);  and  (iii)  any  property
transferred to or from an  Unrestricted  Subsidiary  shall be valued at its fair
market  value  at the  time of such  transfer.  As of the  date of the  original
issuance of the Securities, there shall exist no Unrestricted Subsidiaries.

     Notwithstanding  the  foregoing,  the Board of Directors of the Company may
not designate any Subsidiary of the Company to be an Unrestricted Subsidiary if,
after  such  designation,  (a) the  Company  or any  Subsidiary  of the  Company
provides  credit  support  for, or a  guarantee  of, any  Indebtedness  or other
obligation   (contingent  or  otherwise)  of  such  Subsidiary   (including  any
undertaking, agreement or instrument evidencing such Indebtedness or obligation)
or is otherwise subject to recourse or obligated  thereunder or therefor,  (b) a
default with respect to any Indebtedness of such Subsidiary (including any right
which the  holders  thereof may have to take  enforcement  action  against  such
Subsidiary) would permit (upon notice,  lapse of time or both) any holder of any
other  Indebtedness of the Company or any Subsidiary of the Company to declare a
default  on  such  other  Indebtedness  or  cause  the  payment  thereof  to  be
accelerated or payable prior to its final scheduled maturity (whether or not any
such default had occurred or was continuing as of the time of such designation),
(c) such Subsidiary  owns any Equity  Interests in, or owns or holds any Lien on
any property of, any  Subsidiary  which is not a Subsidiary of the Subsidiary to
be so designated, (d) such Subsidiary has any contract,  arrangement,  agreement
or  understanding  with the Company,  or any Subsidiary of the Company,  whether
written or oral, other than a transaction  having terms no less favorable to the
Company or such  Subsidiary of the Company than those which might be obtained at
the time from persons who are not Affiliates of the Company,  or (e) the Company
or any  Subsidiary of the Company has any obligation to subscribe for any Equity
Interest  in such  Subsidiary  or to  maintain  or  preserve  such  Subsidiary's
financial  condition or to cause such Subsidiary to achieve  specified levels of
operating results.


                                      -30-
<PAGE>


                                   ARTICLE 5.

                                   SUCCESSORS

Section 5.1 Limitations on Mergers and Consolidations

     The Company shall not  consolidate  or merge with or into, or sell,  lease,
convey or otherwise dispose of all or substantially all of its assets, or assign
any of its obligations hereunder or under the Securities, to any Person unless:

     (i) the Person  formed by or  surviving  such  consolidation  or merger (if
other  than  the  Company),  or  to  which  sale,  lease,  conveyance  or  other
disposition or assignment shall be made  (collectively,  the "Successor"),  is a
corporation  organized  and existing  under the laws of the United States or any
State  thereof  or the  District  of  Columbia,  and the  Successor  assumes  by
supplemental  indenture  in a  form  satisfactory  to  the  Trustee  all  of the
obligations of the Company hereunder and under the Securities;

     (ii)  immediately  after giving effect to such  transaction,  no Default or
Event of Default shall have occurred and be continuing;

     (iii)  immediately  after giving effect to such  transaction and the use of
any net proceeds  therefrom on a pro forma basis,  the Consolidated Net Worth of
the Company or the Successor, as the case may be, would be at least equal to the
Consolidated Net Worth of the Company immediately prior to such transaction; and

     (iv) the  Consolidated  Coverage Ratio of the Company or the Successor,  as
the case may be, immediately after giving effect to such transaction, would on a
pro forma basis be such that the Company or the  Successor,  as the case may be,
would be  entitled  to incur at least $1 of  additional  Indebtedness  under the
Consolidated Coverage Ratio test in Section 4.9(a).

                  The  Company  shall  deliver  to  the  Trustee  prior  to  the
consummation  of  the  proposed  transaction  an  Officers'  Certificate  to the
foregoing effect and an Opinion of Counsel stating that the proposed transaction
and such supplemental indenture comply with this Indenture.

Section 5.2 Successor Corporation Substituted

     Upon any consolidation or merger,  or any sale, lease,  conveyance or other
disposition  of all or  substantially  all of the  assets of the  Company or any
assignment  of  its  obligations  under  this  Indenture  or the  Securities  in
accordance with Section 5.1, the Successor formed by such  consolidation or into
or with which the Company is merged or to which such sale, lease,  conveyance or
other  disposition  or assignment  is made shall succeed to, and be  substituted
for, and may exercise every right and power of, the Company under this Indenture
with the same effect as if such  Successor has been named as the Company  herein
and the predecessor  Company, in the case of a sale, lease,  conveyance or other
disposition or  assignment,  shall be released from all  obligations  under this
Indenture and the Securities.


                                   ARTICLE 6.

                              DEFAULTS AND REMEDIES

Section 6.1 Events of Default

     An "Event of Default" occurs if:

     (1) the Company defaults in the payment of the principal of, or any premium
on,  any  Security  when the same  becomes  due and  payable,  whether at Stated
Maturity, upon redemption, upon acceleration or otherwise;


                                      -31-
<PAGE>


     (2) the Company  defaults in the payment of interest on any  Security  when
the same  becomes due and payable and the Default  continues  for a period of 30
days (even if such payment is prohibited by Article 10 hereof);

     (3) the Company fails to comply with any of its agreements or covenants in,
or provisions of, the Securities or this Indenture  (other than a default in the
performance  or breach of a covenant  or  agreement  specifically  addressed  in
clause (1) or (2) of this Section) and such failure continues for the period and
after the notice specified below;

     (4) any  acceleration of the maturity of Indebtedness of the Company or its
Subsidiaries having in the aggregate an outstanding principal amount of at least
$10.0  million or a failure  to pay such  Indebtedness  at its Stated  Maturity;
provided  that such  acceleration  or failure to pay is not cured within 10 days
after such acceleration or failure to pay;

     (5) the  Company  or any of its  Significant  Subsidiaries  pursuant  to or
within the meaning of any Bankruptcy Law:

          (a) commences a voluntary case,

          (b)  consents  to the entry of an order for  relief  against  it in an
     involuntary case,

          (c)  consents to the  appointment  of a Custodian  of it or for all or
     substantially all of its property, or

          (d) makes a general assignment for the benefit of its creditors; or

     (6) a court of competent  jurisdiction  enters an order or decree under any
Bankruptcy Law that:

          (a)  is for  relief  against  the  Company  or any of its  Significant
     Subsidiaries as debtor in an involuntary case,

          (b)  appoints a  Custodian  of the  Company or any of its  Significant
     Subsidiaries or a Custodian for all or substantially all of the property of
     the Company or any of its Significant Subsidiaries, or

          (c) orders the  liquidation  of the Company or any of its  Significant
     Subsidiaries,

     and the order or decree remains unstayed and in effect for 60 days.

     The term "Custodian" means any receiver,  trustee, assignee,  liquidator or
similar official under any Bankruptcy Law.

     The Trustee  shall not be deemed to know of a Default  unless it has actual
knowledge  of such  Default or  receives  written  notice of such  Default  with
specific reference to such Default.

     A Default  under  clause (3) is not an Event of Default  until the  Trustee
notifies  the  Company,  or the Holders of at least 25% in  aggregate  principal
amount of the then outstanding Securities notify the Company and the Trustee, of
the  Default  and the  Company  does not cure the  Default  within 45 days after
receipt of the notice.  The notice must specify the  Default,  demand that it be
remedied and state that the notice is a "Notice of Default."


                                      -32-
<PAGE>


Section 6.2 Acceleration

     If an Event of Default  (other than an Event of Default with respect to the
Company specified in clause (5) or (6) of Section 6.1) occurs and is continuing,
the Trustee by written notice to the Company,  or the Holders of at least 25% in
aggregate principal amount of the then outstanding  Securities by written notice
to the Company and the Trustee, may declare all Securities to be due and payable
immediately.   Upon  such  declaration  the  amounts  due  and  payable  on  the
Securities,  as determined in the next  succeeding  paragraph,  shall be due and
payable  immediately.  If an  Event  of  Default  with  respect  to the  Company
specified in clause (5) or (6) of Section 6.1 occurs,  such an amount shall ipso
facto become and be immediately due and payable without any declaration,  notice
or other act on the part of the Trustee or any Holder. The Holders of a majority
in aggregate  principal  amount of the then  outstanding  Securities  by written
notice to the Trustee may rescind an  acceleration  and its  consequences if the
rescission  would not  conflict  with any judgment or decree and if all existing
Events of Default  (except  nonpayment of principal  of, or premium,  if any, or
interest  on the  Securities  or that  resulted  from a failure  to comply  with
Section 4.10) have been cured or waived.

     In the event that the maturity of the Securities is accelerated pursuant to
this Section 6.2,  100% of the  principal  amount  thereof and premium,  if any,
shall become due and payable  plus accrued  interest to the date of payment plus
interest on defaulted interest to the extent provided herein.

Section 6.3 Other Remedies

     If an Event of Default occurs and is continuing, the Trustee may pursue any
available remedy to collect the payment of the principal of, or premium, if any,
or interest on the Securities or to enforce the  performance of any provision of
the Securities or this Indenture.

     The Trustee may  maintain a  proceeding  even if it does not possess any of
the  Securities  or does not produce any of them in the  proceeding.  A delay or
omission by the Trustee or any Holder in exercising any right or remedy accruing
upon an Event of Default  shall not impair the right or remedy or  constitute  a
waiver of or acquiescence  in the Event of Default.  All remedies are cumulative
to the extent permitted by law.

Section 6.4 Waiver of Past Defaults

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding Securities by notice to the Trustee may waive an existing Default or
Event of Default and its consequences,  except a continuing  Default or Event of
Default in the payment of the principal  of, or premium,  if any, or interest on
any Security or in respect of a provision  under this Indenture  which cannot be
modified  or amended  without the  consent of the Holder of each  Security  then
outstanding.  Upon any such waiver,  such Default shall cease to exist,  and any
Event of Default arising  therefrom shall be deemed to have been cured for every
purpose of this Indenture;  but no such waiver shall extend to any subsequent or
other  Default  or Event of  Default  or impair  any right or remedy  consequent
thereon.

Section 6.5 Control by Majority

     The  Holders  of a  majority  in  aggregate  principal  amount  of the then
outstanding  Securities may direct the time,  method and place of conducting any
proceeding  for any remedy  available to the Trustee or exercising  any trust or
power conferred on it.  However,  the Trustee may refuse to follow any direction
that conflicts with law or this  Indenture,  that the Trustee  determines may be
unduly  prejudicial  to the rights of other  Holders,  or that may  involve  the
Trustee in personal liability, in each case as determined by the Trustee.

Section 6.6 Limitations on Suits

     A  Holder  may  pursue a  remedy  with  respect  to this  Indenture  or the
Securities only if:

     (1) the Holder gives to the Trustee written notice of a continuing Event of
Default;

     (2) the Holders of at least 25% in aggregate  principal  amount of the then
outstanding  Securities  make a written  request  to the  Trustee  to pursue the
remedy;


                                      -33-
<PAGE>

     (3) such Holder or Holders offer to the Trustee  indemnity  satisfactory to
the Trustee in its sole discretion against any loss, liability or expense;

     (4) the  Trustee  does not  comply  with the  request  within 60 days after
receipt of the request and the offer of indemnity; and

     (5) during  such  60-day  period the  Holders  of a majority  in  aggregate
principal  amount of the then  outstanding  Securities do not give the Trustee a
direction inconsistent with the request.

A Holder may not use this Indenture to prejudice the rights of another Holder or
to obtain a preference or priority over another Holder.

Section 6.7 Rights of Holders to Receive Payment

     Notwithstanding  any other  provision of this  Indenture,  the right of any
Holder of a Security  to receive  payment of  principal,  premium,  if any,  and
interest on the Security,  on or after the respective due dates expressed in the
Security,  or to bring suit for the  enforcement of any such payment on or after
such respective dates,  shall not be impaired or affected without the consent of
the Holder.

Section 6.8 Collection Suit by Trustee

     If an Event of Default  specified  in  Section  6.1(1) or (2) occurs and is
continuing, the Trustee is authorized to recover judgment in its own name and as
trustee of an express  trust against the Company for the amount of principal of,
premium, if any, and interest remaining unpaid on the Securities,  determined in
accordance with Section 6.2, and interest on overdue  principal and premium,  if
any, and, to the extent lawful,  interest on overdue  installments  of interest,
and such further  amount as shall be  sufficient to cover the costs and expenses
of collection,  including the reasonable compensation,  expenses,  disbursements
and advances of the Trustee, its agents and counsel.

Section 6.9 Trustee May File Proofs of Claim

     The Trustee is  authorized to file such proofs of claim and other papers or
documents  as may be  necessary  or advisable in order to have the claims of the
Trustee  (including  any  claim  for  the  reasonable  compensation,   expenses,
disbursements  and  advances of the  Trustee,  its agents and  counsel)  and the
Holders  allowed  in any  judicial  proceedings  relative  to the  Company,  its
creditors  or its  property  and shall be  entitled  and  empowered  to collect,
receive and distribute any money or other property payable or deliverable on any
such  claims  and any  Custodian  in any  such  judicial  proceeding  is  hereby
authorized by each Holder to make such payments to the Trustee, and in the event
that the Trustee shall  consent to the making of such  payments  directly to the
Holders,  to  pay to the  Trustee  any  amount  due  to it  for  the  reasonable
compensation,  expenses,  disbursements and advances of the Trustee,  its agents
and counsel,  and any other  amounts due the Trustee  under  Section 7.6. To the
extent that the payment of any such  compensation,  expenses,  disbursements and
advances of the Trustee,  its agents and counsel,  and any other amounts due the
Trustee  under  Section 7.6 out of the estate in any such  proceeding,  shall be
denied  for any  reason,  payment of the same shall be secured by a Lien on, and
shall be paid out of, any and all distributions,  dividends,  money,  securities
and other  properties  which the  Holders of the  Securities  may be entitled to
receive  in  such  proceeding  whether  in  liquidation  or  under  any  plan of
reorganization  or arrangement or otherwise.  Nothing herein  contained shall be
deemed to authorize the Trustee to authorize or consent to or accept or adopt on
behalf of any  Holder any plan of  reorganization,  arrangement,  adjustment  or
composition  affecting the Securities or the rights of any Holder thereof, or to
authorize  the Trustee to vote in respect of the claim of any Holder in any such
proceeding;  provided,  however, that the Trustee may, on behalf of the Holders,
vote for the election of a trustee (or similar  official) in bankruptcy  and may
be a member of the creditors' committee.

Section 6.10 Priorities

     If the Trustee  collects any money pursuant to this Article 6, it shall pay
out the money in the following order:

     First: to the Trustee for amounts due under Section 7.6;

     Second:  to  Holders  for  amounts  due and  unpaid on the  Securities  for
principal,  premium,  if any,  and


                                      -34-
<PAGE>

interest,  ratably, without preference or priority of any kind, according to the
amounts due and payable on the Securities for  principal,  premium,  if any, and
interest, respectively; and

     Third: to the Company.

     The  Trustee  may fix a record  date and  payment  date for any  payment to
Holders pursuant to this Article.

Section 6.11 Undertaking for Costs

     In any suit for the enforcement of any right or remedy under this Indenture
or in any suit  against the  Trustee for any action  taken or omitted by it as a
Trustee,  a court in its discretion may require the filing by any party litigant
in the suit of an undertaking to pay the costs of the suit, and the court in its
discretion may assess reasonable costs,  including  reasonable  attorneys' fees,
against any party litigant in the suit, having due regard to the merits and good
faith of the claims or defenses  made by the party  litigant.  This Section 6.11
does not apply to a suit by the Trustee,  a suit by a Holder pursuant to Section
6.7 or a suit by  Holders  of more  than  10% in  principal  amount  of the then
outstanding Securities.


                                   ARTICLE 7.

                                     TRUSTEE

Section 7.1 Duties of Trustee

     (1) If an Event of Default  has  occurred  and is  continuing,  the Trustee
shall exercise such of the rights and powers vested in it by this Indenture, and
use the same degree of care and skill in such  exercise,  as a prudent man would
exercise or use under the circumstances in the conduct of his own affairs.

     (2) Except during the continuance of an Event of Default:

          (a) the Trustee need  perform only those duties that are  specifically
     set forth in this  Indenture  and no others,  and no implied  covenants  or
     obligations shall be read into this Indenture against the Trustee; and

          (b)  in the  absence  of  bad  faith  on its  part,  the  Trustee  may
     conclusively rely, as to the truth of the statements and the correctness of
     the opinions expressed therein,  upon certificates or opinions furnished to
     the Trustee and conforming to the requirements of this Indenture;  however,
     the  Trustee  shall  examine the  certificates  and  opinions to  determine
     whether or not, on their face,  they appear to conform to the  requirements
     of this Indenture.

     (3) The Trustee may not be relieved from  liabilities for its own negligent
action, its own negligent failure to act, or its own willful misconduct,  except
that:

          (a) this  paragraph does not limit the effect of paragraph (2) of this
     Section;

          (b) the Trustee  shall not be liable for any error of judgment made in
     good faith by a Trust  Officer,  unless it is proved  that the  Trustee was
     negligent in ascertaining the pertinent facts; and

          (c) the  Trustee  shall not be liable  with  respect  to any action it
     takes  or  omits  to take in good  faith  in  accordance  with a  direction
     received by it pursuant to Section 6.5.

     (4) Whether or not therein  expressly so provided,  every provision of this
Indenture  that in any way relates to the Trustee is subject to paragraphs  (1),
(2), (3) and (5) of this Section 7.1.

     (5) No provision of this  Indenture  shall require the Trustee to expend or
risk its own funds or incur any liability. The Trustee may refuse to perform any
duty or exercise any right or power unless it receives indemnity satisfactory to
it against any loss, liability or expense.


                                      -35-
<PAGE>

     (6) The Trustee  shall not be liable for interest on any money  received by
it except as the Trustee may agree in writing  with the  Company.  Money held in
trust by the  Trustee  need not be  segregated  from other  funds  except to the
extent required by law.

Section 7.2 Rights of Trustee

     (1) Subject to Section 7.1,  the Trustee may rely on any document  believed
by it to be genuine and to have been signed or presented  by the proper  Person,
and the Trustee need not investigate any fact or matter stated in the document.

     (2) Before the Trustee  acts or  refrains  from  acting,  it may require an
Officers' Certificate or an Opinion of Counsel or both. The Trustee shall not be
liable  for any action it takes or omits to take in good  faith in  reliance  on
such Officers'  Certificate or Opinion of Counsel.  The Trustee may consult with
counsel and the written  advice of such counsel or any Opinion of Counsel  shall
be full and  complete  authorization  and  protection  in  respect of any action
taken,  suffered  or  omitted  by it  hereunder  in good  faith and in  reliance
thereon.

     (3) The Trustee may act through agents and shall not be responsible for the
misconduct or negligence of any agent appointed with due care.

     (4) The  Trustee  shall not be liable  for any  action it takes or omits to
take in good faith which it believes  to be  authorized  or within its rights or
powers conferred upon it by this Indenture.

     (5) Unless otherwise  specifically provided in this Indenture,  any demand,
request,  direction or notice from the Company  shall be sufficient if signed by
an Officer of the Company.

Section 7.3 Individual Rights of Trustee

     The Trustee in its individual or any other capacity may become the owner or
pledgee of  Securities  and may  otherwise  deal with the  Company or any of its
Affiliates with the same rights it would have if it were not Trustee.  Any Agent
may do the same with like rights.

Section 7.4 Trustee's Disclaimer

     The Trustee makes no  representation as to the validity or adequacy of this
Indenture or the Securities or as to the Company's ability to pay the Securities
when and as due or  perform  its other  obligations  hereunder.  It shall not be
accountable  for the Company's  use of the proceeds  from the  Securities or any
money paid to the Company or upon the  Company's  direction  under any provision
hereof.  It shall not be  responsible  for the use or  application  of any money
received by any Paying Agent other than the Trustee. It shall not be responsible
for any  statement or recital  herein or any statement in the  Securities  other
than its certificate of authentication.

Section 7.5 Notice of Defaults

     If a Default or Event of  Default  occurs  and is  continuing  and if it is
known to the Trustee,  the Trustee shall mail to Holders a notice of the Default
or Event of  Default  within 90 days  after it  occurs.  Except in the case of a
Default or Event of Default in payment of the principal of, or premium,  if any,
or interest on any  Security or that  resulted  from a failure by the Company to
comply with  Section  4.10,  the Trustee may  withhold  the notice if it in good
faith determines that withholding the notice is in the interests of Holders.

Section 7.6 Compensation and Indemnity

     The  Company  shall  pay  to the  Trustee  from  time  to  time  reasonable
compensation  for its acceptance of this Indenture and services  hereunder.  The
Trustee's  compensation  shall not be  limited by any law on  compensation  of a
trustee of an express  trust.  The Company  shall  reimburse  the  Trustee  upon
request for all reasonable disbursements,  advances and expenses incurred by it.
Such  expenses  shall include the  reasonable  compensation,  disbursements  and
expenses of the Trustee's agents and counsel.


                                      -36-
<PAGE>

     The Company shall indemnify the Trustee, its employees, officers, directors
and agents and any predecessor Trustee hereunder against any loss,  liability or
expense  incurred by it arising out of or in connection  with the  acceptance or
administration  of  its  duties  under  this  Indenture  or in  connection  with
enforcing  this  indemnification   provision,  the  offering  and  sale  of  the
Securities,  any act of  negligence or bad faith of the Company or of any of its
officers,  employees,  agents  or  licensees,  except  as set  forth in the next
paragraph.  The Trustee promptly shall notify the Company of any claim for which
it may seek indemnity.  The Company shall defend the claim and the Trustee shall
cooperate in the defense.  The Trustee may have separate counsel and the Company
shall pay the reasonable fees and expenses of such counsel. The Company need not
pay for any  settlement  made without its consent,  which  consent  shall not be
unreasonably withheld.

     The Company need not reimburse any expense or indemnify against any loss or
liability incurred by the Trustee through negligence or bad faith.

     To secure the  Company's  payment  obligations  in this  Section  7.6,  the
Trustee shall have a Lien prior to the  Securities on all money or property held
or  collected  by the Trustee,  except that held in trust to pay  principal  of,
premium, if any, and interest on particular Securities.  Such Lien shall survive
the satisfaction and discharge of this Indenture.

     When the  Trustee  incurs  expenses or renders  services  after an Event of
Default  specified  in  Section  6.1(5)  or (6)  occurs,  the  expenses  and the
compensation   for  the  services  are  intended  to   constitute   expenses  of
administration under any Bankruptcy Law.

Section 7.7 Replacement of Trustee

     A  resignation  or removal of the  Trustee and  appointment  of a successor
Trustee shall become effective only upon the successor  Trustee's  acceptance of
appointment as provided in this Section.

     The Trustee may resign and be discharged  from the trust hereby  created by
so notifying the Company.  The Holders of a majority in principal  amount of the
then  outstanding  Securities may remove the Trustee by so notifying the Trustee
and the Company. The Company may remove the Trustee if:

          (1) the Trustee fails to comply with Section 310(b) of the TIA;

          (2) the Trustee is adjudged a bankrupt or an insolvent or an order for
     relief is entered with respect to the Trustee under any Bankruptcy Law;

          (3) a Custodian or public  officer  takes charge of the Trustee or its
     property; or

          (4) the Trustee becomes incapable of acting.

     If the Trustee  resigns or is removed or if a vacancy  exists in the office
of Trustee  for any  reason,  the  Company  shall  promptly  appoint a successor
Trustee.

     If a  successor  Trustee  does not take  office  within  60 days  after the
retiring Trustee resigns or is removed, the retiring Trustee, the Company or the
Holders of at least 10% in principal amount of the then  outstanding  Securities
may  petition  any court of  competent  jurisdiction  for the  appointment  of a
successor Trustee.

     If the Trustee  fails to comply with Section 310 of the TIA, any Holder may
petition any court of competent  jurisdiction for the removal of the Trustee and
the appointment of a successor Trustee.

     A successor  Trustee shall deliver a written  acceptance of its appointment
to the retiring Trustee and to the Company. Thereupon the resignation or removal
of the retiring Trustee shall become effective,  and the successor Trustee shall
have all the rights, powers and duties of the Trustee under this Indenture.  The
successor Trustee shall mail a notice of its succession to Holders. The retiring
Trustee  shall  promptly  transfer  all  property  held by it as  Trustee to the
successor   Trustee,   subject  to  the  Lien   provided  for  in  Section  7.6.
Notwithstanding  replacement  of the Trustee  pursuant to this  Section 7.7, the
Company's  obligations  under Section 7.6 shall  continue for the benefit of the
retiring Trustee.


                                      -37-
<PAGE>

Section 7.8 Successor Trustee by Merger, etc.

     Subject to Section  7.9,  if the Trustee  consolidates,  merges or converts
into, or transfers all or substantially  all of its corporate trust business to,
another corporation,  the successor corporation without any further act shall be
the successor Trustee.

Section 7.9 Eligibility; Disqualification

     There  shall at all times be a Trustee  hereunder  which shall be a bank or
corporation  organized and doing business under the laws of the United States of
America,  any state  thereof or the District of Columbia  authorized  under such
laws to exercise  corporate  trustee  power,  shall be subject to supervision or
examination  by Federal or state (or the  District of  Columbia)  authority  and
shall have a combined  capital  and surplus of at least $50 million as set forth
in its most recent published annual report of condition.

     This Indenture  shall always have a Trustee who satisfies the  requirements
of TIAss.  310(a)(1) and 310(a)(2).  The Trustee is subject to TIAss. 310(b). If
at any time the  Trustee  shall  cease to be  eligible  in  accordance  with the
provisions of this Section,  it shall resign  immediately in the manner and with
the effect specified in Section 7.7.


                                   ARTICLE 8.

                             DISCHARGE OF INDENTURE

Section 8.1 Termination of Company's Obligations

     (a) This  Indenture  shall cease to be of further  effect  (except that the
Company's  obligations  under Section 7.6 and the  Trustee's and Paying  Agent's
obligations  under Section 8.3 shall  survive) when all  outstanding  Securities
theretofore  authenticated and issued have been delivered (other than destroyed,
lost or stolen  Securities  that have been  replaced or paid) to the Trustee for
cancellation and the Company has paid all sums payable  hereunder.  In addition,
the Company may elect to have either  paragraph  (b) or  paragraph  (c) below be
applied to the  outstanding  Securities  upon compliance with the conditions set
forth in paragraph (d).

     (b)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable  to this  paragraph  (b),  the  Company  shall be deemed to have been
released and discharged  from its  obligations  with respect to the  outstanding
Securities   on  the  date  the   conditions   set  forth  below  are  satisfied
(hereinafter, "legal defeasance"). For this purpose, such legal defeasance means
that the  Company  shall  be  deemed  to have  paid and  discharged  the  entire
indebtedness  represented by the outstanding Securities,  which shall thereafter
be deemed to be  "outstanding"  only for the  purposes  of the  Sections  of and
matters  under this  Indenture  referred to in (i) and (ii)  below,  and to have
satisfied all its other  obligations  under such  Securities  and this Indenture
insofar as such Securities are concerned (and the Trustee, at the expense of the
Company,  shall execute proper instruments  acknowledging the same),  except for
the  following  which shall  survive  until  otherwise  terminated or discharged
hereunder: (i) the rights of Holders of outstanding Securities to receive solely
from the trust fund described in paragraph (d) below and as more fully set forth
in such paragraph, payments in respect of the principal of, premium, if any, and
interest on such  Securities  when such  payments  are due,  (ii) the  Company's
obligations  with respect to such  Securities  under  Sections 2.5, 2.6 and 4.2,
and, with respect to the Trustee,  under Section 7.6, (iii) the rights,  powers,
trusts,  duties and  immunities  of the Trustee  hereunder and (iv) this Section
8.1.  Subject to compliance  with this Section 8.1, the Company may exercise its
option under this paragraph (b) notwithstanding the prior exercise of its option
under paragraph (c) below with respect to the Securities.

     (c)  Upon  the  Company's  exercise  under  paragraph  (a)  of  the  option
applicable to this  paragraph  (c), the Company shall be released and discharged
from its obligations  under any covenant  contained in Article 5 and in Sections
4.3, 4.4 and 4.6 through 4.16 with respect to the outstanding  Securities on and
after the date the  conditions  set  forth  below  are  satisfied  (hereinafter,
"covenant defeasance"),  and the Securities shall thereafter be deemed to be not
"outstanding" for the purpose of any direction,  waiver,  consent or declaration
or act of Holders (and the  consequences of any thereof) in connection with such
covenants,  but shall continue to be deemed "outstanding" for all other purposes
hereunder.  For this purpose,  such covenant defeasance means that, with respect
to the  outstanding  Securities,  the  Company may omit to comply with and shall
have no liability in respect of any term,  condition or limitation  set forth in


                                      -38-
<PAGE>

any such covenant,  whether  directly or indirectly,  by reason of any reference
elsewhere  herein to any such covenant or by reason of any reference in any such
covenant  to any  other  provision  herein  or in any  other  document  and such
omission to comply shall not  constitute a Default or an Event of Default  under
Section 6.1, but, except as specified above, the remainder of this Indenture and
such Securities shall be unaffected thereby.

     (d) The  following  shall be the  conditions to the  application  of either
paragraph (b) or (c) above to the outstanding Securities:

               (1) the  Company  has  irrevocably  deposited  in trust  with the
         Trustee or, at the option of the Trustee,  with a trustee  satisfactory
         to the Trustee and the Company under the terms of an irrevocable  trust
         agreement in form and substance satisfactory to the Trustee in its sole
         discretion,  money or U.S.  Government  Obligations  sufficient  to pay
         principal  of,  premium,  if any,  and  interest on the  Securities  to
         maturity  or  redemption  (in the  opinion of a  nationally  recognized
         accounting firm of independent  certified public accountants  expressed
         in a written certificate delivered to the Trustee) and to pay all other
         sums  payable by it  hereunder;  provided  that (i) the  trustee of the
         irrevocable  trust shall have been  irrevocably  instructed to pay such
         money  or the  proceeds  of such  U.S.  Government  Obligations  to the
         Trustee and (ii) the Trustee shall have been irrevocably  instructed to
         apply such money or the proceeds of such U.S. Government Obligations to
         the payment of said  principal,  premium,  if any,  and  interest  with
         respect to the Securities;

               (2)  the  Company  has  delivered  to the  Trustee  an  Officer's
         Certificate  stating  that (a) all  conditions  precedent  provided for
         relating to either the legal  defeasance  under  paragraph (b) above or
         the covenant  defeasance under paragraph (c) above, as the case may be,
         have  been  complied  with  and (b) if any  other  Indebtedness  of the
         Company shall then be outstanding or committed,  such legal  defeasance
         or  covenant   defeasance  will  not  violate  the  provisions  of  the
         agreements or instruments evidencing such Indebtedness;

               (3) no  Default or Event of Default  shall have  occurred  and be
          continuing on the date of such deposit;

               (4) the Trustee shall not have received notice from any holder of
          Bank  Debt  or any  holder  of  Senior  Indebtedness  in an  aggregate
          principal  amount in excess of $20 million that such legal  defeasance
          or covenant  defeasance would violate the provisions of the agreements
          or instruments evidencing such Senior Indebtedness;

               (5) such legal defeasance or covenant defeasance shall not result
          in a breach or  violation  of,  or  constitute  a default  or event of
          default  under,  this  Indenture  or any other  material  agreement or
          instrument to which the Company is a party or by which it is bound;

               (6) in the case of an election  under  paragraph  (b) above,  the
          Company shall have delivered to the Trustee an Opinion of Counsel from
          nationally  recognized  counsel acceptable to the Trustee stating that
          (x) the Company has received from, or there has been published by, the
          Internal  Revenue  Service a  ruling,  (y)  there  exists  controlling
          precedent,  or (z) since the date of this Indenture,  there has been a
          change in the  applicable  Federal  income tax law, in any case to the
          effect  that  the  Holders  of the  outstanding  Securities  will  not
          recognize  income,  gain or loss for Federal  income tax purposes as a
          result of such legal  defeasance and will be subject to federal income
          tax on the same  amount and in the same manner and at the same time as
          would have been the case if such legal  defeasance  had not  occurred;
          and

               (7) in the case of an election  under  paragraph  (c) above,  the
          Company shall have delivered to the Trustee an Opinion of Counsel from
          nationally  recognized  counsel  acceptable  to the Trustee (i) to the
          effect  that  the  Holders  of the  outstanding  Securities  will  not
          recognize  income,  gain or loss for Federal  income tax purposes as a
          result of such  covenant  defeasance  and will be  subject  to Federal
          income tax on the same  amount and in the same  manner and at the same
          time as would have been the case if such covenant  defeasance  had not
          occurred or (ii) that the Company has received from, or there has been
          published by, the Internal  Revenue  Service a ruling to the foregoing
          effect.

     After such  irrevocable  deposit  made  pursuant  to this  Section  8.1 and
satisfaction of the other conditions set forth herein,  the Trustee upon request
shall  acknowledge in writing the discharge of the Company's  obligations  under
this Indenture except for those surviving obligations specified above.

                                      -39-
<PAGE>

     The Company may make an  irrevocable  deposit  pursuant to this Section 8.1
only if at such time it is not prohibited  from doing so under the provisions of
Article 10 and the Company  shall have  delivered  to the Trustee and any Paying
Agent an Officers' Certificate to that effect.

     In order to have money available on a payment date to pay the principal of,
premium, if any, or interest on the Securities,  the U.S. Government Obligations
shall be payable as to principal, premium, if any, or interest on or before such
payment date in such amounts as will provide the  necessary  money to effect the
applicable defeasance.  U.S. Government Obligations shall not be callable at the
issuer's option.

Section 8.2 Application of Trust Money

     The Trustee or a trustee  satisfactory to the Trustee and the Company shall
hold in trust money or U.S. Government Obligations deposited with it pursuant to
Section  8.1.  It shall  apply  the  deposited  money  and the  money  from U.S.
Government  Obligations  through the Paying  Agent and in  accordance  with this
Indenture to the payment of principal of,  premium,  if any, and interest on the
Securities.

Section 8.3 Repayment to the Company

     The Trustee and the Paying  Agent shall  promptly  pay to the Company  upon
written request any excess money or securities held by them at any time.

     The Trustee and the Paying  Agent shall pay to the Company at their  option
or upon  written  request any money held by them for the  payment of  principal,
premium, if any, or interest that remains unclaimed for two years after the date
upon which such  payment  shall have become  due;  provided,  however,  that the
Company  shall have either  caused  notice of such  payment to be mailed to each
Holder  entitled  thereto no less than 30 days prior to such repayment or within
such  period  shall have  published  such  notice in a  financial  newspaper  of
widespread  circulation  published in The City of New York. After payment to the
Company,  Holders  entitled to the money must look to the Company for payment as
general creditors unless an applicable abandoned property law designates another
Person,  and all  liability of the Trustee and such Paying Agent with respect to
such money shall cease.

Section 8.4 Reinstatement

     If the  Trustee  or  Paying  Agent is  unable  to apply  any  money or U.S.
Government  Obligations  in  accordance  with Section 8.1 by reason of any legal
proceeding  or by reason of any order or judgment  of any court or  governmental
authority enjoining,  restraining or otherwise prohibiting such application, the
Company's  obligations  under this Indenture and the Securities shall be revived
and  reinstated as though no deposit had occurred  pursuant to Section 8.1 until
such time as the Trustee or Paying Agent is permitted to apply all such money or
U.S. Government  Obligations in accordance with Section 8.1; provided,  however,
that if the Company  has made any payment of premium,  if any, or interest on or
principal of any Securities because of the reinstatement of its obligations, the
Company shall be  subrogated to the rights of the Holders of such  Securities to
receive such payment from the money or U.S.  Government  Obligations held by the
Trustee or Paying Agent.


                                   ARTICLE 9.

                                   AMENDMENTS

Section 9.1 Without Consent of Holders

     The Company and the Trustee may amend this  Indenture or the  Securities or
waive any provision hereof without the consent of any Holder:

     (1) to comply with Section 5.1;

     (2) to evidence and provide for the acceptance of appointment  hereunder by
     a successor Trustee with respect to the Securities;


                                      -40-
<PAGE>

     (3) to comply with a provision or provisions of the TIA  applicable to this
     Indenture;

     (4) to add to the  covenants  of the Company for the benefit of the Holders
     or an  additional  Event of Default or to provide for the  surrender by the
     Company of any right or power conferred upon it hereunder;

     (5) to secure the Securities or provide for any Guarantee by a Subsidiary;

     (6) to provide for the  issuance of  securities  identical  in all material
respects to the Rule 144A Notes pursuant to the Exchange Offer; or

     (7) to cure any ambiguity, correct or supplement any provision which may be
defective or inconsistent with any other provision  contained in this Indenture,
or make any provisions  with respect to matters or questions  arising under this
Indenture which shall not be inconsistent with the provisions of this Indenture,
provided  that such  modification  or amendment  does not  adversely  affect the
interests of the Holders.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon  receipt by the Trustee of the  documents  described  in Section  9.6,  the
Trustee  shall  join  with the  Company  in the  execution  of any  supplemental
indenture  authorized  or permitted by the terms of this  Indenture and make any
further  appropriate  agreements and stipulations that may be therein contained,
but the Trustee shall not be obligated to enter into any supplemental  indenture
that  affects its own  rights,  duties or  immunities  under this  Indenture  or
otherwise.  After an amendment or waiver under this Section  becomes  effective,
the Company shall mail to the Holders of each Security affected thereby a notice
briefly  describing the amendment or waiver.  Any failure of the Company to mail
such notice,  or any defect therein,  shall not,  however,  in any way impair or
affect the validity of any such supplemental indenture.

Section 9.2 With Consent of Holders

     Except as provided  in this  Section  9.2,  the Company and the Trustee may
amend this Indenture or the Securities  with the written  consent of the Holders
of at least a majority in principal amount of the then outstanding Securities.

     Upon the request of the Company,  accompanied  by a resolution of the Board
of Directors authorizing the execution of any such supplemental  indenture,  and
upon the filing  with the  Trustee of  evidence of the consent of the Holders as
aforesaid, and upon receipt by the Trustee of the documents described in Section
9.6,  the  Trustee  shall  join  with  the  Company  in the  execution  of  such
supplemental  indenture unless such supplemental indenture affects the Trustee's
own rights,  duties or immunities  under this  Indenture or otherwise,  in which
case the Trustee may in its  discretion,  but shall not be  obligated  to, enter
into such supplemental indenture.

     It shall not be necessary for the consent of the Holders under this Section
to approve the particular form of any proposed amendment or waiver, but it shall
be sufficient if such consent approves the substance thereof.

     The  Holders of a  majority  in  principal  amount of the  Securities  then
outstanding  may waive  compliance in a particular  instance by the Company with
any  provision of this  Indenture or the  Securities.  However,  (a) without the
consent of each Holder  affected,  an amendment or waiver under this Section may
not:

     (1) change the Stated  Maturity of the principal of, or any  installment of
interest on, any Security;

     (2) reduce the principal amount of, or premium, if any, or interest on, any
Security;

     (3) change the place of payment  where,  or the coin or  currency in which,
any Security or any premium or interest thereon is payable;

     (4) impair the right of Holders to institute  suit for the  enforcement  of
payment of the  principal of and premium,  if any, and interest on Securities on
or after the Stated Maturity thereof (or in


                                      -41-
<PAGE>

the case of redemption, on or after the redemption date);

     (5) reduce the percentage in principal amount of Securities, the consent of
whose Holders is required for any modification or amendment of the Indenture, or
the  consent of whose  Holders is  required  for any waiver of  compliance  with
certain  provisions of this  Indenture or certain  Defaults or Events of Default
hereunder and their consequences provided for in this Indenture; or

     (6)  modify  any of the  provisions  of  Section  6.4 or clause (a) of this
sentence of this Section 9.2, 
and (b) without  the  consent of the  Holders of at least 66_% of the  aggregate
principal amount of the outstanding Securities, an amendment or waiver may not:

     (1) amend, change or modify the provisions of Article Three relating to the
optional  redemption of Securities by the Company in accordance with Section 3.7
hereof;

     (2) amend,  change or modify the obligations of the Company with respect to
a Change in Control Repurchase  pursuant to Section 4.10 hereof or modify any of
the provisions or definitions relating thereto; or

     (3) modify or change  any  provision  of Article 10 in a manner  adverse to
Holders of the Securities; or

     (4) modify any of the  provisions  of clause (b) of this  sentence  of this
Section 9.2.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of this  Indenture  (and the obligation of the Company
to obtain any such consent  otherwise  required from such Holder) may be subject
to the requirement  that such Holder shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of this Indenture.

Section 9.3 Compliance with Trust Indenture Act

     Every  amendment to this Indenture or the  Securities  shall comply in form
and substance with the TIA as then in effect.

Section 9.4 Revocation and Effect of Consents

     Until an  amendment  (which  includes  any  supplement)  or waiver  becomes
effective,  a consent to it by a Holder of a Security is a continuing consent by
the Holder and every  subsequent  Holder of a Security  or portion of a Security
that  evidences  the same  debt as the  consenting  Holder's  Security,  even if
notation of the consent is not made on any  Security.  However,  any such Holder
may revoke the consent as to his or her Security or portion of a Security if the
Trustee receives  written notice of revocation  before the date the amendment or
waiver becomes effective. An amendment or waiver becomes effective in accordance
with  its  terms  and  thereafter  binds  every  Holder  of a  Security  whether
theretofore or thereafter authenticated and delivered.

     The Company may,  but shall not be obligated  to, fix a record date for the
purpose of  determining  the  Holders  entitled to consent to any  amendment  or
waiver. If the Company elects to fix a record date for such purpose,  the record
date shall be fixed at (i) the later of 30 days prior to the first  solicitation
of such consent or the date of the most recent list of Holders  furnished to the
Trustee prior to such solicitation, or (ii) such other date as the Company shall
designate. If a record date is fixed, then notwithstanding the provisions of the
immediately  preceding paragraph,  those Persons who were Holders at such record
date (or their  duly  designated  proxies),  and only  those  Persons,  shall be
entitled  to  consent  to such  amendment  or waiver or to  revoke  any  consent
previously given,  whether or not such Persons continue to be Holders after such
record date.  No consent shall be valid or effective for more than 90 days after
such  record  date  unless  consents  from  Holders of the  principal  amount of
Securities required hereunder for such amendment or waiver to be effective shall
have also been given and not revoked within such 90-day period.


                                      -42-
<PAGE>


Section 9.5 Notation on or Exchange of Securities

     The Trustee may place an appropriate  notation about an amendment or waiver
on any  Security  thereafter  authenticated.  The  Company in  exchange  for the
Securities  may issue and the Trustee shall  authenticate  new  Securities  that
reflect the amendment or waiver.

Section 9.6 Trustee to Sign Amendments, etc.

     The Trustee shall sign any amendment or supplemental  indenture  authorized
pursuant  to this  Article 9 if the  amendment  does not  adversely  affect  the
rights,  duties,  liabilities  or  immunities  of the Trustee.  If it does,  the
Trustee  may,  but need  not,  sign it.  In  signing  or  refusing  to sign such
amendment or  supplemental  indenture,  the Trustee shall be entitled to receive
and, subject to Section 7.1 and 7.2 shall be fully protected in relying upon, an
Officers' Certificate and an Opinion of Counsel as conclusive evidence that such
amendment  or  supplemental   indenture  is  authorized  or  permitted  by  this
Indenture,  that it is not inconsistent  herewith, and that it will be valid and
binding upon the Company in accordance with its terms.


                                   ARTICLE 10.

                                  SUBORDINATION

Section 10.1 Securities Subordinated to Senior Indebtedness

     The Company  covenants  and agrees,  and each Holder of a Security,  by his
acceptance  thereof,  likewise covenants and agrees,  that, to the extent and in
the  manner   hereinafter  set  forth  in  this  Article  10,  the  indebtedness
represented by the Securities  and all Payments or  Distributions  in Respect of
the Securities are hereby  expressly  made  subordinate  and subject in right of
payment  to the  prior  payment  in full  of all  Senior  Indebtedness,  whether
outstanding on the date of this Indenture or thereafter incurred.

     If at any time  following  the  payment of any amount to a holder of Senior
Indebtedness with respect to such Senior Indebtedness, such payment is rescinded
or must  otherwise be returned by such holder upon the  insolvency,  bankruptcy,
reorganization, dissolution or liquidation of the Company or any other Person or
otherwise,  and is so rescinded or returned to the party or parties  making such
payment,  such Senior  Indebtedness  shall be  reinstated  to the extent of such
payment and the  provisions  of this Article 10 shall be  applicable  as if such
payment were never made.

     The  provisions  of this  Article 10 are for the  benefit of the holders of
Senior Indebtedness, and each Holder of the Securities, by his purchase or other
acquisition of the  Securities,  hereby agrees for the benefit of each holder of
Senior  Indebtedness  that his  Securities are subject to the provisions of this
Article 10.

Section 10.2 Payment Over of Proceeds Upon Dissolution, Etc.

     In the event of (a) any insolvency or bankruptcy case or proceeding, or any
receivership,  liquidation,  reorganization or other similar case or proceeding,
relative to the Company or to its creditors,  as such, or to a substantial  part
of its assets,  or (b) any proceeding for the liquidation,  dissolution or other
winding up of the Company,  whether  voluntary or involuntary and whether or not
involving  insolvency or  bankruptcy,  or (c) any  assignment for the benefit of
creditors or any other  marshalling  of assets and  liabilities  of the Company,
then and in any such event the holders of Senior  Indebtedness shall be entitled
to receive  payment in full of all amounts due or to become due on or in respect
of all Senior  Indebtedness  (including,  without  limitation,  all  Allowed and
Disallowed  Post-Commencement Interest and Expenses), or provision shall be made
for such payment in cash or in a manner otherwise satisfactory to the holders of
Senior  Indebtedness,  before the  Holders of the  Securities  are  entitled  to
receive any Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 8 hereof),  and to that end the holders of Senior  Indebtedness shall be
entitled to receive,  for  application  to the payment  thereof,  any payment or
distribution of any kind or character,  whether in cash, property or securities,
including any such payment or  distribution  which may be payable or deliverable
by  reason  of the  payment  of any  other  indebtedness  of the  Company  being
subordinated  to the  payment  of  the  Securities,  which  may  be  payable  or
deliverable  in  respect  of  the  Securities  in  any  such  case,  proceeding,
dissolution, liquidation or other winding up or event.


                                      -43-
<PAGE>


     In the  event  that,  notwithstanding  the  foregoing  provisions  of  this
Section,  the  Trustee or the Holder of any  Security  shall have  received  any
Payment  or  Distribution  in  Respect  of  the  Securities  in any  such  case,
proceeding,  dissolution,  liquidation  or other winding up or event (other than
payments of amounts deposited prior to any such case, proceeding, dissolution or
other  winding  up or event in  accordance  with the  defeasance  provisions  of
Article 8  hereof),  including  any such  payment or  distribution  which may be
payable or deliverable by reason of the payment of any other indebtedness of the
Company being  subordinated to the payment of the Securities,  before all Senior
Indebtedness  (including,   without  limitation,   all  Allowed  and  Disallowed
Post-Commencement  Interest  and  Expenses)  is paid in full or payment  thereof
provided for, and, if (i) subject to Section 10.8,  such fact shall, at or prior
to the  time of such  payment  or  distribution,  have  been  made  known to the
Trustee,  then and in such event such payment or distribution shall be paid over
or  delivered   forthwith  to  the  holders  of  Senior  Indebtedness  or  to  a
representative   duly  appointed  by  any  such  holder  or  holders  of  Senior
Indebtedness  unless otherwise  required by law or court order or (ii) such fact
shall  have been made  known to such  Holder  at any time  before or after  such
payment, then and in such event such Holder shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed  by any such  holder or holders  of such  Senior  Indebtedness  unless
otherwise required by law or court order, in either such case for application to
the payment of all Senior Indebtedness remaining unpaid, to the extent necessary
to pay all Senior Indebtedness (including,  without limitation,  all Allowed and
Disallowed Post-Commencement Interest and Expenses) in full, after giving effect
to any  concurrent  payment  or  distribution  to or for the  holders  of Senior
Indebtedness.

     The  consolidation  of the Company with, or the merger of the Company into,
another Person or the  liquidation  or dissolution of the Company  following the
conveyance or transfer of its properties and assets substantially as an entirety
to another Person upon the terms and conditions set forth in Article 5 shall not
be deemed a dissolution, winding up, liquidation, reorganization, assignment for
the benefit of creditors or marshalling of assets and liabilities of the Company
for the purposes of this Section if the Person formed by such  consolidation  or
into which the  Company is merged or which  acquires by  conveyance  or transfer
such  properties and assets  substantially  as an entirety,  as the case may be,
shall, as a part of such consolidation,  merger,  conveyance or transfer, comply
with the conditions set forth in Article 5.

Section  10.3  Prior  Payment  to  Senior   Indebtedness  Upon  Acceleration  of
Securities

     In the event that any  Securities are declared due and payable before their
Stated  Maturity,  then and in such  event the  holders  of Senior  Indebtedness
outstanding  at the time such  Securities  so become  due and  payable  shall be
entitled  to  receive  payment  in  full  in  cash,  or  in a  manner  otherwise
satisfactory to the holders of Senior Indebtedness,  of all amounts due on or in
respect of such Senior Indebtedness (including,  without limitation, all Allowed
and Disallowed  Post-Commencement  Interest and Expenses)  before the Holders of
the Securities are entitled to receive any Payment or Distribution in Respect of
the  Securities  (including  any  payment  which may be payable by reason of the
payment of any other  indebtedness  of the  Company  being  subordinated  to the
payment of the Securities),  other than payment of amounts previously  deposited
in accordance with the defeasance  provisions of Article 8 hereof, by or for the
account of the Company.

     In the event that,  notwithstanding  the foregoing,  the Company shall make
any Payment or  Distribution  in Respect of the Securities to the Trustee or the
Holder of any Security  prohibited by the foregoing  provisions of this Section,
then if (i) subject to Section 10.8, such fact shall,  prior to the time of such
payment, have been made known to the Trustee, then and in such event the Trustee
shall  forthwith pay over and deliver such payment to the holders of such Senior
Indebtedness or to a representative duly appointed by any such holder or holders
of such Senior Indebtedness or (ii) such fact shall have been made known to such
Holder at any time  before or after  such  payment,  then and in such event such
Holder  shall  forthwith  pay over and  deliver  such  payment to the holders of
Senior  Indebtedness or to a representative duly appointed by any such holder or
holders of such Senior Indebtedness,  in either such case for application to the
payment of all Senior  Indebtedness  then remaining unpaid  (including,  without
limitation, all Allowed and Disallowed Post-Commencement Interest and Expenses),
after giving  effect to any  concurrent  payment or  distribution  to or for the
benefit of holders of Senior Indebtedness.

     The  provisions of this Section shall not apply to any payment with respect
to which Section 10.2 is applicable.

Section  10.4  No  Payment  Upon  Certain   Defaults   with  Respect  to  Senior
Indebtedness


                                      -44-
<PAGE>

     (a) No Payment or  Distribution  in Respect of the  Securities  (other than
payments of amounts  previously  deposited  in  accordance  with the  defeasance
provisions  of  Article 8  hereof)  shall be made by or for the  account  of the
Company or any other Person upon its behalf upon the  occurrence  of any default
in the payment of principal,  premium,  if any,  interest on or any other amount
due under or with  respect  to any Bank Debt or any Senior  Indebtedness  (other
than Bank Debt) in excess of $20 million  beyond any  applicable  grace  period,
unless  and  until  such  default  is cured or waived or ceases to exist or such
Senior  Indebtedness has been paid in full or provision for such payment in cash
or in a manner otherwise satisfactory to holders of Senior Indebtedness has been
made.

     (b) Upon any default  with  respect to the  financial  covenants  under the
Credit Agreement as specified therein,  or if any payment or distribution by the
Company with  respect to any Security  would,  immediately  after giving  effect
thereto,  result in such default,  no Payment or  Distribution in Respect of the
Securities  (other than payments of amounts  previously  deposited in accordance
with the defeasance provisions of Article 8 hereof), including any payment which
may be  payable  by  reason  of the  payment  of any  other  indebtedness  being
subordinated  to the  payment  of the  Securities,  shall  be made by or for the
account of the  Company  on  account of  principal  of or  premium,  if any,  or
interest on the  Securities or on account of the  purchase,  redemption or other
acquisition  of the  Securities  for the period  specified  below (the  "Payment
Blockage  Period").  The Payment Blockage Period shall commence upon the receipt
of notice by the Company or the Trustee from the Bank Agent and shall end on the
earlier of (i) 179 days  thereafter,  (ii) the date on which such  default  with
respect to the financial covenants under the Credit Agreement is cured or waived
or ceases to exist or on which such Bank Debt is paid in full or  provision  for
such  payment in money or money's  worth has been made,  (iii) the date on which
the maturity of any  Indebtedness  (other than Senior  Indebtedness)  shall have
been accelerated by virtue of such event, or (iv) the date on which such Payment
Blockage  Period shall have been  terminated by written notice to the Company or
the Trustee from the Bank Agent,  after which any and all  required  payments in
respect of the Securities,  including any missed payments,  may resume. Only one
Payment  Blockage  Period may be commenced  during any period of 365 consecutive
days.  No default  with  respect  to the  financial  covenants  under the Credit
Agreement that existed or was continuing on the date of the  commencement of any
Payment  Blockage Period will be, or can be, made the basis for the commencement
of a second  Payment  Blockage  Period  whether  or not  within a period  of 365
consecutive  days,  unless such default has been cured or waived for a period of
not less than 90 consecutive  days. In no event will a Payment  Blockage  Period
extend beyond 179 days from the receipt by the Trustee of notice initiating such
Payment  Blockage  Period and there must be a 186  consecutive day period in any
365 day period during which no Payment Blockage Period is in effect.

     (c) In the event that,  notwithstanding  the  foregoing,  the Company shall
make any payment to the Trustee or the Holder of any Security  prohibited by the
foregoing provisions of this Section,  then (i) subject to Section 10.8, if such
fact shall, at or prior to the time of such payment, have been made known to the
Trustee, then and in such event the Trustee shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed by any such holder or holders of such Senior Indebtedness or (ii) such
fact shall have been made known to such  Holder at any time before or after such
payment, then and in such event such Holder shall forthwith pay over and deliver
such payment to the holders of Senior  Indebtedness or to a representative  duly
appointed by any such holder or holders of such Senior Indebtedness.


                                      -45-
<PAGE>

     The  provisions of this Section shall not apply to any payment with respect
to which Section 10.2 is applicable.

Section 10.5 Payment Permitted If No Default

     Nothing  contained in this Article or elsewhere in this Indenture or in any
of the Securities  shall prevent (a) the Company,  at any time except during the
pendency of any case, proceeding, dissolution,  liquidation or other winding up,
assignment  for the  benefit of  creditors  or other  marshalling  of assets and
liabilities  of the Company  referred to in Section 10.2 or under the conditions
described  in  Section  10.3  or  Section  10.4,  from  making  any  Payment  or
Distribution in Respect of the Securities, or (b) the application by the Trustee
of any  money  deposited  with it  hereunder  with  respect  to any  Payment  or
Distribution  in Respect of the  Securities  or the retention of such Payment or
Distribution  in Respect of the  Securities  by the Holders,  if, at the time of
such  application  by the Trustee,  it had not been notified in accordance  with
Section 10.8 that such payment was  prohibited by the provisions of this Article
10.

Section 10.6 Subrogation to Rights of Holders of Senior Indebtedness

     Subject to the  payment in full in cash of all amounts due on or in respect
of  Senior  Indebtedness  (including,   without  limitation,   all  Allowed  and
Disallowed  Post-Commencement  Interest  and  Expenses,  except  to  the  extent
provided below), the Holders of the Securities shall be subrogated to the extent
of the payments or distributions made to the holders of such Senior Indebtedness
pursuant to the  provisions  of this  Article 10 (equally  and ratably  with the
holders  of all  indebtedness  of the  Company  which  by its  express  terms is
subordinated  to other  indebtedness  of the Company to  substantially  the same
extent as the  Securities  are  subordinated  and are entitled to like rights of
subrogation) to the rights of the holders of such Senior Indebtedness to receive
payments and  distributions of cash,  property and securities  applicable to the
Senior  Indebtedness until the principal of and premium, if any, and interest on
the  Securities  shall be paid in full.  For  purposes of such  subrogation,  no
payments or distributions to the holders of the Senior Indebtedness of any cash,
property or  securities  to which the Holders of the  Securities  or the Trustee
would be entitled  except for the provisions of this Article 10, and no payments
over  pursuant  to the  provisions  of this  Article  to the  holders  of Senior
Indebtedness  by Holders of the Securities or the Trustee,  shall,  as among the
Company, its creditors other than holders of Senior Indebtedness and the Holders
of the  Securities,  be deemed to be a payment or distribution by the Company to
or on account of the Senior Indebtedness.

     Notwithstanding  anything to the contrary in this Section 10.6, the Holders
of the  Securities  hereby  agree that they shall have no rights of  subrogation
with respect to amounts paid to the holders of Senior Indebtedness in payment of
any  interest,  reimbursements,  costs,  expenses  or  indemnities  that are not
allowed  claims  enforceable  against the Company in a case or proceeding  under
Bankruptcy Law.

Section 10.7 Provisions Solely to Define Relative Rights











                                      -46-
<PAGE>

     The  provisions  of this  Article  10 are and are  intended  solely for the
purpose of defining the relative  rights of the Holders of the Securities on the
one hand and the  holders  of Senior  Indebtedness  on the other  hand.  Nothing
contained in this Article or elsewhere in this Indenture or in the Securities is
intended to or shall (a) impair, as among the Company,  its creditors other than
holders of Senior Indebtedness and the Holders of the Securities, the obligation
of the Company,  which is absolute and  unconditional,  to pay to the Holders of
the  Securities  the  principal  of and  premium,  if any,  and  interest on the
Securities as and when the same shall become due and payable in accordance  with
their  terms;  or (b) affect the  relative  rights  against  the  Company of the
Holders of the Securities and creditors of the Company other than the holders of
Senior  Indebtedness;  or (c) prevent the Trustee or the Holder of any  Security
from exercising all remedies otherwise  permitted by applicable law upon default
under this  Indenture,  subject to the rights,  if any, under this Article 10 of
the holders of Senior  Indebtedness  to receive  cash,  property and  securities
otherwise  payable or deliverable to the Trustee or such Holder.  The failure to
make a payment on account of principal of,  premium,  if any, or interest on, or
any other amounts then payable with respect to, the  Securities by any reason of
this Article 10 shall not be construed as preventing  the occurrence of an Event
of Default under Section 6.1.

Section 10.8 Application by Trustee of Monies Deposited With It

     Money and U.S. Government  Obligations  deposited in trust with the Trustee
pursuant to Section 8.2 and in compliance with Section 8.1 shall be for the sole
benefit  of the  Holders  and,  to the  extent  allocated  for  the  payment  of
Securities, shall not be subject to the subordination provisions of this Article
10.  Otherwise,  any  deposit of monies by the  Company  with the Trustee or any
Paying Agent  (whether or not in trust) for payment on account of principal  of,
premium, if any, and interest on the Securities or that otherwise  constitutes a
Payment or  Distribution  in Respect of the  Securities  shall be subject to the
provisions of Sections 10.1,  10.2, 10.3 and 10.4 except that, if at least three
Business Days prior to the date on which by the terms of this Indenture any such
monies may become payable for any purpose (including,  without  limitation,  the
payment of the principal of,  premium,  if any, or the interest on any Security)
the  Trustee  shall not have  received  with  respect to such  monies the notice
provided for in Section 10.4(b) or 10.11, then the Trustee shall have full power
and  authority  to receive  such monies and to apply the same to the purpose for
which  they  were  received,  and  shall not be  affected  by any  notice to the
contrary  which may be received by it within three  Business  Days of such date.
This Section shall be construed solely for the benefit of the Trustee and Paying
Agent  and  shall  not  otherwise   affect  the  rights  of  holders  of  Senior
Indebtedness.

Section 10.9 Trustee to Effectuate Subordination

     Each holder of a Security by his acceptance  thereof authorizes and directs
the Trustee on his behalf to take such action as may be necessary or appropriate
to  effectuate  the  subordination  provided in this  Article and  appoints  the
Trustee his attorney-in-fact for any and all such purposes.

Section 10.10 No Waiver of Subordination Provisions

     No right of any  present  or future  holder of any Senior  Indebtedness  to
enforce  subordination  as  herein  provided  shall  at any  time  in any way be
prejudiced  or  impaired by any act or failure to act on the part of the Company
or by any act or failure to act, in good faith,  by any such  holder,  or by any
noncompliance  by the Company with the terms,  provisions  and covenants of this
Indenture,  regardless of any  knowledge  thereof any such holder may have or be
otherwise charged with.

     Without in any way limiting the generality of the foregoing paragraph,  the
holders of Senior  Indebtedness may, at any time and from time to time,  without
the  consent  of or notice to the  Trustee  or the  Holders  of the  Securities,
without  incurring  responsibility  to the Holders of the Securities and without
impairing  or  releasing  the  subordination  provided  in this  Article  or the
obligations  hereunder of the Holders of the Securities to the holders of Senior
Indebtedness,  do any one or more of the following: (i) change the manner, place
or terms of  payment  or  extend  the time of  payment  of,  or renew or  alter,
compromise,  accelerate,  extend or refinance Senior Indebtedness,  or otherwise
amend  or  supplement  in any  manner  Senior  Indebtedness  or  any  instrument
evidencing  the  same  or any  agreement  under  which  Senior  Indebtedness  is
outstanding; (ii) sell, exchange, release, foreclose upon or otherwise deal with
any property pledged, mortgaged or otherwise securing Senior Indebtedness; (iii)
release any Person  liable in any manner for the payment or collection of Senior
Indebtedness;  (iv) exercise or refrain from  exercising  any rights against the
Company  and any other  Person;  (v)  increase or reduce the rate of interest or
amount  of  principal  payable  on any  Senior  Indebtedness;  (vi)  release  or
discharge  the  Company,  by  acceptance  of a deed  or  assignment  in  lieu of
foreclosure or otherwise,  as to all or any portion of the Senior  Indebtedness;
or (vii)  release,  substitute  or add any one or more


                                      -47-
<PAGE>

guarantors or endorsers,  accept additional or substituted  security for payment
or  performance  of the  Senior  Indebtedness,  or release  or  subordinate  any
security therefor. No exercise,  delay in exercise or failure to exercise by any
holder of any Senior  Indebtedness  of any right  hereby given it, no dealing by
any holder of any Senior  Indebtedness  with the Company or any other guarantor,
endorser or other  person,  no change,  impairment or suspension of any right or
remedy of any holder of any Senior  Indebtedness,  and no act or thing which but
for this  provision  could act as a release or exoneration of the Holders of the
Securities hereunder, shall in any way affect, decrease,  diminish or impair any
of the  obligations  of the Holders of the Securities and the Trustee or give to
the Holders of the  Securities,  the  Trustee or any other  person or entity any
recourse or defense against any holder of any Senior Indebtedness.

Section 10.11 Notice to Trustee

     The  Company  shall give prompt  written  notice to the Trustee of any fact
known to the Company which would prohibit the making of any payment to or by the
Trustee in respect of the  Securities.  Notwithstanding  the  provisions of this
Article or any other  provision  of this  Indenture,  the  Trustee  shall not be
charged with  knowledge of the  existence of any facts which would  prohibit the
making of any payment to or by the Trustee in respect of the Securities,  unless
and until the  Trustee  shall have  received  written  notice  thereof  from the
Company  or a  holder  of  Senior  Indebtedness  or from  any  trustee  or other
representative  therefor;  and, prior to the receipt of any such written notice,
the  Trustee,  subject  to the  provisions  of  Sections  7.1 and 7.2,  shall be
entitled in all respects to assume that no such facts exist.

     Subject to the  provisions  of Sections 7.1 and 7.2,  the Trustee  shall be
entitled  to  rely  on  the  delivery  to it of a  written  notice  by a  Person
representing  himself  to be a  holder  of  Senior  Indebtedness  (or a  trustee
therefor)  to  establish  that such  notice has been given by a holder of Senior
Indebtedness (or a trustee  therefor).  In the event that the Trustee determines
in good faith that further evidence is required with respect to the right of any
Person as a holder of Senior  Indebtedness  to  participate  in any  payment  or
distribution pursuant to this Article 10, the Trustee may request such Person to
furnish evidence to the reasonable  satisfaction of the Trustee as to the amount
of Senior  Indebtedness held by such Person,  the extent to which such Person is
entitled to  participate  in such  payment or  distribution  and any other facts
pertinent  to the  rights of such  Person  under  this  Article  10, and if such
evidence  is not  furnished,  the  Trustee  may defer any payment to such Person
pending  judicial  determination  as to the right of such Person to receive such
payment.

Section 10.12 Reliance on Judicial Order or Certificate of Liquidating Agent

     Upon any payment or  distribution  of assets of the Company  referred to in
this Article 10, the Trustee, subject to the provisions of Sections 7.1 and 7.2,
and the  Holders of the  Securities  shall be entitled to rely upon any order or
decree entered by any court of competent  jurisdiction in which such insolvency,
bankruptcy, receivership, liquidation,  reorganization,  dissolution, winding up
or similar case or  proceeding is pending,  or a  certificate  of the trustee in
bankruptcy,  receiver,  liquidating trustee, custodian, assignee for the benefit
of  creditors,  agent or other  person  making  such  payment  or  distribution,
delivered  to the  Trustee or to the Holders of  Securities,  for the purpose of
ascertaining   the  Persons   entitled  to   participate   in  such  payment  or
distribution,  the holders of the Senior  Indebtedness and other indebtedness of
the Company,  the amount thereof or payable thereon,  the amount or amounts paid
or distributed  thereon and all other facts pertinent thereto or to this Article
10.

Section 10.13 Trustee Not Fiduciary for Holders of Senior Indebtedness

     The Trustee shall not be deemed to owe any fiduciary duty to the holders of
Senior  Indebtedness  and shall not be liable to any such holders if it shall in
good faith  mistakenly pay over or distribute to Holders of Securities or to the
Company or to any other Person cash,  property or securities to which holders of
Senior Indebtedness shall be entitled by virtue of this Article 10 or otherwise.

Section 10.14 Rights of Trustee as Holder of Senior  Indebtedness;  Preservation
of Trustee's Rights

     The Trustee in its individual  capacity shall be entitled to all the rights
set forth in this Article with respect to any Senior  Indebtedness  which may at
any  time be held by it,  to the same  extent  as any  other  holder  of  Senior
Indebtedness,  and nothing in this Indenture shall deprive the Trustee of any of
its rights as such holder.

     Nothing  in this  Article  shall  apply to claims of, or  payments  to, the
Trustee under or pursuant to Section 7.6.


                                      -48-
<PAGE>



                                   ARTICLE 11.

                                  MISCELLANEOUS

Section 11.1 Trust Indenture Act Controls

     If any provision of this Indenture limits,  qualifies or conflicts with the
duties imposed by TIA ss. 318(c), the imposed duties shall control.

Section 11.2 Notices

     Any notice or  communication  by the Company or the Trustee to the other is
duly given if in writing and delivered in Person or mailed by  first-class  mail
(registered  or  certified,  return  receipt  requested),  telex,  telecopier or
overnight air courier guaranteeing next day delivery, to the other's address:

                  If to the Company:

                  Integrated Health Services, Inc.
                  10065 Red Run Boulevard
                  Owings Mills, Maryland  21117
                  Attention:  General Counsel


                  If to the Trustee:

                  First Union National Bank of Virginia
                  901 East Cary Street Second Floor
                  Richmond, Virginia 23219
                  Attn:  Corporate Trust

     The Company or the Trustee by notice to the other may designate  additional
or different addresses for subsequent notices or communications.

     All notices and communications  shall be deemed to have been duly given: at
the time  delivered by hand, if personally  delivered;  five Business Days after
being deposited in the mail, postage prepaid,  if mailed; when answered back, if
telexed;  when receipt  acknowledged,  if telecopied;  and the next Business Day
after  timely  delivery  to the  courier,  if  sent  by  overnight  air  courier
guaranteeing next day delivery.

     Any notice or communication to a Holder shall be mailed by first-class mail
to the Holder's address shown on the register kept by the Registrar.  Failure to
mail a notice or  communication to a Holder or any defect in it shall not affect
its sufficiency with respect to other Holders.

     If a notice or  communication is mailed in the manner provided above within
the time prescribed, it is duly given, whether or not the addressee receives it.

     If the Company mails a notice or communication to Holders,  it shall mail a
copy to the Trustee and each Agent at the same time.

Section 11.3 Certificate and Opinion as to Conditions Precedent

     Upon any request or  application  by the Company to the Trustee to take any
action under this Indenture, the Company shall furnish to the Trustee:

     (1) an Officers'  Certificate (which shall include the statements set forth
in Section 11.4) stating


                                      -49-
<PAGE>

     that,  in  the  opinion  of  the  signers,  all  conditions  precedent  and
     covenants,  if any, provided for in this Indenture relating to the proposed
     action have been complied with; and

     (2) an Opinion of Counsel  (which shall include the statements set forth in
Section 11.4) stating that, in the opinion of such counsel,  all such conditions
precedent and covenants have been complied with.

Section 11.4 Statements Required in Certificate or Opinion

     Each  certificate or opinion with respect to compliance with a condition or
covenant  provided  for in this  Indenture  (other than a  certificate  provided
pursuant to TIA ss. 314(a)(4)) shall include:

     (1) a statement that the Person making such certificate or opinion has read
such covenant or condition;

     (2) a brief  statement  as to the  nature and scope of the  examination  or
investigation   upon  which  the  statements  or  opinions   contained  in  such
certificate or opinion are based;

     (3) a  statement  that,  in the  opinion of such  Person,  he has made such
examination  or  investigation  as is  necessary  to enable  him to  express  an
informed  opinion as to  whether  or not such  covenant  or  condition  has been
complied with; and

     (4) a statement as to whether or not, in the opinion of such  Person,  such
condition or covenant has been complied with.

Section 11.5 Rules by Trustee and Agents

     The  Trustee  may make  reasonable  rules for  action by or at a meeting of
Holders.  The  Registrar  or  Paying  Agent  may make  reasonable  rules and set
reasonable requirements for its functions.

Section 11.6 Legal Holidays

     A  "Legal  Holiday"  is a  Saturday,  a Sunday  or a day on  which  banking
institutions  in The  City of New  York or the City of  Richmond,  Virginia  are
authorized or obligated by law,  regulation or executive order to remain closed.
If a payment date is a Legal Holiday at a place of payment,  payment may be made
at that place on the next  succeeding  day that is not a Legal  Holiday,  and no
interest shall accrue for the intervening period.

Section 11.7 No Recourse Against Others

     A director, officer, employee or stockholder of the Company or the Trustee,
as such,  shall not have any liability for any  obligations of the Company under
the  Securities or this Indenture or for any claim based on, in respect of or by
reason  of such  obligations  or their  creation.  Each  Holder by  accepting  a
Security waives and releases all such liability.

Section 11.8 Governing Law

     THIS  INDENTURE  AND THE  SECURITIES  SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK,  WITHOUT REGARD TO PRINCIPLES
OF CONFLICTS OF LAW.

Section 11.9 No Adverse Interpretation of Other Agreements

     This Indenture may not be used to interpret another indenture, loan or debt
agreement  of the  Company or a  Subsidiary.  Any such  indenture,  loan or debt
agreement may not be used to interpret this Indenture.


                                      -50-
<PAGE>


Section 11.10 Successors

     All agreements of the Company in this  Indenture and the  Securities  shall
bind its successor.  All agreements of the Trustee in this Indenture  shall bind
its successor.

Section 11.11 Severability

     In case any  provision  in this  Indenture  or in the  Securities  shall be
invalid, illegal or unenforceable,  the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby.

Section 11.12 Counterpart Originals

     The  parties may sign any number of copies of this  Indenture.  Each signed
copy  shall  be an  original,  but  all of  them  together  represent  the  same
agreement.

Section 11.13     Trustee as Paying Agent and Registrar

     The Company initially appoints the Trustee as Paying Agent and Registrar.

Section 11.14 Table of Contents, Headings, etc.


     The Table of Contents,  Cross-Reference  Table and Headings of the Articles
and Sections of this Indenture  have been inserted for  convenience of reference
only,  are not to be  considered  a part  hereof  and shall in no way  modify or
restrict any of the terms or provisions hereof.



                            [Signatures on Next Page]







                                      -51-
<PAGE>



                                   SIGNATURES





Dated as of May 30, 1997            
                                           (SEAL)

                                           INTEGRATED HEALTH SERVICES, INC.



                                           By:  /s/
                                                -------------------------------
                                                Name:
                                                Title:

Attest:

/s/
- ---------------------------------


Dated as of May 30, 1997
                                           (SEAL)

                                           FIRST UNION NATIONAL BANK of VIRGINIA
                                           as Trustee



                                           By:  /s/
                                                -------------------------------
                                                Name:
                                                Title:
Attest:

/s/
- ---------------------------------














                                      -52-
<PAGE>



                                    EXHIBIT A

LEGENDS FOR GLOBAL SECURITY:

     UNLESS  AND UNTIL IT IS  EXCHANGED  IN WHOLE OR IN PART FOR  SECURITIES  IN
DEFINITIVE  FORM, THIS SECURITY MAY NOT BE TRANSFERRED  EXCEPT AS A WHOLE BY THE
DEPOSITARY TO A NOMINEE OF THE  DEPOSITARY OR BY A NOMINEE OF THE  DEPOSITARY TO
THE DEPOSITARY OR ANOTHER  NOMINEE OF THE DEPOSITARY OR BY THE DEPOSITARY OR ANY
SUCH  NOMINEE  TO  A  SUCCESSOR  DEPOSITARY  OR  A  NOMINEE  OF  SUCH  SUCCESSOR
DEPOSITARY. UNLESS THIS SECURITY IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF
THE DEPOSITORY TRUST COMPANY (55 WATER STREET,  NEW YORK, NEW YORK) ("DTC"),  TO
THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER,  EXCHANGE OR PAYMENT,  AND
ANY SECURITY  ISSUED IS  REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME
AS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO
CEDE & CO. OR SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE
OF DTC),  ANY TRANSFER,  PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR
TO ANY PERSON IS WRONGFUL  INASMUCH AS THE REGISTERED OWNER HEREOF,  CEDE & CO.,
HAS AN INTEREST HEREIN.

     THIS SECURITY HAS NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE  "SECURITIES  ACT"),  OR ANY STATE  SECURITIES  LAWS.  NEITHER THIS
SECURITY  NOR ANY  INTEREST  OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED  OR  OTHERWISE  DISPOSED OF IN THE
ABSENCE OF SUCH  REGISTRATION OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR NOT
SUBJECT TO, REGISTRATION UNDER SUCH LAWS.

     THE HOLDER OF THIS SECURITY BY ITS  ACCEPTANCE  HEREOF AGREES NOT TO OFFER,
SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY  PRIOR  TO THE  DATE  (THE  "RESALE
RESTRICTION  TERMINATION  DATE")  WHICH  IS TWO  YEARS  AFTER  THE  LATER OF THE
ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST  DATE ON WHICH  THE  COMPANY  OR ANY
AFFILIATED  PERSON OF THE  COMPANY  WAS THE OWNER OF THIS  SECURITY  UNLESS SUCH
OFFER,  SALE  OR  OTHER  TRANSFER  IS (A)  TO THE  COMPANY,  (B)  PURSUANT  TO A
REGISTRATION  STATEMENT  WHICH HAS BEEN DECLARED  EFFECTIVE UNDER THE SECURITIES
ACT, (C) FOR SO LONG AS THE SECURITIES ARE ELIGIBLE FOR RESALE  PURSUANT TO RULE
144A, TO A PERSON THE HOLDER REASONABLY  BELIEVES IS A "QUALIFIED  INSTITUTIONAL
BUYER" AS DEFINED IN RULE 144A UNDER THE  SECURITIES  ACT THAT PURCHASES FOR ITS
OWN ACCOUNT OR FOR THE ACCOUNT OF A QUALIFIED INSTITUTIONAL BUYER TO WHOM NOTICE
IS GIVEN THAT THE  TRANSFER IS BEING MADE IN  RELIANCE  ON RULE 144A,  (D) TO AN
INSTITUTIONAL  "ACCREDITED  INVESTOR" WITHIN THE MEANING OF SUBPARAGRAPH (a)(1),
(a)(2),  (a)(3) OR (a)(7) OF RULE 501 UNDER THE SECURITIES ACT THAT IS ACQUIRING
THE SECURITY FOR ITS OWN  ACCOUNT,  OR FOR THE ACCOUNT OF SUCH AN  INSTITUTIONAL
"ACCREDITED  INVESTOR," FOR  INVESTMENT  PURPOSES AND NOT WITH A VIEW TO, OR FOR
OFFER  OR  SALE  IN  CONNECTION  WITH,  ANY  DISTRIBUTION  IN  VIOLATION  OF THE
SECURITIES  ACT,  OR (E)  PURSUANT  TO  ANOTHER  AVAILABLE  EXEMPTION  FROM  THE
REGISTRATION  REQUIREMENTS  OF THE  SECURITIES  ACT AND IN EACH OF THE FOREGOING
CASES SUCH OFFER,  SALE OR OTHER  TRANSFER IS IN COMPLIANCE  WITH ANY APPLICABLE
STATE SECURITIES LAWS, SUBJECT TO THE COMPANY'S AND THE TRUSTEE'S RIGHT PRIOR TO
ANY SUCH OFFER,  SALE OR TRANSFER  PURSUANT TO CLAUSES (D) OR (E) TO REQUIRE THE
DELIVERY  OF AN OPINION  OF  COUNSEL,  CERTIFICATION  AND/OR  OTHER  INFORMATION
SATISFACTORY TO EACH OF THEM, AND IN EACH OF THE FOREGOING  CASES, A CERTIFICATE
OF TRANSFER IN THE FORM  PROVIDED  FOR IN THE  INDENTURE (A COPY OF WHICH MAY BE
OBTAINED FROM THE TRUSTEE) IS COMPLETED  AND DELIVERED BY THE  TRANSFEROR TO THE
TRUSTEE. THIS LEGEND WILL BE REMOVED UPON THE REQUEST OF THE THEN HOLDER OF THIS
SECURITY AFTER THE RESALE  RESTRICTION  TERMINATION DATE. ANY TRANSFEREE OF THIS
SECURITY SHALL BE DEEMED TO HAVE REPRESENTED EITHER (A) THAT IT IS NOT USING THE
ASSETS OF AN EMPLOYEE  BENEFIT PLAN SUBJECT TO THE  EMPLOYEE  RETIREMENT  INCOME
SECURITY ACT  ("ERISA")  OR THE  INTERNAL  REVENUE CODE


                                      A-1
<PAGE>

(THE "CODE") TO PURCHASE  THIS  SECURITY OR (B) THAT ITS PURCHASE AND  CONTINUED
HOLDING OF THE  SECURITY  WILL BE COVERED BY A U.S.  DEPARTMENT  OF LABOR  CLASS
EXEMPTION  (WITH RESPECT TO  PROHIBITED  TRANSACTIONS  UNDER  SECTION  406(a) OF
ERISA).


LEGENDS FOR DEFINITIVE SECURITY

     THIS SECURITY HAS NOT BEEN REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE  "SECURITIES  ACT"),  OR ANY STATE  SECURITIES  LAWS.  NEITHER THIS
SECURITY  NOR ANY  INTEREST  OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED  OR  OTHERWISE  DISPOSED OF IN THE
ABSENCE OF SUCH  REGISTRATION OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR NOT
SUBJECT TO, REGISTRATION UNDER SUCH LAWS.

     THE HOLDER OF THIS SECURITY BY ITS  ACCEPTANCE  HEREOF AGREES NOT TO OFFER,
SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY,  PRIOR  TO THE DATE  (THE  "RESALE
RESTRICTION  TERMINATION  DATE")  WHICH  IS TWO  YEARS  AFTER  THE  LATER OF THE
ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST  DATE ON WHICH  THE  COMPANY  OR ANY
AFFILIATED  PERSON OF THE  COMPANY  WAS THE OWNER OF THIS  SECURITY  UNLESS SUCH
OFFER,  SALE  OR  OTHER  TRANSFER  IS (A)  TO THE  COMPANY,  (B)  PURSUANT  TO A
REGISTRATION  STATEMENT  WHICH HAS BEEN DECLARED  EFFECTIVE UNDER THE SECURITIES
ACT, (C) FOR SO LONG AS THE SECURITIES ARE ELIGIBLE FOR RESALE  PURSUANT TO RULE
144A, TO A PERSON THE HOLDER REASONABLY  BELIEVES IS A "QUALIFIED  INSTITUTIONAL
BUYER" AS DEFINED IN RULE 144A UNDER THE  SECURITIES  ACT THAT PURCHASES FOR ITS
OWN ACCOUNT OR FOR THE ACCOUNT OF A QUALIFIED INSTITUTIONAL BUYER TO WHOM NOTICE
IS GIVEN THAT THE  TRANSFER IS BEING MADE IN  RELIANCE  ON RULE 144A,  (D) TO AN
INSTITUTIONAL  "ACCREDITED  INVESTOR" WITHIN THE MEANING OF SUBPARAGRAPH (a)(1),
(a)(2),  (a)(3) OR (a)(7) OF RULE 501 UNDER THE SECURITIES ACT THAT IS ACQUIRING
THE SECURITY FOR ITS OWN  ACCOUNT,  OR FOR THE ACCOUNT OF SUCH AN  INSTITUTIONAL
"ACCREDITED  INVESTOR," FOR  INVESTMENT  PURPOSES AND NOT WITH A VIEW TO, OR FOR
OFFER  OR  SALE  IN  CONNECTION  WITH,  ANY  DISTRIBUTION  IN  VIOLATION  OF THE
SECURITIES  ACT,  OR (E)  PURSUANT  TO  ANOTHER  AVAILABLE  EXEMPTION  FROM  THE
REGISTRATION  REQUIREMENTS  OF THE  SECURITIES  ACT AND IN EACH OF THE FOREGOING
CASES SUCH OFFER,  SALE OR OTHER  TRANSFER IS IN COMPLIANCE  WITH ANY APPLICABLE
STATE SECURITIES LAWS, SUBJECT TO THE COMPANY'S AND THE TRUSTEE'S RIGHT PRIOR TO
ANY SUCH OFFER,  SALE OR TRANSFER  PURSUANT TO CLAUSES (D) OR (E) TO REQUIRE THE
DELIVERY  OF AN OPINION  OF  COUNSEL,  CERTIFICATION  AND/OR  OTHER  INFORMATION
SATISFACTORY TO EACH OF THEM, AND IN EACH OF THE FOREGOING  CASES, A CERTIFICATE
OF TRANSFER IN THE FORM  PROVIDED  FOR IN THE  INDENTURE (A COPY OF WHICH MAY BE
OBTAINED FROM THE TRUSTEE) IS COMPLETED  AND DELIVERED BY THE  TRANSFEROR TO THE
TRUSTEE. THIS LEGEND WILL BE REMOVED UPON THE REQUEST OF THE THEN HOLDER OF THIS
SECURITY AFTER THE RESALE  RESTRICTION  TERMINATION DATE. ANY TRANSFEREE OF THIS
SECURITY SHALL BE DEEMED TO HAVE REPRESENTED EITHER (A) THAT IT IS NOT USING THE
ASSETS OF AN EMPLOYEE  BENEFIT PLAN SUBJECT TO THE  EMPLOYEE  RETIREMENT  INCOME
SECURITY ACT  ("ERISA")  OR THE  INTERNAL  REVENUE CODE (THE "CODE") TO PURCHASE
THIS  SECURITY OR (B) THAT ITS  PURCHASE AND  CONTINUED  HOLDING OF THE SECURITY
WILL BE COVERED BY A U.S.  DEPARTMENT OF LABOR CLASS  EXEMPTION (WITH RESPECT TO
PROHIBITED TRANSACTIONS UNDER SECTION 406(a) OF ERISA).


                                      A-2
<PAGE>



                    9 1/2% SENIOR SUBORDINATED NOTES DUE 2007


Cusip No.                                                                      $


INTEGRATED HEALTH SERVICES, INC.

promises to pay to



or registered assigns,

the principal sum of



Dollars  [or such  greater or lesser  amount as  indicated  on the  Schedule  of
Exchanges of Definitive Securities on the reverse hereof] on September 15, 2007

Interest Payment Dates: March 15 and September 15

Record Dates:                   February 28 and August 31



Authentication:                 Dated:           , 1997

This is one of the Securities referred
to in the within-mentioned Indenture.

FIRST UNION NATIONAL BANK
OF VIRGINIA,
as Trustee                                  INTEGRATED HEALTH SERVICES, INC.



By:                                         By:
   ---------------------------                 --------------------------------
   Authorized Officer                                 Authorized Officer


                                            By:
                                               --------------------------------


                                                                         (SEAL)



- ----------
1  This phrase should be included only if the Security is issued on global form.


                                      A-3
<PAGE>



                    9 1/2% SENIOR SUBORDINATED NOTES DUE 2007


     1. Interest.  INTEGRATED HEALTH SERVICES, INC., a Delaware corporation (the
"Company"), promises to pay interest on the principal amount of this Security at
9 1/2% per annum  from the date this  Security  is issued  until  maturity.  The
Company  will pay  interest  semiannually  on March 15 and  September 15 of each
year, or if any such day is not a Business Day, on the next succeeding  Business
Day (each an "Interest  Payment Date") and any Penalty Interest payable pursuant
to Section 6 of the Registration Rights Agreement on such Interest Payment Date.
Interest  on the  Securities  will  accrue  from the most  recent  date on which
interest  has been  paid or,  if no  interest  has been  paid,  from the date of
issuance;  provided,  that if there is no  existing  Default  in the  payment of
interest,  and if this Security is authenticated  between a record date referred
to on the face hereof and the next succeeding  Interest  Payment Date,  interest
shall accrue from such next succeeding Interest Payment Date; provided, further,
that the first Interest Payment Date shall be September 15, 1997.  Interest will
be computed on the basis of a 360-day year of twelve 30-day months.

     2.  Method of  Payment.  The Company  will pay  interest on the  Securities
(except  defaulted  interest)  to the  Persons  who are  registered  Holders  of
Securities  at the close of  business  on the  record  date next  preceding  the
Interest  Payment Date,  even if such  Securities are canceled after such record
date and on or before such  Interest  Payment Date. In the case of a Security to
be repurchased by the Company in connection with a Change in Control  Repurchase
pursuant to paragraph 6, on or after an interest  payment  record date and prior
to the next Interest Payment Date, the registered  holder of such Security as of
such  record  date shall be  entitled  to accrued  and  unpaid  interest  to the
repurchase  date,  as provided in paragraph 6 below.  The Holder must  surrender
this Security to a Paying Agent to collect principal payments.  The Company will
pay the principal of,  premium,  if any, and interest on the Securities in money
of the United  States of America that at the time of payment is legal tender for
payment of public and private debts. Such amounts will be payable (i) in respect
of Securities in book-entry form held of record by the Depository  Trust Company
("DTC") or its nominee,  in same day funds on or prior to the payment dates with
respect to such amounts and (ii) in respect of Securities issued in certificated
form,  at the office of the Trustee,  and the  Securities  may be presented  for
registration  of  transfer  or  exchange,  at the  offices of the  Trustee.  The
Company,  however,  may pay such amounts in respect of the Securities  issued in
certificated form by check payable in such money mailed to a Holder's registered
address.

     3. Paying Agent and  Registrar.  Initially,  FIRST UNION  NATIONAL  BANK OF
VIRGINIA,  the  Trustee  under  the  Indenture,  will act as  Paying  Agent  and
Registrar.  The Company may change any Paying Agent,  Registrar or  co-registrar
without notice to any Holder.  The Company or any of its Subsidiaries may act in
any such capacity.

     4. Indenture. The Company issued the Securities under an Indenture dated as
of May 30, 1997 ("Indenture")  between the Company and the Trustee. The terms of
the Securities  include those stated in the Indenture and those made part of the
Indenture by reference to the Trust  Indenture  Act of 1939, as amended (15 U.S.
Code  ss.ss.  77aaa-77bbbb),  as in  effect  on the  date  of  execution  of the
Indenture.  The  Securities  are  subject to all such  terms,  and  Holders  are
referred  to the  Indenture  and such Act for a  statement  of such  terms.  The
Securities  are  unsecured  general   obligations  of  the  Company  limited  to
$450,000,000 in aggregate  principal amount, plus amounts, if any, sufficient to
pay interest on outstanding  Securities as set forth in Paragraph 2 hereof.  The
Securities will rank pari passu with the Exchange  Notes,  the Company's 10 1/4%
Senior  Subordinated  Notes due 2006,  the Company's 9 5/8% Senior  Subordinated
Notes due 2002, Series A and the Company's 10 3/4% Senior Subordinated Notes due
2004.

     5. Optional Redemption. The Company may redeem all or any of the Securities
at any time on or after  September 15, 2002 at the following  redemption  prices
(expressed as percentages of principal amount), plus accrued and unpaid interest
to the redemption date:


                                       A-4
<PAGE>

    If Redeemed During                 
the 12-Month Period Commencing                     Redemption Price
- ------------------------------                     ----------------
September 15, 2002                                     104.750%
September 15, 2003                                     103.167%
September 15, 2004                                     101.583%
September 15, 2005 and thereafter                        100%

     Notwithstanding  the foregoing,  the Company may redeem in the aggregate up
to $150,000,000 principal amount of Securities at any time and from time to time
prior to  September  15,  2000 at a  redemption  price  equal to 108.500% of the
aggregate principal amount so redeemed,  plus accrued interest to the redemption
date,  out of the net cash  proceeds  of one or more  Public  Equity  Offerings;
provided that at least  $300,000,000  aggregate  principal  amount of Securities
originally  issued  remains   outstanding  after  the  occurrence  of  any  such
redemption  and that any such  redemption  occurs  within 60 days  following the
closing of any such Public Equity Offering.

     6. Right to Require  Repurchase.  Following the occurrence of any Change in
Control,  each Holder will have the right to require that the Company repurchase
(a "Change in Control  Repurchase") such Holder's Securities at a purchase price
equal to 101% of the aggregate principal amount of the Securities,  plus accrued
and unpaid interest thereon,  if any, to the date of repurchase.  Within 30 days
after any Change in  Control,  the  Company or, at the  Company's  request,  the
Trustee, shall cause to be mailed a notice to all Holders notifying such Holders
of the  occurrence of such Change in Control,  the Holder's  rights arising as a
result thereof and the procedures to be followed by Holders  wishing to exercise
such rights.

     A Holder  of  Securities  may  exercise  the  right to  require a Change in
Control  Repurchase  after  receipt of notice of the  existence of such right by
completing the form entitled  "OPTION OF HOLDER TO ELECT PURCHASE"  appearing on
this  Security  and by  complying  with the other  procedures  set forth in such
notice.  Any portion of  Securities  with respect to which the Holder  wishes to
exercise such right must be in integral multiples of $1,000.

     7. Mandatory Offer to Repurchase.  If the Company consummates an Asset Sale
(as such term is defined in the  Indenture),  the  Company  may,  under  certain
circumstances,  be  required to utilize a portion of the net  proceeds  received
from such Asset Sale to offer to purchase  Securities at a purchase  price equal
to 100% of the  aggregate  principal  amount  of the  Securities,  plus  accrued
interest to the date fixed for redemption  (the "Asset Sale Offer").  Holders of
Securities  that are the subject of an offer to purchase  will  receive an Asset
Sale Offer from the Company or the  Trustee.  The Asset Sale Offer shall  remain
open for a period of 30 days  after its  commencement  unless a longer  offering
period is required by law (the  "Asset Sale Offer  Period").  On or prior to the
fifth Business Day following the termination of the Asset Sale Offer Period (the
"Asset Sale Payment Date"), the Company shall purchase,  or cause the Trustee to
purchase,  and mail or deliver payment for the amount of Securities  required to
be  purchased  pursuant  to the Asset  Sale Offer or, if less than the amount of
Securities  required to be  purchased  pursuant to the Asset Sale Offer has been
tendered, all Securities tendered in response to the Asset Sale Offer

     A Holder of  Securities  may tender or refrain  from  tendering  all or any
portion of his  Securities at his  discretion  by  completing  the form entitled
"OPTION OF HOLDER TO ELECT PURCHASE" appearing on this Security.  Any portion of
Securities tendered must be in integral multiples of $1,000.

     8. Notice of  Redemption.  Notice of Redemption  will be mailed at least 30
days but not more than 60 days  before  the  redemption  date to each  Holder of
Securities to be redeemed at his registered address. Securities in denominations
larger  than  $1,000  may be  redeemed  in part but only in whole  multiples  of
$1,000, unless all of the Securities held by a Holder are to be redeemed. On and
after the  redemption  date  interest  will  cease to accrue  on  Securities  or
portions  thereof  called for  redemption  (unless the  Company  defaults on its
obligation to repurchase Securities).

     9.  Subordination.  The indebtedness  evidenced by this Security is, to the
extent provided in the Indenture, subordinate and subject in right of payment to
the  prior  payment  in full  of all  Senior  Indebtedness  (as  defined  in the
Indenture),  and this  Security  is  issued  subject  to the  provisions  of the
Indenture with respect thereto.  Each Holder of this Security,  by accepting the
same,  (a) agrees to and shall be bound by such  provisions,  (b) authorizes and
directs


                                      A-5
<PAGE>

the Trustee on his behalf to take such action as may be necessary or appropriate
to effectuate the  subordination  so provided,  and (c) appoints the Trustee his
attorney-in-fact for any and all such purposes.

     10.  Denominations,  Transfer,  Exchange.  The Securities are in registered
form  without  coupons in  denominations  of $1,000 and  integral  multiples  of
$1,000.  The transfer of Securities  may be  registered  and  Securities  may be
exchanged  as  provided  in the  Indenture.  The  Registrar  and the Trustee may
require a Holder,  among other things, to furnish  appropriate  endorsements and
transfer documents and to pay any taxes and fees required by law or permitted by
the Indenture.

     11.  Persons  Deemed  Owners.  The  registered  Holder of a Security may be
treated as its owner for all purposes.

     12. Amendments and Waivers. Subject to certain exceptions, the Indenture or
the Securities may be amended or supplemented with the consent of the Holders of
at least a majority in principal amount of the Securities then outstanding,  and
any existing  default under,  or compliance with any provision of, the Indenture
may be waived  (other  than any  continuing  Default  or Event of Default in the
payment of interest or premium, if any, on or the principal of the Securities or
in respect of a  provision  under the  Indenture  which  cannot be  modified  or
amended  without the consent of the Holder of each  Security  then  outstanding)
with the  consent  of the  Holders  of a  majority  in  principal  amount of the
Securities then outstanding.  Without the consent of any Holder, the Company and
the Trustee may amend or supplement  the Indenture or the  Securities to provide
for the  assumption  of the  Company's  obligations  to Holders in the case of a
merger or acquisition; to evidence and provide for the acceptance of appointment
of any successor Trustee under the Indenture; to comply with the requirements of
the Trust  Indenture  Act of 1939,  as amended;  to add to the  covenants of the
Company for the benefit of the Holders or an  additional  Event of Default or to
provide for the surrender by the Company of any right or power conferred upon it
under the  Indenture;  secure the  Securities  or provide for any Guarantee by a
Subsidiary;  to provide for the issuance of securities identical in all material
respects  to the  Securities  pursuant  to the  Exchange  Offer;  or to cure any
ambiguity,  correct  or  supplement  any  provision  which may be  defective  or
inconsistent  with any other provision in the Indenture,  or make any provisions
with respect to matters or questions arising under the Indenture which shall not
be  inconsistent  with the  provisions  of the  Indenture,  provided  that  such
modification  or  amendment  does not  adversely  affect  the  interests  of the
holders.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of the Indenture (and the obligation of the Company to
obtain any such consent  otherwise  required from such Holder) may be subject to
the  requirement  that such  Holder  shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of the Indenture.

     Without  the consent of each Holder  affected,  the Company may not,  among
other  things,  (i) change  the  Stated  Maturity  of the  principal  of, or any
installment of interest on, any Security,  (ii) reduce the principal  amount of,
or premium,  if any, or interest  on, any  Security,  (iii)  change the place of
payment where, or the coin or currency in which,  any Security or any premium or
interest thereon is payable, (iv) impair the right of a Holder to institute suit
for the  enforcement  of payment of the  principal of and  premium,  if any, and
interest on any Security on or after the Stated Maturity thereof (or in the case
of a redemption,  on or after the redemption  date) or (v) reduce the percentage
in principal  amount of Securities  the consent of whose Holders is required for
any modification or amendment of the Indenture,  or the consent of whose Holders
is  required  for any  waiver  of  compliance  with  certain  provisions  of the
Indenture or certain Defaults or Events of Default thereunder.

     Without the consent of at least 66_% of the aggregate  principal  amount of
outstanding  Securities,  the  Company  may not (i) amend,  change or modify the
provisions of Article Three of the Indenture relating to the optional redemption
of the  Securities by the Company in accordance  with Section 3.7 thereof,  (ii)
amend,  change or modify the obligations of the Company with respect to a Change
in Control Repurchase pursuant to Section 4.10 of the Indenture or modify any of
the  provisions or  definitions  relating  thereto or (iii) modify or change any
provision  of the  Indenture  affecting  the  subordination  or  ranking  of the
Securities in a manner adverse to Holders of the Securities.

     13.  Defaults  and  Remedies.  Events of Default  include:  (i)  default in
payment of  principal or premium on the  Securities;  (ii) default in payment of
interest on the Securities for 30 days; (iii) failure by the Company for 45 days
after notice to it to comply with any of its other  agreements  in the Indenture
or the Securities;  (iv) any  acceleration of Indebtedness of the Company or its
Subsidiaries  having  an  outstanding  principal  amount of $10  million


                                      A-6
<PAGE>


in the aggregate or a failure to pay such Indebtedness at its stated maturity if
such  acceleration  or  failure  to pay is not  cured  within  10  days  of such
acceleration  or  failure  to pay;  and (v)  certain  events  of  bankruptcy  or
insolvency. If an Event of Default occurs and is continuing,  the Trustee or the
Holders of at least 25% in aggregate  principal  amount of the then  outstanding
Securities may declare all the Securities to be immediately  due and payable for
an amount equal to 100% of the principal amount of the Securities,  and premium,
if any, plus accrued interest to the date of payment, except that in the case of
an Event of Default arising from certain events of bankruptcy or insolvency, all
outstanding Securities become due and payable immediately without further action
or notice.  Holders may not enforce the  Indenture or the  Securities  except as
provided in the Indenture.  The Trustee may require indemnity satisfactory to it
before  it  enforces  the  Indenture  or  the  Securities.  Subject  to  certain
limitations,  Holders of a majority in principal  amount of the then outstanding
Securities  may direct the Trustee in its  exercise  of any trust or power.  The
Trustee may withhold from Holders  notice of any  continuing  default  (except a
default in payment of principal or interest or that resulted from the failure of
the Company to comply with its  obligations  with respect to Holders'  rights to
require repurchase of Securities upon a Change in Control) if it determines that
withholding  notice is in their  interests.  The Company  must furnish an annual
compliance certificate to the Trustee.

     14. Trustee  Dealings with Company.  The Trustee,  in its individual or any
other capacity,  may make loans to, accept  deposits from, and perform  services
for the Company or its  Affiliates,  and may otherwise  deal with the Company or
its Affiliates, as if it were not Trustee.

     15.  No  Recourse  Against  Others.  A  director,   officer,   employee  or
stockholder,  as such,  of the  Company  shall  not have any  liability  for any
obligations  of the Company  under the  Securities  or the  Indenture or for any
claim  based  on,  in  respect  of or by  reason  of such  obligations  or their
creation.  Each Holder by  accepting  a Security  waives and  releases  all such
liability. The waiver and release are part of the consideration for the issuance
of the Securities.

     16. ERISA Matters.  Each Holder of Securities,  by its acceptance  thereof,
will be deemed to certify  that (i) no part of the funds used by such  Holder to
purchase the Securities  constitutes  assets of an employee benefit plan or (ii)
the  acquisition  and continued  holding of the Securities  will be covered by a
U.S.   Department  of  Labor  class   exemption   (with  respect  to  prohibited
transactions set forth under Section 406(a) of ERISA).

     17. Authentication. This Security shall not be valid until authenticated by
the manual signature of the Trustee or an authenticating agent.

     18.  Abbreviations.  Customary  abbreviations  may be used in the name of a
Holder  or an  assignee,  such  as:  TEN  COM  (--tenants  in  common),  TEN ENT
(--tenants  by  the   entireties),   JT  TEN  (--joint  tenants  with  right  of
survivorship  and not as tenants in  common),  CUST  (--Custodian),  and U/G/M/A
(--Uniform Gifts to Minors Act).


     The Company  will  furnish to any Holder upon  written  request and without
charge a copy of the Indenture. Request may be made to:

                       Integrated Health Services, Inc.
                       10065 Red Run Boulevard
                       Owings Mills, Maryland  21117
                       Attention:  Secretary


                                      A-7
<PAGE>



                                 ASSIGNMENT FORM



     To assign this  Security,  fill in the form  below:  (I) or (we) assign and
transfer this Security to

- ----------------------------------------------------------------
(Insert assignee's Soc. Sec. or Tax I.D. no.)

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

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

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

- ----------------------------------------------------------------
(Print or type assignee's name, address and zip code)

and  irrevocably  appoint  ________________________________________  to transfer
this Security on the books of the Company.  The agent may substitute  another to
act for him.


Date:  ______________

                                    Your Signature:----------------------------
                                             (Sign exactly as your name appears
                                              on the face of this Security)






Signature Guarantee:____________________________





                                      A-8
<PAGE>



                       OPTION OF HOLDER TO ELECT PURCHASE


     If you  want to  elect  to have  this  Security  purchased  by the  Company
pursuant to Section 3.8 or 4.10 of the Indenture, check the appropriate box:

                  |_| Section 3.8            |_| Section 4.10

     If you want to elect to have only  part of the  Security  purchased  by the
Company  pursuant to Section 3.8 or 4.10 of the Indenture,  state the amount you
elect to have purchased: $________.

Date: __________


                                           Your Signature:____________________
                                           (Sign exactly as your name appears
                                           on the face of this Security)




Signature Guarantee:____________________






                                      A-9
<PAGE>



            [FORM OF SCHEDULE OF EXCHANGES OF DEFINITIVE SECURITIES2]


     The following  exchanges of a part of this Global  Security for  Definitive
Securities have been made.

<TABLE>
<CAPTION>

               Amount of            Amount in          Principal Amount of
               decrease in          increase in        this Global Security
               Principal Amount     Principal Amount   following such            Signature of autho-
     Date of   of this Global       of this Global     decrease or (increase)    rized officer of
     Exchange  Security             Security                                     Trustee
     --------  ----------------     ----------------   ----------------------    -------------------

<S>            <C>

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

- ----------
     2 This schedule should be included only if the Security is issued in global
form.
</TABLE>






                                      A-10
<PAGE>



                                    EXHIBIT B


LEGEND FOR GLOBAL SECURITY:

     UNLESS  AND UNTIL IT IS  EXCHANGED  IN WHOLE OR IN PART FOR  SECURITIES  IN
DEFINITIVE  FORM, THIS SECURITY MAY NOT BE TRANSFERRED  EXCEPT AS A WHOLE BY THE
DEPOSITARY TO A NOMINEE OF THE  DEPOSITARY OR BY A NOMINEE OF THE  DEPOSITARY TO
THE DEPOSITARY OR ANOTHER  NOMINEE OF THE DEPOSITARY OR BY THE DEPOSITARY OR ANY
SUCH  NOMINEE  TO  A  SUCCESSOR  DEPOSITARY  OR  A  NOMINEE  OF  SUCH  SUCCESSOR
DEPOSITARY. UNLESS THIS SECURITY IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF
THE DEPOSITORY TRUST COMPANY (55 WATER STREET,  NEW YORK, NEW YORK) ("DTC"),  TO
THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER,  EXCHANGE OR PAYMENT,  AND
ANY SECURITY  ISSUED IS  REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME
AS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO
CEDE & CO. OR SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED  REPRESENTATIVE
OF DTC),  ANY TRANSFER,  PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR
TO ANY PERSON IS WRONGFUL  INASMUCH AS THE REGISTERED OWNER HEREOF,  CEDE & CO.,
HAS AN INTEREST HEREIN.










                                      B-1
<PAGE>



               9 1/2% SENIOR SUBORDINATED NOTES DUE 2007, SERIES A


Cusip No.                                                                      $


INTEGRATED HEALTH SERVICES, INC.

promises to pay to



or registered assigns,

the principal sum of



Dollars  [or such  greater or lesser  amount as  indicated  on the  Schedule  of
Exchanges of Definitive Securities on the reverse hereof] on 2007

Interest Payment Dates:    March 15 and September 15

Record Dates:              February 28 and August 31



Authentication:                          Dated:                       , 1997

This is one of the Securities referred to in the within-mentioned Indenture.

FIRST UNION NATIONAL BANK
OF VIRGINIA,
as Trustee                                  INTEGRATED HEALTH SERVICES, INC.



By:                                         By:
   -----------------------------               --------------------------------
   Authorized Officer


                                            By:
                                               --------------------------------


                                                                          (SEAL)

- ----------
     *This  phrase  should be included  only if the Security is issued in global
form.





                                      B-2
<PAGE>



               9 1/2% SENIOR SUBORDINATED NOTES DUE 2007, SERIES A


     1. Interest.  INTEGRATED HEALTH SERVICES,  INC. a Delaware corporation (the
"Company"),  promises to pay  interest on the  principal  amount of his Security
(which has been  exchanged for one of the  Company's 9 1/2% Senior  Subordinated
Notes due 2007 (the  "Rule  144A  Notes)) at 9 1/2% per annum from the date this
security is issued until maturity. The Company will pay interest semiannually on
March 15 and  September  15 of each  year,  or if any such day is not a Business
Day, on the next  succeeding  Business  Day (each an "Interest  Payment  Date").
Interest  on the  Securities  will  accrue  from the most  recent  date on which
interest  has been paid or, if no interest  has been paid,  from the most recent
date on which  interest  was paid on the Rule 144A Notes or, if no interest  was
paid on the Rule 144A Notes, from the date of original issuance of the Rule 144A
Notes;  provided,  that if  there  is no  existing  Default  in the  payment  of
interest,  and if this Security is authenticated  between a record date referred
to on the face hereof and the next succeeding  Interest  Payment Date,  interest
shall accrue from such next succeeding Interest Payment Date; provided, further,
that the first Interest Payment Date shall be September 15, 1997.  Interest will
be computed on the basis of a 360-day year of twelve 30-day months.

     2.  Method of  Payment.  The Company  will pay  interest on the  Securities
(except  defaulted  interest)  to the  Persons  who are  registered  Holders  of
Securities  at the close of  business  on the  record  date next  preceding  the
Interest  Payment Date,  even if such  Securities are canceled after such record
date and on or before such  Interest  Payment Date. In the case of a Security to
be repurchased by the Company in connection with a Change in Control  Repurchase
pursuant to paragraph 6, on or after an interest  payment  record date and prior
to the next Interest Payment Date, the registered  holder of such Security as of
such  record  date shall be  entitled  to accrued  and  unpaid  interest  to the
repurchase  date,  as provided in paragraph 6 below.  The Holder must  surrender
this Security to a Paying Agent to collect principal payments.  The Company will
pay the principal of,  premium,  if any, and interest on the Securities in money
of the United  States of America that at the time of payment is legal tender for
payment of public and private debts. Such amounts will be payable (i) in respect
of Securities in book-entry form held of record by the Depository  Trust Company
("DTC") or its nominee,  in same day funds on or prior to the payment dates with
respect to such amounts and (ii) in respect of Securities issued in certificated
form,  at the office of the Trustee,  and the  Securities  may be presented  for
registration  of  transfer  or  exchange,  at the  offices of the  Trustee.  The
Company,  however,  may pay such amounts in respect of the Securities  issued in
certificated form by check payable in such money mailed to a Holder's registered
address.

     3. Paying Agent and  Registrar.  Initially,  FIRST UNION  NATIONAL  BANK OF
VIRGINIA,  the  Trustee  under  the  Indenture,  will act as  Paying  Agent  and
Registrar.  The Company may change any Paying Agent,  Registrar or  co-registrar
without notice to any Holder.  The Company or any of its Subsidiaries may act in
any such capacity.

     4. Indenture. The Company issued the Securities under an Indenture dated as
of May 30, 1997 ("Indenture")  between the Company and the Trustee. The terms of
the Securities  include those stated in the Indenture and those made part of the
Indenture by reference to the Trust  Indenture  Act of 1939, as amended (15 U.S.
Code  ss.ss.  77aaa-77bbbb),  as in  effect  on the  date  of  execution  of the
Indenture.  The  Securities  are  subject to all such  terms,  and  Holders  are
referred  to the  Indenture  and such Act for a  statement  of such  terms.  The
Securities  are  unsecured  general   obligations  of  the  Company  limited  to
$450,000,000 in aggregate  principal amount, plus amounts, if any, sufficient to
pay interest on outstanding  Securities as set forth in Paragraph 2 hereof.  The
Securities will rank pari passu with the Rule 144A Notes,  the Company's 10 1/4%
Senior  Subordinated Notes due 2006, the Company's 9_% Senior Subordinated Notes
due 2002, Series A and the Company's 10 3/4% Senior Subordinated Notes due 2004.

     5. Optional Redemption. The Company may redeem all or any of the Securities
at any time on or after  September 15, 2002 at the following  redemption  prices
(expressed as percentages of principal amount), plus accrued and unpaid interest
to the redemption date:


                                      B-3
<PAGE>


     If Redeemed During                                Redemption Price
 the 12-month Period Commencing                        ----------------
- -------------------------------                        
September 15, 2002                                          104.750%
September 15, 2003                                          103.167%
September 15, 2004                                          101.583%
September 15, 2005 and thereafter                             100%

     Notwithstanding  the foregoing,  the Company may redeem in the aggregate up
to $150,000,000 principal amount of Securities at any time and from time to time
prior to  September  15,  2000 at a  redemption  price  equal to 108.500% of the
aggregate principal amount so redeemed,  plus accrued interest to the redemption
date,  out of the net cash  proceeds  of one or more  Public  Equity  Offerings;
provided that at least  $300,000,000  aggregate  principal  amount of Securities
originally  issued  remains   outstanding  after  the  occurrence  of  any  such
redemption  and that any such  redemption  occurs  within 60 days  following the
closing of any such Public Equity Offering.

     6. Right to Require  Repurchase.  Following the occurrence of any Change in
Control,  each Holder will have the right to require that the Company repurchase
(a "Change in Control  Repurchase") such Holder's Securities at a purchase price
equal to 101% of the aggregate principal amount of the Securities,  plus accrued
and unpaid interest thereon,  if any, to the date of repurchase.  Within 30 days
after any Change in  Control,  the  Company or, at the  Company's  request,  the
Trustee, shall cause to be mailed a notice to all Holders notifying such Holders
of the  occurrence of such Change in Control,  the Holder's  rights arising as a
result thereof and the procedures to be followed by Holders  wishing to exercise
such rights.

     A Holder  of  Securities  may  exercise  the  right to  require a Change in
Control  Repurchase  after  receipt of notice of the  existence of such right by
completing the form entitled  "OPTION OF HOLDER TO ELECT PURCHASE"  appearing on
this  Security  and by  complying  with the other  procedures  set forth in such
notice.  Any portion of  Securities  with respect to which the Holder  wishes to
exercise such right must be in integral multiples of $1,000.

     7. Mandatory Offer to Repurchase.  If the Company consummates an Asset Sale
(as such term is defined in the  Indenture),  the  Company  may,  under  certain
circumstances,  be  required to utilize a portion of the net  proceeds  received
from such Asset Sale to offer to purchase  Securities at a purchase  price equal
to 100% of the  aggregate  principal  amount  of the  Securities,  plus  accrued
interest to the date fixed for redemption  (the "Asset Sale Offer").  Holders of
Securities  that are the subject of an offer to purchase  will  receive an Asset
Sale Offer from the Company or the  Trustee.  The Asset Sale Offer shall  remain
open for a period of 30 days  after its  commencement  unless a longer  offering
period is required by law (the  "Asset Sale Offer  Period").  On or prior to the
fifth Business Day following the termination of the Asset Sale Offer Period (the
"Asset Sale Payment Date"), the Company shall purchase,  or cause the Trustee to
purchase,  and mail or deliver payment for the amount of Securities  required to
be  purchased  pursuant  to the Asset  Sale Offer or, if less than the amount of
Securities  required to be  purchased  pursuant to the Asset Sale Offer has been
tendered, all Securities tendered in response to the Asset Sale Offer

     A Holder of  Securities  may tender or refrain  from  tendering  all or any
portion of his  Securities at his  discretion  by  completing  the form entitled
"OPTION OF HOLDER TO ELECT PURCHASE" appearing on this Security.  Any portion of
Securities tendered must be in integral multiples of $1,000.

     8. Notice of  Redemption.  Notice of Redemption  will be mailed at least 30
days but not more than 60 days  before  the  redemption  date to each  Holder of
Securities to be redeemed at his registered address. Securities in denominations
larger  than  $1,000  may be  redeemed  in part but only in whole  multiples  of
$1,000, unless all of the Securities held by a Holder are to be redeemed. On and
after the  redemption  date  interest  will  cease to accrue  on  Securities  or
portions  thereof  called for  redemption  (unless the  Company  defaults on its
obligation to repurchase Securities).

     9.  Subordination.  The indebtedness  evidenced by this Security is, to the
extent provided in the Indenture, subordinate and subject in right of payment to
the  prior  payment  in full  of all  Senior  Indebtedness  (as  defined  in the
Indenture),  and this  Security  is  issued  subject  to the  provisions  of the
Indenture with respect thereto.  Each


                                      B-4
<PAGE>

Holder of this Security, by accepting the same, (a) agrees to and shall be bound
by such provisions, (b) authorizes and directs the Trustee on his behalf to take
such action as may be necessary or appropriate  to effectuate the  subordination
so provided,  and (c) appoints the Trustee his  attorney-in-fact for any and all
such purposes.

     10.  Denominations,  Transfer,  Exchange.  The Securities are in registered
form  without  coupons in  denominations  of $1,000 and  integral  multiples  of
$1,000.  The transfer of Securities  may be  registered  and  Securities  may be
exchanged  as  provided  in the  Indenture.  The  Registrar  and the Trustee may
require a Holder,  among other things, to furnish  appropriate  endorsements and
transfer documents and to pay any taxes and fees required by law or permitted by
the Indenture.

     11.  Persons  Deemed  Owners.  The  registered  Holder of a Security may be
treated as its owner for all purposes.

     12. Amendments and Waivers. Subject to certain exceptions, the Indenture or
the Securities may be amended or supplemented with the consent of the Holders of
at least a majority in principal amount of the Securities then outstanding,  and
any existing  default under,  or compliance with any provision of, the Indenture
may be waived  (other  than any  continuing  Default  or Event of Default in the
payment of interest or premium, if any, on or the principal of the Securities or
in respect of a  provision  under the  Indenture  which  cannot be  modified  or
amended  without the consent of the Holder of each  Security  then  outstanding)
with the  consent  of the  Holders  of a  majority  in  principal  amount of the
Securities then outstanding.  Without the consent of any Holder, the Company and
the Trustee may amend or supplement  the Indenture or the  Securities to provide
for the  assumption  of the  Company's  obligations  to Holders in the case of a
merger or acquisition; to evidence and provide for the acceptance of appointment
of any successor Trustee under the Indenture; to comply with the requirements of
the Trust  Indenture  Act of 1939,  as amended;  to add to the  covenants of the
Company for the benefit of the Holders or an  additional  Event of Default or to
provide for the surrender by the Company of any right or power conferred upon it
under the  Indenture;  secure the  Securities  or provide for any Guarantee by a
Subsidiary;  to provide for the issuance of securities identical in all material
respects  to the  Securities  pursuant  to the  Exchange  Offer;  or to cure any
ambiguity,  correct  or  supplement  any  provision  which may be  defective  or
inconsistent  with any other provision in the Indenture,  or make any provisions
with respect to matters or questions arising under the Indenture which shall not
be  inconsistent  with the  provisions  of the  Indenture,  provided  that  such
modification  or  amendment  does not  adversely  affect  the  interests  of the
holders.

     The right of any Holder to  participate  in any consent  required or sought
pursuant to any provision of the Indenture (and the obligation of the Company to
obtain any such consent  otherwise  required from such Holder) may be subject to
the  requirement  that such  Holder  shall have been the Holder of record of any
Securities with respect to which such consent is required or sought as of a date
identified by the Trustee in a notice  furnished to Holders in  accordance  with
the terms of the Indenture.

     Without  the consent of each Holder  affected,  the Company may not,  among
other  things,  (i) change  the  Stated  Maturity  of the  principal  of, or any
installment of interest on, any Security,  (ii) reduce the principal  amount of,
or premium,  if any, or interest  on, any  Security,  (iii)  change the place of
payment where, or the coin or currency in which,  any Security or any premium or
interest thereon is payable, (iv) impair the right of a Holder to institute suit
for the  enforcement  of payment of the  principal of and  premium,  if any, and
interest on any Security on or after the Stated Maturity thereof (or in the case
of a redemption,  on or after the redemption  date) or (v) reduce the percentage
in principal  amount of Securities  the consent of whose Holders is required for
any modification or amendment of the Indenture,  or the consent of whose Holders
is  required  for any  waiver  of  compliance  with  certain  provisions  of the
Indenture or certain Defaults or Events of Default thereunder.

     Without the consent of at least 66_% of the aggregate  principal  amount of
outstanding  Securities,  the  Company  may not (i) amend,  change or modify the
provisions of Article Three of the Indenture relating to the optional redemption
of the  Securities by the Company in accordance  with Section 3.7 thereof,  (ii)
amend,  change or modify the obligations of the Company with respect to a Change
in Control Repurchase pursuant to Section 4.10 of the Indenture or modify any of
the  provisions or  definitions  relating  thereto or (iii) modify or change any
provision  of the  Indenture  affecting  the  subordination  or  ranking  of the
Securities in a manner adverse to Holders of the Securities.

     13.  Defaults  and  Remedies.  Events of Default  include:  (i)  default in
payment of  principal or premium on the  Securities;  (ii) default in payment of
interest on the Securities for 30 days; (iii) failure by the Company for 45 days
after notice to it to comply with any of its other  agreements  in the Indenture
or the Securities;  (iv) any


                                      B-5
<PAGE>

acceleration  of  Indebtedness  of the  Company  or its  Subsidiaries  having an
outstanding principal amount of $10 million in the aggregate or a failure to pay
such  Indebtedness at its stated maturity if such acceleration or failure to pay
is not cured  within 10 days of such  acceleration  or failure  to pay;  and (v)
certain events of bankruptcy or insolvency. If an Event of Default occurs and is
continuing,  the Trustee or the Holders of at least 25% in  aggregate  principal
amount of the then  outstanding  Securities may declare all the Securities to be
immediately due and payable for an amount equal to 100% of the principal  amount
of the  Securities,  and premium,  if any, plus accrued  interest to the date of
payment,  except that in the case of an Event of Default  arising  from  certain
events of bankruptcy or insolvency,  all outstanding  Securities  become due and
payable  immediately  without further action or notice.  Holders may not enforce
the Indenture or the Securities except as provided in the Indenture. The Trustee
may require indemnity satisfactory to it before it enforces the Indenture or the
Securities.  Subject to certain limitations,  Holders of a majority in principal
amount of the then outstanding Securities may direct the Trustee in its exercise
of any trust or power.  The  Trustee may  withhold  from  Holders  notice of any
continuing default (except a default in payment of principal or interest or that
resulted  from the failure of the Company to comply  with its  obligations  with
respect to Holders' rights to require  repurchase of Securities upon a Change in
Control) if it determines that  withholding  notice is in their  interests.  The
Company must furnish an annual compliance certificate to the Trustee.

     14. Trustee  Dealings with Company.  The Trustee,  in its individual or any
other capacity,  may make loans to, accept  deposits from, and perform  services
for the Company or its  Affiliates,  and may otherwise  deal with the Company or
its Affiliates, as if it were not Trustee.

     15.  No  Recourse  Against  Others.  A  director,   officer,   employee  or
stockholder,  as such,  of the  Company  shall  not have any  liability  for any
obligations  of the Company  under the  Securities  or the  Indenture or for any
claim  based  on,  in  respect  of or by  reason  of such  obligations  or their
creation.  Each Holder by  accepting  a Security  waives and  releases  all such
liability. The waiver and release are part of the consideration for the issuance
of the Securities.

     16. ERISA Matters.  Each Holder of Securities,  by its acceptance  thereof,
will be deemed to certify  that (i) no part of the funds used by such  Holder to
purchase the Securities  constitutes  assets of an employee benefit plan or (ii)
the  acquisition  and continued  holding of the Securities  will be covered by a
U.S.   Department  of  Labor  class   exemption   (with  respect  to  prohibited
transactions set forth under Section 406(a) of ERISA).

     17. Authentication. This Security shall not be valid until authenticated by
the manual signature of the Trustee or an authenticating agent.

     18.  Abbreviations.  Customary  abbreviations  may be used in the name of a
Holder  or an  assignee,  such  as:  TEN  COM  (--tenants  in  common),  TEN ENT
(--tenants  by  the   entireties),   JT  TEN  (--joint  tenants  with  right  of
survivorship  and not as tenants in  common),  CUST  (--Custodian),  and U/G/M/A
(--Uniform Gifts to Minors Act).


     The Company  will  furnish to any Holder upon  written  request and without
charge a copy of the Indenture. Request may be made to:

                           Integrated Health Services, Inc.
                           10065 Red Run Boulevard
                           Owings Mills, Maryland  21117
                           Attention:  Secretary



                                      B-6
<PAGE>



                                 ASSIGNMENT FORM



     To assign this  Security,  fill in the form  below:  (I) or (we) assign and
transfer this Security to

- ----------------------------------------------------------------
(Insert assignee's Soc. Sec. or Tax I.D. no.)

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

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

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

- ----------------------------------------------------------------
(Print or type assignee's name, address and zip code)

and  irrevocably  appoint  ________________________________________  to transfer
this Security on the books of the Company.  The agent may substitute  another to
act for him.


Date:  ______________

                                    Your Signature:
                                                   ----------------------------
                                             (Sign exactly as your name appears
                                              on the face of this Security)






Signature Guarantee:____________________________




                                      B-7
<PAGE>



                       OPTION OF HOLDER TO ELECT PURCHASE


                  If you want to elect to have this  Security  purchased  by the
Company pursuant to Section 3.8 or 4.10 of the Indenture,  check the appropriate
box:

             |_| Section 3.8           |_| Section 4.10

     If you want to elect to have only  part of the  Security  purchased  by the
Company  pursuant to Section 3.8 or 4.10 of the Indenture,  state the amount you
elect to have purchased: $
                          ---------------.

Date: __________


              Your Signature:____________________
               (Sign exactly as your name appears on the face of this Security)




Signature Guarantee:____________________




                                      B-8
<PAGE>



            [FORM OF SCHEDULE OF EXCHANGES OF DEFINITIVE SECURITIES*]


     The following  exchanges of a part of this Global  Security for  Definitive
Securities have been made.
<TABLE>
<CAPTION>

               Amount of             Amount of         Principal Amount of
               decrease in           increase in       this Global Security
               Principal Amount      Principal Amount  following such           Signature of autho-
   Date of     of this Global        of this Global    decrease or (increase)   rized officer of
   Exchange    Security              Security                                   Trustee
   --------    ----------------      ----------------  ----------------------   -------------------

<S>            <C>
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

- ----------
    *This  schedule  should be included only if the Security is issued in global
form.

</TABLE>






                                      B-9
<PAGE>



                                    EXHIBIT C

[FORM OF CERTIFICATE TO BE DELIVERED UPON EXCHANGE OR  REGISTRATION  OF TRANSFER
OF RULE 144A NOTES]

                      CERTIFICATE FOR EXCHANGE OR TRANSFER

Re:  9 1/2% Senior Subordinated Notes due 2007 ("Rule 144A Notes")

     This Certificate relates to $_________  Principal amount of Securities held
in *__________  book-entry or *__________  definitive form by  _________________
(the "Transferor").

The Transferor*:

o    has  requested  the Trustee by written order to deliver in exchange for its
     beneficial  interest  in the  Global  Security  held  by the  Depositary  a
     Security  or  Securities  in  definitive,  registered  form  of  authorized
     denominations  and an aggregate  principal  amount equal to its  beneficial
     interest in such Global Security (or the portion thereof  indicated above);
     or

o    has  requested  the Trustee by written  order to  exchange or register  the
     transfer of a Security or Securities.

     In connection  with such request and in respect of each such security,  the
Transferor  does hereby  certify that  Transferor is familiar with the Indenture
relating  to the  above-captioned  Notes and as  provided in Section 2.5 of such
Indenture, the transfer of this Security does not require registration under the
Securities Act (as defined below) because*:

o    Such Security is being acquired for the Transferor's  own account,  without
     transfer (in satisfaction of Section  2.5(a)(ii)(A) or Section 2.5(d)(i)(A)
     of the Indenture).

o    Such Security is being transferred to a "qualified institutional buyer" (as
     defined  in rule 144A under the  Securities  Act of 1933,  as amended  (the
     "Securities  Act") in  reliance  on Rule 144A (in  satisfaction  of Section
     2.5(a)(ii)(B), section 2.5(b)(i) or Section 2.5(d)(i)(B) of the Indenture).

o    Such Security is being  transferred  in accordance  with Rule 144 under the
     Securities  Act, or pursuant to an effective  registration  statement under
     the Securities Act.

o    Such Security is being  transferred  in reliance and in compliance  with an
     exemption from the  registration  requirements of the Securities Act, other
     than Rule 144A or Rule 144 under the Securities  Act. An opinion of counsel
     to the effect that such  transfer does not require  registration  under the
     Securities Act accompanies this Certificate.

- ------------------------------------------------------
[INSERT NAME OF TRANSFEROR]

By:___________________________________________________

Date:________________________

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


- ----------
    *Check applicable box.




                                      C-1


                                                                  EXECUTION COPY











                                  $700,000,000


                           REVOLVING CREDIT AGREEMENT

                            Dated as of May 15, 1996


                                      Among


                        INTEGRATED HEALTH SERVICES, INC.,

                                  as Borrower,


                   The Lenders from time to time party hereto,


                                       and


                                 CITIBANK, N.A.

                             as Administrative Agent



<PAGE>


                                TABLE OF CONTENTS


                                   ARTICLE I

                        DEFINITIONS AND ACCOUNTING TERMS

SECTION 1.01.  Certain Defined Terms.........................................  1
SECTION 1.02.  Accounting Terms.............................................. 27
SECTION 1.03.  Other Definitional Provisions................................. 27


                                   ARTICLE II

                       AMOUNTS AND TERMS OF THE ADVANCES

SECTION 2.01.  Revolving Facility............................................ 28
         (a)      Advances................................................... 28
         (b)      Borrowings................................................. 28
         (c)      Notice of Borrowing........................................ 28
         (d)      Telephonic Notice of Borrowing............................. 28
         (e)      Funding of Advances........................................ 29
         (f)      Notice of Borrowing Irrevocable............................ 29
         (g)      Assumption of Funding...................................... 29
         (h)      Failure of Lender to Fund.................................. 29
SECTION 2.02.  Letter of Credit Subfacility.................................. 29
         (a)      Issuance of the Letters of Credit.......................... 29
         (b)      LC Application............................................. 30
         (c)      Reimbursement.............................................. 30
         (d)      Reimbursement Obligation Absolute.......................... 30
         (e)      Lender Participation....................................... 31
         (f)      Commercial Practices....................................... 31
         (g)      Replacement of LC Bank..................................... 32
SECTION 2.03.  Promissory Notes.............................................. 32
         (a)      Notes...................................................... 32
         (b)      Recording of Amounts....................................... 32
SECTION 2.04.  Fees.......................................................... 33
         (a)      Closing Fees............................................... 33
         (b)      Commitment Fees............................................ 33
         (c)      Letter of Credit Fees...................................... 33
         (d)      Facing Fees................................................ 33
         (e)      Letter of Credit Administration............................ 33
         (f)      Agent's Fees............................................... 33
         (g)      Contingent Fees............................................ 33


<PAGE>

                                       ii

SECTION 2.05.  Voluntary and Scheduled Facility Reductions................... 33
SECTION 2.06.  Principal Payments............................................ 34
         (a)      Final Maturity............................................. 34
         (b)      Excess Revolving Credit Exposure........................... 34
         (c)      Excess LC Exposure......................................... 34
         (d)      Payment on Date of Change of Control....................... 34
         (e)      Facility Reduction for Receivables Sale Program............ 35
         (f)      Application of LC Cash Collateral.......................... 35
SECTION 2.07.  Interest...................................................... 35
         (a)      Base Rate Advances......................................... 35
         (b)      Eurodollar Rate Advances................................... 36
         (c)      Default Interest........................................... 36
SECTION 2.08.  Additional Interest on Eurodollar Rate Advances............... 36
SECTION 2.09.  Interest Rate Determination and Protection.................... 36
         (a)      Determination of Eurodollar Rate........................... 36
         (b)      Notice of Eurodollar Rate.................................. 36
         (c)      Failure to Provide Information............................. 37
         (d)      Suspension of Eurodollar Rate Advances..................... 37
         (e)      Failure to Specify Duration................................ 37
         (f)      Agent's Determination Conclusive........................... 37
SECTION 2.10.  Voluntary Conversion of Advances.............................. 37
         (a)      Notice of Continuance/Conversion........................... 37
         (b)      Telephonic Notice.......................................... 38
         (c)      Requirements............................................... 38
         (d)      Base Rate Advances......................................... 38
SECTION 2.11.  Prepayments................................................... 38
SECTION 2.12.  Funding Losses................................................ 39
SECTION 2.13.  Increased Costs............................................... 39
         (a)      Increase in Cost........................................... 39
         (b)      Increase in Capital Requirements........................... 39
         (c)      Replacement Lenders and Participants....................... 40
SECTION 2.14.  Illegality.................................................... 41
SECTION 2.15.  Payments and Computations..................................... 41
         (a)      Payments................................................... 41
         (b)      Charging of Accounts....................................... 41
         (c)      Computations............................................... 41
         (d)      Payment on Business Day.................................... 42
         (e)      Presumption of Payment..................................... 42
SECTION 2.16.  Taxes......................................................... 42
         (a)      Net Payments............................................... 42
         (b)      Payment of Other Taxes..................................... 42
         (c)      Indemnification............................................ 43


<PAGE>

                                       iii

         (d)      Evidence of Payments....................................... 43
         (e)      Withholding Tax Exemption.................................. 43
         (f)      Withholding Taxes.......................................... 44
         (g)      Indemnification of the Agent............................... 44
         (h)      Subsequent Lenders......................................... 44
         (i)      Refund, Deduction or Credit of Taxes....................... 45
         (j)      Exclusion of Certain Taxes................................. 45
         (k)      Additional Cooperation..................................... 45
SECTION 2.17.  Sharing of Payments........................................... 45


                                   ARTICLE III

                              CONDITIONS OF LENDING

SECTION 3.01.  Conditions Precedent on the Closing Date...................... 46
         (a)      Loan Documents............................................. 46
         (b)      Corporate Documents........................................ 47
         (c)      Governmental Consents...................................... 47
         (d)      No Injunction.............................................. 48
         (e)      Other Deliveries........................................... 48
         (f)      Legal Opinions............................................. 48
         (g)      Payout and Release Agreement............................... 49
         (h)      Payment of Existing Facility............................... 49
         (i)      Payment of Fees and Expenses............................... 49
         (j)      Section 3.02 Conditions.................................... 49
SECTION 3.02.  Conditions Precedent to Each Extension of Credit.............. 49
         (a)      Notice..................................................... 49
         (b)      Certification.............................................. 49


                                   ARTICLE IV

                         REPRESENTATIONS AND WARRANTIES

SECTION 4.01.  Representations and Warranties of the Borrower................ 50
         (a)      Organization............................................... 50
         (b)      Power and Authority........................................ 50
         (c)      Due Authorization.......................................... 51
         (d)      Subsidiaries and Ownership of Capital Stock................ 51
         (e)      Health Care Facilities..................................... 51
         (f)      Governmental Approval...................................... 52


<PAGE>

                                       iv

         (g)      Binding and Enforceable.................................... 52
         (h)      Financial Information...................................... 52
         (i)      Material Adverse Change.................................... 52
         (j)      Compliance................................................. 52
         (k)      Litigation................................................. 52
         (l)      No Conflict................................................ 53
         (m)      No Default................................................. 53
         (n)      Payment of Taxes........................................... 53
         (o)      Margin Regulations......................................... 53
         (p)      Conduct of Business........................................ 53
         (q)      Health Care Permits........................................ 53
         (r)      Environmental Matters...................................... 54
         (s)      ERISA Compliance........................................... 55
         (t)      Title to Assets............................................ 55
         (u)      Collateral Documents....................................... 56
         (v)      Senior Indebtedness........................................ 56


                                    ARTICLE V

                            COVENANTS OF THE BORROWER

SECTION 5.01.  Financial Covenants........................................... 56
         (a)      Maximum Debt/EBITDAR Ratio................................. 56
         (b)      Minimum Cash Flow Coverage Ratio........................... 57
         (c)      Minimum Interest&Rent Coverage Ratio....................... 58
         (d)      Minimum Net Worth.......................................... 58
SECTION 5.02.  Affirmative Covenants......................................... 58
         (a)      Compliance with Laws....................................... 58
         (b)      Inspection of Property and Books and Records............... 58
         (c)      Reporting Requirements..................................... 59
         (d)      Preservation of Corporate Existence, Etc................... 62
         (e)      New Subsidiaries........................................... 62
         (f)      Maintenance of Property.................................... 62
         (g)      Insurance.................................................. 62
         (h)      Payment of Obligations..................................... 63
         (i)      Environmental Laws......................................... 64
         (j)      Use of Proceeds............................................ 64
         (k)      Health Care Permits and Approvals.......................... 64
         (l)      Further Assurances......................................... 64
SECTION 5.03.  Negative Covenants............................................ 65
         (a)      Liens...................................................... 65


<PAGE>

                                       v

         (b)      Disposition of Assets...................................... 67
         (c)      Investments................................................ 68
         (d)      Limitation on Indebtedness................................. 73
         (e)      Transactions with Affiliates............................... 74
         (f)      Accommodation Obligations.................................. 75
         (g)      Leases of Health Care Facilities........................... 75
         (h)      Restricted Junior Payments................................. 76
         (i)      Mergers, Etc............................................... 77
         (j)      Capital Expenditures....................................... 78
         (k)      Conduct of Business........................................ 79
         (l)      Unpledged Assets........................................... 79
         (m)      Compliance with ERISA...................................... 79
         (n)      Health Care Permits and Approvals.......................... 79
         (o)      Retained Interest Criteria................................. 80
         (p)      Payment Restrictions Affecting Subsidiaries................ 80


                                   ARTICLE VI

                                EVENTS OF DEFAULT

SECTION 6.01.  Events of Default............................................. 80
         (a)      Non-Payment of Principal................................... 80
         (b)      Non-Payment of Interest or Fees............................ 80
         (c)      Representations and Warranties............................. 80
         (d)      Financial, Lien and Debt Covenants......................... 81
         (e)      Reporting and Negative Covenants........................... 81
         (f)      Covenants.................................................. 81
         (g)      Debt....................................................... 81
         (h)      Leases..................................................... 81
         (i)      Bankruptcy................................................. 82
         (j)      Judgments.................................................. 82
         (k)      Guaranty................................................... 82
         (l)      Collateral Documents....................................... 82
         (m)      ERISA...................................................... 82
SECTION 6.02.  Rights Not Exclusive.......................................... 83


<PAGE>

                                       vi

                                   ARTICLE VII

                                    THE AGENT

SECTION 7.01.  Authorization and Action...................................... 84
SECTION 7.02.  Agent Not Liable.............................................. 84
SECTION 7.03.  Rights as Lender.............................................. 85
SECTION 7.04.  Lender Credit Decision........................................ 85
SECTION 7.05.  Indemnification............................................... 85
SECTION 7.06.  Successor Agent............................................... 86
SECTION 7.07.  Release of Collateral......................................... 86
SECTION 7.08.  Release of Guarantor upon Sale of Stock....................... 86


                                  ARTICLE VIII

                                  MISCELLANEOUS

SECTION 8.01.  Amendments.................................................... 87
SECTION 8.02.  Notices....................................................... 88
SECTION 8.03.  No Waiver; Remedies........................................... 88
SECTION 8.04.  Costs and Expenses............................................ 89
SECTION 8.05.  Right of Set-off.............................................. 89
SECTION 8.06.  Indemnity..................................................... 89
         (a)      General Indemnity.......................................... 89
         (b)      Environmental Indemnity.................................... 90
SECTION 8.07.  Assignments and Participations................................ 90
         (a)      Permitted Assignment....................................... 90
         (b)      Effect of Assignment....................................... 91
         (c)      Maintenance of Agreements.................................. 91
         (d)      Procedure.................................................. 92
         (e)      Participations............................................. 92
         (f)      Additional Information..................................... 92
         (g)      Permitted Assignments...................................... 92
SECTION 8.08.  Binding Effect................................................ 93
SECTION 8.09.  Governing Law; Consent to Jurisdiction; Venue................. 93
SECTION 8.10.  Waiver of Jury Trial.......................................... 93
SECTION 8.11.  Limitation of Liability....................................... 94
SECTION 8.12.  Entire Agreement.............................................. 94
SECTION 8.13.  Survival...................................................... 94
SECTION 8.14.  Execution in Counterparts..................................... 94




<PAGE>


                                      vii

                                    EXHIBITS


         Exhibit A         Form of Note

Forms of Loan Administration Documents

  Exhibit B-1    Form of Notice of Borrowing
  Exhibit B-2    Form of Notice of Continuance/Conversion
  Exhibit B-3    Form of LC Application
  Exhibit B-4    Form of Pricing Certificate

Forms of Certain Loan Documents

  Exhibit C-1     Form of Subsidiary Guaranty
  Exhibit C-2     Form of IHS Pledge and Security Agreement
  Exhibit C-3     Form of Subsidiary Pledge and Security Agreement
  Exhibit C-4     Form of Confirmation and Agreement of Guarantors

Forms of Opinion of Counsel

  Exhibit D-1     Form of Opinion of Counsel for the Borrower and the Guarantors
  Exhibit D-2     Form of Opinion of Special Local Counsel for a Guarantor

Other Forms

  Exhibit E-1     Form of Compliance Certificate
  Exhibit E-2     Form of Assignment and Acceptance
  Exhibit E-3     Form of Payment and Release Agreement




<PAGE>


                                      viii

                                    SCHEDULES

  Schedule I               List of Lenders, Commitments and Pro Rata Shares
  Schedule 1.01(a)         List of Senior Debt Excluded from Current Portion of
                           Long-Term Debt
  Schedule 1.01(b)         List of "Schedule 1.01(b) Assets" Designated for Sale
  Schedule 1.01(c)         List of "Schedule 1.01(c) Assets" Designated for Sale
  Schedule 2.04(a)         Itemization of Closing Fees
  Schedule 4.01(d)         List of Subsidiaries
  Schedule 4.01(e)         List of Health Care Facilities
  Schedule 4.01(f)         List of Government Approvals
  Schedule 4.01(k)         List of Litigation
  Schedule 4.01(r)         List of Environmental Matters
  Schedule 4.01(s)         List of ERISA Matters
  Schedule 5.03(c)         List of Loans and Investments
  Schedule 5.03(c)(xv)     List of Permitted Acquisitions
  Schedule 5.03(d)         List of Liens and Debt
  Schedule 5.03(f)         List of Accommodation Obligations




<PAGE>

                           REVOLVING CREDIT AGREEMENT

     REVOLVING  CREDIT  AGREEMENT,  dated as of May 15, 1996,  among  INTEGRATED
HEALTH  SERVICES,  INC.,  a Delaware  corporation,  the  financial  institutions
signatory hereto as Lenders, and CITIBANK, N.A., a national banking association,
as Administrative Agent for the Lenders.

     In  consideration  of the mutual  agreements set forth herein,  the parties
hereto hereby agree as follows:


                                    ARTICLE I

                        DEFINITIONS AND ACCOUNTING TERMS

     SECTION 1.01. Certain Defined Terms. As used in this Agreement:

     "ACCOMMODATION  OBLIGATION"  means, as applied to any Person, any direct or
indirect guaranty, endorsement or other liability of that Person with respect to
any Debt,  lease,  dividend,  letter of credit or other obligation (the "PRIMARY
OBLIGATION") of another Person (the "PRIMARY OBLIGOR"), including any obligation
of that  Person,  whether or not  contingent,  (i) to  purchase,  repurchase  or
otherwise  acquire any such  primary  obligation  or any  property  constituting
direct or indirect  security  therefor,  or (ii) to advance or provide funds (A)
for the payment or discharge of any such primary obligation,  or (B) to maintain
working  capital  or equity  capital of the  primary  obligor  or  otherwise  to
maintain the net worth or solvency or any balance sheet item, level of income or
financial  condition  of the primary  obligor,  or (iii) to  purchase  property,
securities  or services  primarily  for the purpose of assuring the owner of any
such primary obligation of the ability of the primary obligor to make payment of
such primary obligation, or (iv) otherwise to assure or hold harmless the holder
of any such primary  obligation  against loss in respect thereof.  The amount of
any  Accommodation  Obligation  shall be  deemed  to be an  amount  equal to the
maximum stated or  determinable  amount of the primary  obligation in respect of
which  such   Accommodation   Obligation  is  made  or,  if  not  stated  or  if
indeterminable,  the maximum reasonably estimated potential liability in respect
thereof.

     "ADVANCE" means a loan by a Lender to the Borrower pursuant to Article II.

     "ADJUSTED  STOCKHOLDERS'  EQUITY"  means  the sum of (i) net  stockholders'
equity of the Borrower and its Subsidiaries,  determined as of a particular time
on a consolidated  basis in accordance with GAAP, and (ii) the principal  amount
of Convertible Subordinated Debt then outstanding.

     "AFFILIATE"  of a specified  Person means any other Person that directly or
indirectly through one or more intermediaries  controls,  is controlled by or is
under common  control with the Person  specified.  For this purpose,  "control,"
"controlled by" and "under common control



<PAGE>


                                        2

with" with respect to any Person mean the possession, directly or indirectly, of
the power to direct or cause the  direction  of the  management  and policies of
such Person,  whether through the ownership of voting  securities or by contract
or otherwise.

     "AGENT" means  Citibank,  in its capacity as  administrative  agent for the
Lenders hereunder, and any successor appointed pursuant to Section 7.06.

     "AGREEMENT"  means this Revolving Credit Agreement,  as hereafter  amended,
modified or supplemented.

     "APPLICABLE  LENDING  OFFICE"  means,  with  respect to each  Lender,  such
Lender's  Domestic  Lending  Office in the case of a Base Rate  Advance and such
Lender's Eurodollar Lending Office in the case of a Eurodollar Rate Advance.

     "ASSET SALE" means the sale,  transfer or other  disposition  of any asset,
business or property of the Borrower or any of its Subsidiaries, or the issuance
or sale of any capital stock of or other equity, ownership or profit interest in
any Subsidiary of the Borrower  (except a dividend on any such stock or interest
declared and payable solely in additional shares of such stock or interest),  to
any Person other than the Borrower or a wholly-owned Subsidiary of the Borrower,
for a total  consideration  in an amount  greater  than  $5,000,000  in a single
transaction  or  series of  related  transactions.  A  disposition  of  accounts
receivable (i) shall not be an Asset Sale if made pursuant to a Receivables Sale
Program  permitted  under this Agreement and (ii) shall be an Asset Sale only if
disposed  of as  part  of a  disposition  of  all  or  substantially  all of the
operating assets of the business from which such accounts receivable arose.

     "ASSIGNMENT AND ACCEPTANCE" means an assignment and acceptance entered into
by a Lender and an Eligible Assignee,  in substantially the form of Exhibit E-2,
and accepted by the Agent.

     "AUTHORIZED  OFFICER"  means the  principal  financial  officer,  the chief
accounting officer, the controller,  the treasurer or the vice president-finance
of the Borrower.

     "BASE RATE" means, for any day, a fluctuating interest rate per annum equal
to the higher of (i) the then effective rate of interest  announced  publicly by
Citibank in New York, New York,  from time to time, as Citibank's  base rate, or
(ii) the then Federal Funds Rate plus one percent per annum.

     "BASE RATE ADVANCE"  means an Advance which bears  interest by reference to
the Base Rate as provided in Section 2.07(a).


     "BASE RATE MARGIN" means,  for any Pricing  Period,  the rate per annum set
forth below opposite the Pricing Ratio determined for that Pricing Period:


<PAGE>


                                        3

                   Pricing Ratio                          Base Rate Margin
                   -------------                          ----------------

        greater than or equal to 6.00                          1.25%

greater than or equal to 5.50 but less than 6.00               0.75%

greater than or equal to 5.00 but less than 5.50               0.50%

greater than or equal to 4.25 but less than 5.00               0.25%

              greater than 4.25                                0.00%


     "BORROWER" means Integrated Health Services, Inc., a Delaware corporation.

     "BORROWING"  means a Base Rate Advance or  Eurodollar  Rate Advance made by
the Lenders on a Borrowing Date.

     "BORROWING  DATE" means the Closing Date or any subsequent  Business Day on
which a Borrowing is requested from the Lenders.

     "BREAKAGE COSTS" is defined in Section 2.12.

     "BUSINESS  DAY"  means any day  except a  Saturday  or Sunday or a day when
commercial banks are authorized or required by law to be closed in New York, New
York, Hartford,  Connecticut, San Francisco,  California or Baltimore,  Maryland
and, where used in reference to any Eurodollar Rate Advance, means such a day on
which dealings are carried on in the London interbank market.

     "CAPITAL  EXPENDITURES" means expenditures for Hard Costs,  whether paid in
cash or accrued as  liabilities,  made by the Borrower or any  Subsidiary of the
Borrower.

     "CAPITAL  LEASE"  means,  with  respect  to any  Person,  any  lease of any
property by that Person as lessee which, in accordance with GAAP, is required to
be accounted for as a capital lease on the balance sheet of that Person.

     "CASH  FLOW  COVERAGE  RATIO"  means the  ratio,  as of the last day of any
Quarter,  of (i) Cash Flow from Operations of the Borrower and its  Subsidiaries
for the 12- month  period then ending to (ii) the sum of (A)  Interest  Expense,
Receivables  Program Charges and Lease Expense counted in determining  such Cash
Flow from  Operations,  (B) the then Current  Portion of Long-Term Debt, and (C)
all cash  dividends  paid on the  Borrower's  common  stock  during the 12-month
period then ending.

     "CASH FLOW FROM  OPERATIONS"  means,  with respect to any Person,  the sum,
determined  as of  the  last  day  of  any  Quarter  for  such  Person  and  its
subsidiaries on a


<PAGE>


                                        4

consolidated  basis for the  12-month  period  including  such  Quarter  and the
immediately  preceding  three Quarters  (taken as a single  period),  of (i) net
income after taxes minus any extraordinary  gain and any  non-recurring  gain on
any divestiture and plus any extraordinary  loss and any  non-recurring  loss on
any divestiture,  (ii)  depreciation,  amortization,  and other non-cash charges
deducted in determining net income,  (iii) Interest Expense,  (iv) Lease Expense
and (v) with  respect  to Cash  Flow from  Operations  of the  Borrower  and its
Subsidiaries  only,  Receivables  Program Charges,  all determined in accordance
with GAAP; provided,  however,  that (A) income attributable to any other Person
or  business  that is not at least 50% owned,  directly or  indirectly,  by such
Person  shall be counted,  in  determining  net income,  only to the extent such
income is received in cash by such Person or a subsidiary of such Person in such
period and is not  reinvested in such other Person or business  (other than as a
loan payable on demand) within six months thereafter,  except that, with respect
to the Borrower only, income from minority  Investments  existing on the Closing
Date and described in Schedule  5.03(c) shall be counted in accordance  with the
Borrower's  past  practice,  and (B) no  adjustments  shall  be made to  reflect
minority interests in subsidiaries.

     "CASH PROCEEDS OF SALE" means all cash and cash equivalents received by the
Borrower or any of its Subsidiaries as the cash  consideration in any Asset Sale
or  from  any  payment  or  distribution  on,  or sale or  liquidation  of,  any
promissory  note or other  property  received as non-cash  consideration  in any
Asset Sale.

     "CHANGE OF CONTROL" means (i) a "change in control" as that term is defined
in any of the  Subordinated  Debt  Indentures,  (ii) a transaction  or series of
transactions  whereby any Person or group within the meaning of Section 13(d)(3)
of the 1934 Act and the rules and regulations promulgated thereunder (other than
Robert N. Elkins,  M.D. or a group managed by Robert N. Elkins,  M.D.)  acquires
beneficial  ownership  (within  the  meaning  of Rule  13d-3 of the  1934  Act),
directly or  indirectly,  of  securities  of the Borrower  (or other  securities
convertible into such securities)  representing 40% of the combined voting power
of all securities of the Borrower  entitled to vote in the election of directors
(a  "CONTROLLING  PERSON") or (iii) at any time,  a majority  of the  Borrower's
directors  are  persons  who were not (A) in office  on the  Closing  Date,  (B)
initially  nominated by  directors  who were in office on the Closing Date or by
successor  directors  elected or appointed  upon the initial  nomination of such
directors or successor  directors or (C) initially  nominated by a group managed
by Robert N.  Elkins,  M.D. For this  purpose,  a Person or group shall not be a
Controlling  Person if such Person or group holds voting power in good faith and
not for the purpose of circumventing the effect of the occurrence of a Change of
Control as an agent,  bank,  broker,  nominee,  trustee,  or holder of revocable
proxies given in response to a solicitation pursuant to the 1934 Act, for one or
more beneficial owners who do not  individually,  or, if they are a group acting
in  concert,  as a group,  have  the  voting  power  specified  in the  previous
sentence.

     "CITIBANK" means Citibank, N.A., a national banking association.


<PAGE>


                                        5


     "CLOSING DATE" means the date on which all of the conditions  precedent set
forth in Section 3.01 are satisfied or waived in writing by the Lenders.

     "CODE"  means  the  Internal  Revenue  Code  of 1986  and  the  regulations
thereunder.

     "COLLATERAL"  means  all  property  which at any time is  subject  or is to
become  subject  to any Lien  granted  or  created  under any of the  Collateral
Documents.

     "COLLATERAL  DOCUMENTS"  means the Pledge and Security  Agreements  and all
other  security  agreements,   collateral  assignments  and  other  instruments,
documents  and  agreements  at any time  delivered  to the  Agent to  create  or
evidence Liens to secure the Obligations.

     "COMMITMENT  FEE RATE" means,  for commitment  fees accruing in any Pricing
Period, the rate per annum set forth below opposite the Pricing Ratio determined
for such Pricing Period:

                  Pricing Ratio                           Commitment Fee Rate
                  -------------                           -------------------

          greater than or equal to 5.00                         0.50%

greater than or equal to 4.25 but less than 5.00               0.375%

greater than or equal to 3.75 but less than  4.25               0.25%

                 less than 3.75                                 0.20%


     "CONSENT SOLICITATION" means the solicitation of the consent of the holders
of Debt  outstanding  under the 1994  Subordinated  Debt  Indenture and the 1995
Subordinated Debt Indenture to certain amendments to such indentures pursuant to
the  consent,  dated and mailed to such  holders on May 3, 1996,  as  thereafter
amended with the approval of the Agent in its sole discretion.

     "CONVERTIBLE  SUBORDINATED  DEBT" means the Debt outstanding under the 1992
Convertible  Subordinated  Debt Indenture and the 1993 Convertible  Subordinated
Debt Indenture.

     "CURRENT  PORTION OF  LONG-TERM  DEBT"  means  that  portion of Debt of the
Borrower  and its  Subsidiaries  on a  consolidated  basis  (including,  without
limitation,  the Advances,  but excluding the  Subordinated  Debt and the senior
Debt listed on Schedule  1.01(a))  that is, at the end of any  Quarter,  due and
payable within the next 12 months.

     "DEBT,"  as  applied  to  any  Person  and in  each  case  determined  on a
consolidated basis in conformity with GAAP, means (without  duplication) (i) all
indebtedness  for  borrowed  money  (whether  by  loan or the  issuance  of debt
securities or otherwise);  (ii) all obligations issued, undertaken or assumed as
the deferred purchase price of property or services or interest


<PAGE>


                                        6


thereon,  except  accounts and accrued  expenses  currently  payable;  (iii) all
reimbursement  obligations  with  respect  to surety  bonds,  letters of credit,
bankers'  acceptances and similar instruments,  whether or not contingent;  (iv)
all  monetary   obligations   under  any  Capital  Lease;  (v)  all  obligations
(contingent or otherwise) to purchase, retire or redeem any capital stock or any
other equity interest of such Person; (vi) all monetary obligations measured by,
or  determined  on the basis of, the value of any capital  stock of such Person;
and (vii) all obligations,  whether or not such  obligations  constitute Debt as
defined in clauses (i) through  (vi) above,  secured by (or for which the holder
of the obligation has an existing right,  contingent or otherwise, to be secured
by) any Lien upon any property of such Person or any  Subsidiary of such Person,
except  any such  obligation  secured  by a Lien that is  imposed by law and not
voluntarily granted.

     "DEBT/EBITDAR  RATIO"  means the ratio,  as of the last day of any Quarter,
of:

          (i) the sum of:

               (A) the  difference,  if any,  between  (x) the sum of (1) Funded
          Debt and (2) eight times the  Specified  Lease Expense of the Borrower
          and its Subsidiaries for the 12-month period then ending, less (y) the
          lesser  of (1)  Quarter-End  Excess  Cash  and (2) the  Advances  then
          outstanding, and

               (B) the Purchasers' Aggregate Net Investment  outstanding on such
          day; to

          (ii) EBITDAR of the Borrower and such  Subsidiaries  for the 12- month
     period then ending,  after pro forma (1) adding to Specified  Lease Expense
     of the Borrower and such  Subsidiaries,  all amounts that would  constitute
     additional  Specified  Lease Expense of the Borrower and such  Subsidiaries
     for such period if any  acquisition  of a company that was made at any time
     during such  period by the  Borrower  or any of its  Subsidiaries  had been
     consummated  at the  commencement  of such period;  (2) adding to Specified
     Lease Expense of the Borrower and such Subsidiaries, all amounts that would
     constitute  additional  Specified  Lease  Expense of the  Borrower and such
     Subsidiaries  for such period if any lease of a Health Care  Facility  that
     was entered  into by the  Borrower or any of its  Subsidiaries  at any time
     during such  period had been so entered  into at the  commencement  of such
     period;  (3) adding to EBITDAR of the Borrower and such  Subsidiaries,  the
     EBITDAR and Non-Recurring  Charges  determined solely for any such acquired
     company  or Health  Care  Facility,  for the  portion of such  period  that
     preceded the  acquisition;  provided,  however,  that for  Quarters  ending
     during the 12-month period  immediately  following the closing of the First
     American Merger,  EBITDAR of First American for the period from the closing
     to the date of determination, annualized for the 12-month period then ended
     shall  be added to  EBITDAR  of the  Borrower  and such  Subsidiaries;  (4)
     subtracting   from  Specified  Lease  Expense  of  the  Borrower  and  such
     Subsidiaries,  the Specified Lease Expense for such period  attributable to
     any business or



<PAGE>


                                        7

     facility that was sold or closed by the Borrower or any of its Subsidiaries
     in such period;  and (5) subtracting  from EBITDAR of the Borrower and such
     Subsidiaries,  the EBITDAR for such period of any business or facility that
     was so sold or closed.

     "DOLLARS"  and "$" mean United  States  dollars or such coin or currency of
the United States of America as at the time of payment shall be legal tender for
the payment of public and private debts in the United States of America.

     "DOMESTIC LENDING OFFICE" means, with respect to any Lender,  the office of
such Lender  specified as its  "Domestic  Lending  Office"  opposite its name on
Schedule  I hereto  or in the  Assignment  and  Acceptance  by which it became a
Lender or such other  office of such Lender as such Lender may from time to time
specify to the Borrower and the Agent.

     "EBITDAR" means, with respect to any Person,  the sum of (i) Cash Flow from
Operations  of such Person for any period and (ii) all charges for taxes counted
in determining the consolidated net income of such Person for such period.

     "ELIGIBLE ASSIGNEE" means (i) a commercial bank organized under the laws of
the United States,  or any State  thereof,  and having total assets in excess of
$5,000,000,000;  (ii) a savings and loan  association  or savings bank organized
under the laws of the United  States,  or any State  thereof,  and having  total
assets in excess of $3,000,000,000;  (iii) a commercial bank organized under the
laws of any  other  country  which  is a  member  of the  OECD,  or a  political
subdivision  of  any  such  country,  and  having  total  assets  in  excess  of
$5,000,000,000, if such bank is acting through a branch or agency located in the
United  States;  (iv) the central  bank of any country  which is a member of the
OECD; (v) a finance  company,  insurance or other financial  institution that is
engaged in making,  purchasing or otherwise investing in commercial loans in the
ordinary   course  of  its  business  and  having  total  assets  in  excess  of
$3,000,000,000;  (vi) a fund that is engaged in making,  purchasing or otherwise
investing in commercial  loans in the ordinary course of its business and having
total assets in excess of $200,000,000;  (vii) Affiliates of an existing Lender;
and (viii) any other Person approved by the Agent, the LC Bank and the Borrower,
which approval shall not be unreasonably  withheld;  provided,  however, that no
Person who is a non-resident  alien or a foreign entity for United States income
tax  purposes  (except a commercial  bank of the type  described in clause (iii)
above),  may be an  Eligible  Assignee  unless  each Note to be acquired by such
Person is reissued in registered form prior to transfer.

     "ENVIRONMENTAL  CLAIMS"  means any and all  administrative,  regulatory  or
judicial claims, demands, directives, proceedings, orders, decrees and judgments
relating in any way to any Environmental Law or any Environmental Permit.

     "ENVIRONMENTAL  LAWS" means all  federal,  state and local laws,  statutes,
rules,   regulations,   ordinances  and  codes,  and  any  binding  judicial  or
administrative  interpretation thereof or requirement thereunder,  including any
judicial or administrative order, by any


<PAGE>


                                        8

Governmental  Authority,  relating  to the  regulation  or  protection  of human
health, safety, the environment and natural resources.

     "ENVIRONMENTAL   PERMIT"   means  any   license,   permit,   authorization,
registration or approval issued or required under any Environmental Law.

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

     "ERISA AFFILIATE" means any entity which is (or at any relevant time was) a
member of a "controlled  group of  corporations,"  under  "common  control" or a
member of an "affiliated  service group" with the Borrower as defined in Section
414(b), (c) or (m) of the Code.

     "ERISA  EVENT" means (i) any of the events set forth in Section  4043(b) of
ERISA or the  regulations  thereunder,  with respect to a Pension  Plan;  (ii) a
withdrawal by the Borrower or any ERISA Affiliate from a Pension Plan subject to
Section 4063 of ERISA during a plan year in which it was a substantial  employer
(as  defined  in Section  4001(a)(2)  of  ERISA);  (iii) a  complete  or partial
withdrawal by the Borrower or any ERISA  Affiliate  from a  Multiemployer  Plan;
(iv) the  filing of a notice of intent to  terminate,  the  treatment  of a plan
amendment  as a  termination  under  Section  4041  or  4041A  of  ERISA  or the
commencement  of  proceedings  by the  PBGC  to  terminate  a  Pension  Plan  or
Multiemployer  Plan subject to Title IV of ERISA; (v) a failure to make required
contributions  to a Pension Plan or  Multiemployer  Plan; (vi) the imposition of
any  liability  under Title VI of ERISA,  other than PBGC  premiums  due but not
delinquent  under  Section  4007  of  ERISA,  upon  the  Borrower  or any  ERISA
Affiliate;  (vii) an  application  for a funding  waiver or an  extension of any
amortization  period  pursuant  to Section  412 of the Code with  respect to any
Pension  Plan;  (viii) the  Borrower or ERISA  Affiliate  engages in a nonexempt
prohibited  transaction or otherwise  becomes liable with respect to a nonexempt
prohibited transaction, the consequences of which, in the aggregate,  constitute
or could reasonably be expected to result in a Material Adverse Change;  or (ix)
a violation of the applicable requirements of Section 404 or 405 of ERISA or the
exclusive  benefit rule under Section  401(a) of the Code by the Borrower or any
ERISA  Affiliate  with respect to any Pension Plan for which the Borrower or any
of its Subsidiaries may be liable,  the consequences of which, in the aggregate,
constitute  or could  reasonably  be  expected  to result in a Material  Adverse
Change.

     "EUROCURRENCY  LIABILITIES"  has  the  meaning  assigned  to  that  term in
Regulation  D of the Board of  Governors of the Federal  Reserve  System,  as in
effect from time to time.

     "EURODOLLAR  LENDING OFFICE" means, with respect to any Lender,  the office
of such Lender specified as its "Eurodollar Lending Office" opposite its name on
Schedule  I hereto  or in the  Assignment  and  Acceptance  by which it became a
Lender (or, if no such office is specified, its Domestic Lending Office) or such
other  office of such Lender as such Lender may from time to time specify to the
Borrower and the Agent as its Eurodollar Lending Office.



<PAGE>


                                        9

     "EURODOLLAR  RATE" means,  for any Interest Period for each Eurodollar Rate
Advance comprising part of the same Borrowing,  an interest rate per annum equal
to the average  (rounded  upward to the nearest whole multiple of 1/16 of 1% per
annum,  if such  average is not such a multiple)  of the rate per annum at which
deposits  in U.S.  dollars are  offered by the  principal  office of each of the
Reference Banks in London to prime banks in the interbank market for U.S. Dollar
Deposits at 11:00 a.m.  (London  time) two Business Days before the first day of
such Interest Period in an amount  substantially  equal to such Reference Bank's
Eurodollar Rate Advance comprising part of such Borrowing (or, if such Reference
Bank is not a  Lender,  10% of such  Borrowing)  and for a period  equal to such
Interest Period.

     "EURODOLLAR  RATE  ADVANCE"  means  an  Advance  which  bears  interest  by
reference to the Eurodollar Rate as provided in Section 2.07(b).

     "EURODOLLAR RATE MARGIN" means, for any Pricing Period,  the rate per annum
set forth below opposite the Pricing Ratio determined for that Pricing Period:

             Pricing Ratio                         Eurodollar Rate Margin
             -------------                         ----------------------

      greater than or equal to 6.00                          2.50%

greater than or equal to 5.50 but less than 6.00             2.00%

greater than or equal to 5.00 but less than 5.50             1.75%

greater than or equal to 4.25 but less than 5.00             1.50%

greater than or equal to 3.75 but less than 4.25             1.25%

greater than or equal to 3.25 but less than 3.75             1.00%

greater than or equal to 2.75 but less than 3.25             0.875%

              less than 2.75                                 0.75%

     "EURODOLLAR  RATE  RESERVE  PERCENTAGE"  of any  Lender  for any day in the
Interest  Period for any  Eurodollar  Rate Advance means the reserve  percentage
applicable for such day under regulations  issued from time to time by the Board
of Governors of the Federal  Reserve System (or any  successor) for  determining
the maximum reserve requirement (including any emergency,  supplemental or other
marginal  reserve  requirement)  for such Lender with respect to  liabilities or
assets consisting of or including  Eurocurrency  liabilities having a term equal
to such Interest Period.

     "EVENTS OF DEFAULT" has the meaning provided in Section 6.01.

     "EXISTING  FACILITY"  means the Revolving  Credit and Term Loan  Agreement,
dated as of April 20, 1995,  by and among the Borrower,  Citicorp  USA,  Inc., a
Delaware  corporation,   as



<PAGE>


                                       10

administrative agent thereunder,  and the other financial institutions signatory
thereto as lenders, as amended.

     "FACILITY  AMOUNT" means, on any date of  determination,  $700,000,000 less
all Facility Reductions which are then effective.

     "FACILITY  REDUCTION"  means each  temporary or permanent  reduction of the
credit available to the Borrower under this Agreement,  whether voluntarily made
or scheduled to be made pursuant to Section 2.05 or required to be made pursuant
to Section  2.06,  Section  6.01 or any other  provision  of this  Agreement  or
otherwise becoming effective in accordance with this Agreement.

     "FEDERAL FUNDS RATE" means, for any period, a fluctuating interest rate per
annum equal for each day during such period to the weighted average of the rates
on overnight  Federal  funds  transactions  with members of the Federal  Reserve
System arranged by Federal funds brokers, as published for such day (or, if such
day is not a Business Day, for the next  preceding  Business Day) by the Federal
Reserve Bank of New York, or, if such rate is not so published for any day which
is a  Business  Day,  the  average  of the  quotations  for  such  day  on  such
transactions received by Citibank from three Federal funds brokers of recognized
standing selected by it.

     "FEE  LETTER"  means the letter  dated  April 8, 1996 from  Citibank to the
Borrower.

     "FIRST  AMERICAN"  means First  American  Health Care of Georgia,  Inc.,  a
Georgia corporation.

     "FIRST  AMERICAN  MERGER"  means  the  proposed  merger  of a  wholly-owned
Subsidiary of the Borrower with and into First  American  pursuant to which,  on
the terms and conditions set forth in the First American Merger Agreement, First
American will become a wholly-owned Subsidiary of the Borrower.

     "FIRST AMERICAN MERGER AGREEMENT" means the merger  agreement,  dated as of
February 21, 1996,  among the Borrower,  IHS  Acquisition  XIV, Inc., a Delaware
corporation  and  wholly-owned  Subsidiary of the Borrower,  First  American and
certain principal  shareholders thereof, as amended by Amendment No. 1, dated as
of March 12, 1996, and as thereafter  further amended in accordance with Section
5.03(c)(xii).

     "FUNDED DEBT" means all Debt of the type described in clauses (i), (ii) and
(iv) of the  definition of "Debt," plus all  Accommodation  Obligations,  except
those  described  in clauses (i) through  (vi) of Section  5.03(f),  owed by the
Borrower or any of its Subsidiaries and outstanding, on a consolidated basis, on
the last day of any Quarter.



<PAGE>


                                       11

     "FUNDED LC EXPOSURE" means the aggregate  principal  amount, as of any date
of determination, of all payments that were made by the LC Bank under any Letter
of Credit but have not been  reimbursed to the LC Bank by the Borrower  pursuant
to Section 2.02(c) or converted into Advances pursuant to Section 2.02(e).

     "GAAP" means  generally  accepted  accounting  principles  set forth in the
opinions and pronouncements of the Accounting  Principles Board and the American
Institute of Certified Public  Accountants and statements and  pronouncements of
the Financial  Accounting Standards Board (or agencies with similar functions of
comparable stature and authority within the accounting  profession),  or in such
other statements by such entity as may be in general use by significant segments
of the U.S.  accounting  profession,  which  are  applicable  to the  facts  and
circumstances on the date of determination.

     "GOVERNMENTAL  AUTHORITY" means any nation, state, sovereign or government,
any  political   subdivision  thereof  and  any  entity  exercising   executive,
legislative,  judicial,  regulatory or administrative functions of or pertaining
to government.

     "GUARANTOR"  means each Subsidiary of the Borrower that executes,  or joins
in, the Guaranty.

     "GUARANTOR  CONFIRMATION"  means a Confirmation and Agreement of Guarantors
in  substantially  the  form of  Exhibit  C-4,  duly  authorized,  executed  and
delivered by the Guarantors, setting forth the Guarantor Liability Limit as to a
particular Guarantor.

     "GUARANTOR LIABILITY LIMIT" means:

               (i) In respect of any  Subsidiary  that is  (either  directly  or
          indirectly  through  one  or  more  wholly-owned  Subsidiaries  of the
          Borrower) a  wholly-owned  Subsidiary  of the  Borrower,  an unlimited
          amount, and

               (ii) In respect of any Subsidiary that is not such a wholly-owned
          Subsidiary of the Borrower, an amount determined as of the last day of
          the then most recently  ended Quarter for which  financial  statements
          are  available  by  multiplying  (A)  EBITDAR  plus any  Non-Recurring
          Charges,  determined  solely for such Subsidiary and its  Subsidiaries
          and any business,  assets or entity  directly or  indirectly  owned by
          such  Subsidiary at such time, on a consolidated  basis,  for the four
          Quarters  most  recently  ended  prior  to  the  date  on  which  such
          Subsidiary  first became a  Subsidiary  not  (directly or  indirectly)
          wholly-owned by the Borrower by (B) six and further by (C) a fraction,
          the  numerator  of which is the number of shares of  capital  stock or
          other  equity,  ownership  or  profit  interests  in  such  Subsidiary
          directly or  indirectly  owned by the  Borrower at such time and after
          giving  effect  to any  transaction  then  being  consummated  and the
          denominator  of which is the  total  number  of all  such  shares  and
          interests outstanding at


<PAGE>


                                       12

          such time and after giving effect to any such  transaction;  provided,
          however,  that  if  the  Borrower  elects,  in  respect  of  any  such
          Subsidiary  no later than the date that is 10 Business Days after such
          Subsidiary  first became a  Subsidiary  not  (directly or  indirectly)
          wholly-owned  by the  Borrower,  voluntarily  to reduce  the  Facility
          Amount effective as of such date in accordance with Section 2.05 by an
          amount equal to the amount so determined, then the Guarantor Liability
          Limit as to such Subsidiary (and only as to such Subsidiary)  shall be
          zero.

     "GUARANTY"  means  the  guaranty  by the  Borrower's  Subsidiaries,  except
Inactive  Subsidiaries,  delivered  pursuant to Section 3.01(a) and each joinder
therein by any other Subsidiary of the Borrower and all Guarantor Confirmations,
guaranties,  instruments  and agreements at any time delivered by any Subsidiary
of  the  Borrower  in  respect  of or in  exchange  or  substitution  for  or in
replacement  of such  guaranty or to evidence  its guaranty of payment of any of
the Obligations.

     "HARD COSTS" means the direct costs of building,  improving or  maintaining
any Health Care  Facility or other  property  used by the Borrower or any of its
Subsidiaries (including the cost of land, construction, bricks, mortar, painting
and  related  building  maintenance,  carpeting,  roof  repair and  replacement,
parking  lot  replacement  and  maintenance,  landscaping,  HVAC  equipment  and
sprinkler  systems  and  other  items  generally  considered  hard  costs  under
construction  industry  practice  but not  including  the  purchase  price of an
existing  Health Care  Facility or any  allocated  overhead  and  administrative
expenses  and other items  generally  considered  soft costs under  construction
industry  practice)  and the  purchase  price of any  fixed,  movable  or mobile
equipment located on or used in connection with any such Health Care Facility or
otherwise used in conducting  business if such equipment is or is required to be
reflected as property,  plant and equipment on the consolidated balance sheet of
the Borrower and its Subsidiaries.

     "HAZARDOUS   MATERIALS"   means  (i)  flammable   explosives,   radioactive
materials, friable asbestos, urea formaldehyde foam insulation,  transformers or
other equipment that contain  dielectric  fluid  containing  regulated levels of
polychlorinated biphenyls and petroleum products, and (ii) chemicals, materials,
substances or wastes which are now or hereafter become defined as or included in
the definition,  listing or identification of "hazardous substances," "hazardous
wastes,"  hazardous   materials,"   "extremely  hazardous  wastes,"  "restricted
hazardous  wastes," "toxic  substances,"  "toxic  pollutants,"  "medical waste,"
"infectious  waste,"  "biomedical  waste,"  "biohazardous  waste,"  or  words of
similar import, under any applicable Environmental Law.

     "HEALTH CARE COMPANY" means a Person that is principally engaged,  directly
or indirectly through its Subsidiaries,  in the business of owning, operating or
managing Health Care Facilities or healthcare operations or providing healthcare
services.




<PAGE>


                                       13

     "HEALTH CARE  FACILITY"  means a facility  which  provides  any  healthcare
services,  whether  licensed as a skilled nursing  facility,  intermediate  care
facility, personal care facility or a hospital or otherwise.

     "HEALTH CARE PERMIT" means every accreditation,  authorization, certificate
of need,  license or permit that is required  pursuant to applicable  federal or
state law to own, lease, operate or manage a Health Care Facility or conduct the
business of a Health Care Company.

     "INACTIVE SUBSIDIARY" means a Subsidiary of the Borrower that carries on no
business  operations or other activities and has an aggregate  capitalization of
$1,500 or less.

     "INDEMNIFIED LIABILITIES" is defined in Section 8.06(a).

     "INDEMNIFIED PERSON" is defined in Section 8.06(a).

     "INTANGIBLE   ASSETS"   means,   with  respect  to  the  Borrower  and  its
Subsidiaries  on  a  consolidated  basis,  all  assets  properly  classified  as
intangible  assets  under  GAAP,   including  goodwill,   patents,   copyrights,
trademarks,  trade names,  franchises,  licenses,  organization costs,  deferred
charges,  and deferred  pre-opening  costs, but excluding all intangible  assets
classified  as such under the  provisions  of  Statements  87, 88 and 106 of the
Financial  Accounting  Standards  Board  relating to Accounting for Pensions and
Post- Retirement Benefits other than Pensions,  so long as such intangible asset
has a related liability under GAAP of equal or substantially equal amount on the
consolidated  balance sheet of the Borrower and its  Subsidiaries as of the date
of determination.

     "INTEREST&RENT  COVERAGE  RATIO" means the ratio, as of the last day of any
Quarter,  of (A) EBITDAR of the Borrower and its  Subsidiaries  for the 12-month
period  then  ending to (B) the sum of  Interest  Expense,  Receivables  Program
Charges and Lease Expense counted in determining such EBITDAR.

     "INTEREST  EXPENSE" means,  with respect to any Person,  for any period for
such Person and its subsidiaries on a consolidated  basis,  interest expense net
of interest income, determined in conformity with GAAP.

     "INTEREST  PERIOD" means, for each Eurodollar Rate Advance  comprising part
of the same Borrowing,  the period commencing on the date of such Advance or the
date of the  conversion  of any  Advance  into such an Advance and ending on the
last day of the period selected by the Borrower pursuant to the provisions below
and,  thereafter,  each  subsequent  period  commencing  on the  last day of the
immediately  preceding  Interest Period and ending on the last day of the period
selected by the Borrower  pursuant to the provisions below. The duration of each
such Interest Period shall be 1, 2, 3 or 6 months, as the Borrower may select by



<PAGE>


                                       14

notice  received  by the Agent not later than  11:00  a.m.  (New York City time)
three  Business Days prior to the first day of such Interest  Period;  provided,
however, that:

          (a) the Borrower  may not select any Interest  Period which ends after
     the Maturity Date;

          (b) the Borrower  may not select any Interest  Period which ends after
     any date on which any payment on any  Advances is due unless,  after giving
     effect to such selection,  the aggregate  unpaid  principal  amount of Base
     Rate Advances and Eurodollar Rate Advances  having  Interest  Periods which
     end on or prior to such date is at least equal to the  principal  amount of
     Advances due and payable on and prior to such date;

          (c)  Interest  Periods  commencing  on  the  same  date  for  Advances
     comprising part of the same Borrowing shall be of the same duration;

          (d) whenever the last day of any Interest Period would otherwise occur
     on a day that is not a Business Day, the last day of such  Interest  Period
     shall be extended to the next succeeding  Business Day, except that if such
     extension  would cause the last day of such Interest Period to occur in the
     next following  calendar month,  the last day of such Interest Period shall
     be the next preceding Business Day; and

          (e) the Borrower may not have more than 15 Interest  Periods in effect
     at any one time.

     "INVESTMENT"  means (i) the  acquisition  of any interest in any  property,
assets or business from any Person,  whether by sale,  lease or otherwise,  (ii)
the  funding  of  any  loan,  extension  of  credit,  accommodation  or  capital
contribution  to or for the benefit of any Person,  and (iii) the acquisition of
any debt or equity  securities  of or claim  against or  interest in any Person,
whether upon original issuance, by purchase or otherwise.

     "LC   APPLICATION"   means  an  application  for  a  Letter  of  Credit  in
substantially  the form of Exhibit B-3, setting forth the information  described
therein and such other  information  as the LC Bank may  reasonably  request and
signed by an Authorized Officer.

     "LC BANK"  means The Bank of Nova  Scotia  and any Lender  which  agrees to
become, and is designated as, a replacement LC Bank pursuant to Section 2.02(g).

     "LC CASH COLLATERAL ACCOUNT" means a general deposit account established at
and  maintained  by  Citibank in the name of and for the benefit of the Agent on
behalf of the Lenders and under the exclusive dominion and control of the Agent.




<PAGE>


                                       15

     "LC  EXPOSURE"  means  the  sum,  as of any date of  determination,  of the
Unfunded LC Exposure and the Funded LC Exposure.

     "LC FEE RATE"  means,  for any day,  the then  Eurodollar  Rate Margin less
0.025% per annum.

     "LC  SUBCOMMITMENT"  means the lesser, as of any date of determination,  of
(i) $100,000,000 and (ii) the Facility Amount.

     "LEASE EXPENSE" means, with respect to any Person,  for any period for such
Person and its  subsidiaries on a consolidated  basis,  lease and rental expense
accrued  during such period under all leases and rental  agreements,  other than
Capital  Leases and leases of  personal  property,  of Health  Care  Facilities,
determined in conformity with GAAP.

     "LENDER" means each financial institution  signatory hereto,  including the
LC Bank,  and any other  financial  institution  that  pursuant to Section  8.07
becomes a party to this Agreement.

     "LETTER  OF  CREDIT"  means a letter of credit  that (i) is  available  for
funding in Dollars until an expiry date no later than the Maturity Date, (ii) is
issued by the LC Bank at the request and for the account of the Borrower,  (iii)
is governed by the Uniform Customs and Practices for  Documentary  Credits (1994
Revision),   International  Chamber  of  Commerce  Publication  500,  except  as
otherwise agreed by the LC Bank, and (iv) is in form reasonably  satisfactory to
the LC Bank.

     "LIEN" means any mortgage,  deed of trust, lien, pledge,  charge,  security
interest,  hypothecation,  assignment, deposit arrangement or encumbrance of any
kind in respect  of any asset,  whether  or not  filed,  recorded  or  otherwise
perfected or effective under applicable law, as well as the interest of a vendor
or lessor under any  conditional  sale  agreement,  capital or finance  lease or
other title retention agreement relating to such asset.

     "LOAN AVAILABILITY" means the difference,  as of any date of determination,
between (i) the Facility Amount, and (ii) the Outstanding Revolving Credit.

     "LOAN DOCUMENTS" means this Agreement, the Notes, the Guaranty, the Letters
of Credit, the Collateral Documents, each Rate Contract and all other guaranties
and  other  agreements,  instruments  and  written  indicia  of the  Obligations
delivered  to the Agent or any  Lender by or on  behalf of the  Borrower  or any
other Loan Party pursuant to or in connection with the transactions contemplated
hereby.

     "LOAN PARTIES" means the Borrower and each  Subsidiary of the Borrower that
is a party to any Loan Document.




<PAGE>


                                       16

     "MATERIAL  ADVERSE  CHANGE"  means  any  materially  adverse  change in the
financial condition,  assets, nature of the assets,  liabilities,  operations or
prospects of the Borrower and its Subsidiaries, taken as a whole.

     "MATERIAL ENVIRONMENTAL CLAIM" means any Environmental Claim, regardless of
merit, which does or can reasonably be expected to (i) result in the Borrower or
any of its  Subsidiaries  expending  in the  aggregate  an  amount  in excess of
$10,000,000 to defend against,  settle or satisfy, or (ii) prevent or enjoin the
Borrower or any of its Subsidiaries from operating a Health Care Facility on any
property on which it conducts operations.

     "MATERIAL  LEASE" means any lease  agreement  with respect to a Health Care
Facility or Facilities for which during the most recent four Quarters either (i)
total  revenues  from such Health  Care  Facility or  Facilities  represent  ten
percent  or  more  of  the  consolidated   revenues  of  the  Borrower  and  its
Subsidiaries, or (ii) net income from the operation of such Health Care Facility
or Facilities  represents ten percent or more of the  consolidated net income of
the Borrower and its Subsidiaries.

     "MATERIAL  SUBSIDIARY"  means each Subsidiary of the Borrower which has (i)
as of the end of the most recent  Quarter,  total assets (other than  Intangible
Assets) representing ten percent or more of the consolidated total assets (other
than Intangible Assets) of the Borrower and its Subsidiaries,  (ii) for the most
recent four  Quarters,  total revenues  representing  ten percent or more of the
consolidated  revenues of the  Borrower and its  Subsidiaries,  or (iii) for the
most recent four Quarters,  net income  representing  ten percent or more of the
consolidated net income of the Borrower and its Subsidiaries.

     "MATURITY DATE" means June 30, 2002.

     "MINIMUM NET WORTH"  means the sum, as of the last day of any  Quarter,  of
(i) $590,000,000 less up to $10,000,000 of extraordinary  losses  (determined in
accordance  with GAAP) of the Borrower and its  Subsidiaries  on a  consolidated
basis  incurred  at any time  after  December  31,  1995,  plus  (ii) 75% of the
aggregate net income  (determined  in accordance  with GAAP) of the Borrower and
its  Subsidiaries on a consolidated  basis earned in the Quarter ended March 31,
1996 and in each  Quarter  thereafter,  if net income was earned in such Quarter
(and  not  reduced  for a net  loss  in any  Quarter),  plus  (iii)  100% of all
additions to Adjusted  Stockholders' Equity resulting at any time after December
31,  1995 from the sale or  issuance  of any  common or  preferred  stock of the
Borrower, except upon conversion of any Convertible Subordinated Debt.

     "MOODY'S" means Moody's Investor Service, Inc., and its successors.

     "MULTIEMPLOYER  PLAN"  means any Plan which is a  "multiemployer  plan," as
defined in Section 4001(a)(3) of ERISA.



<PAGE>


                                       17

     "NET CASH PROCEEDS OF SALE" means, with respect to any Asset Sale, the Cash
Proceeds  of Sale of such  sale  less (i) all  reasonable  brokerage,  legal and
accounting fees and disbursements,  and any governmental fees and taxes incurred
(or reasonably  expected to be incurred) in connection  with such sale which are
not payable to Affiliates of the Borrower (or, if to Affiliates,  are in amounts
no greater than would be payable in an arm's-length transaction);  (ii) any Debt
secured by the assets  subject to such Asset Sale repaid with such  proceeds (to
the extent such  repayment is  permitted  under the Loan  Documents);  and (iii)
reserves  against  any  liabilities  incurred  as a result  of such  Asset  Sale
reflected  on the balance  sheet of the Borrower or any of its  Subsidiaries  in
accordance with GAAP; provided,  however,  that in the event any such reserve is
subsequently decreased,  other than as a result of the accrual or payment of any
liability for which such reserve was established, Net Cash Proceeds of Sale with
respect to such Asset Sale shall be increased by a like amount.

     "1934 ACT" means the  Securities  Exchange Act of 1934 and the  regulations
thereunder.

     "1992 CONVERTIBLE  SUBORDINATED DEBT INDENTURE" means the Indenture,  dated
as of  December 1, 1992,  between  the  Borrower,  as Issuer,  and Signet  Trust
Company, as Trustee.

     "1993  CONVERTIBLE  SUBORDINATED  DEBT  INDENTURE"  means the  Amended  and
Restated  Supplemental  Indenture  dated as of September  15, 1994,  between the
Borrower, as Issuer, and NationsBank of Virginia, N.A., as Trustee.

     "1994  SUBORDINATED DEBT INDENTURE" means the Indenture dated as of July 1,
1994, between the Borrower, as Issuer, and Signet Trust Company, as Trustee.

     "1995 SUBORDINATED DEBT INDENTURE" means the Indenture, dated as of May 15,
1995, between the Borrower, as Issuer and Signet Trust Company, as Trustee.

     "1996  SUBORDINATED  DEBT INDENTURE" means the Indenture to be entered into
after the Closing between the Borrower, as Issuer, and the trustee thereunder in
connection with the proposed senior subordinated note offering.

     "NON-RECURRING  CHARGES" means all charges  against the income of a company
or facility  acquired by the Borrower or one of its  Subsidiaries  that (i) were
taken by the owners of such company or facility  prior to or  concurrently  with
the acquisition,  on the initiative solely of such owners or their management or
accountants  and without any demand or influence from the Borrower or any of its
Affiliates or any Person acting for any of them, and (ii) either (A) reflect the
direct  costs of the  acquisition,  including  fees and  expenses of  attorneys,
accountants,  advisors,  architects,  engineers,  consultants  and  agents,  and
environmental  and travel costs, or (B) are charges taken in the current year to
make  adjustments  for charges for  accruals,  bad debt  provisions or valuation
allowances in a prior year, if (x) the charges in the current year would be



<PAGE>


                                       18

entirely eliminated if the prior year's income was restated,  in accordance with
GAAP,  to  reflect  such  adjustments,   and  (y)  the  Borrower  provides  such
information  relating to the adjustments and the restatement of the prior year's
income as the Agent or Requisite Lenders may reasonably request.

     "NOTES" means the promissory  notes of the Borrower  delivered  pursuant to
Section  3.01(a) and all promissory  notes and other evidence of indebtedness at
any time  delivered by the Borrower in exchange or  substitution  therefor or in
replacement thereof or as additional evidence of the Borrower's indebtedness for
the Advances.

     "NOTICE OF BORROWING"  means a notice  substantially in the form of Exhibit
B-1.

     "NOTICE OF CONTINUANCE/CONVERSION" means a notice substantially in the form
of Exhibit B-2.

     "OBLIGATIONS"   means  all  present  and  future  Debts,   obligations  and
liabilities  of every type and  description  of the  Borrower  or any other Loan
Party at any time arising under or in connection with this Agreement,  any other
Loan  Document  or any Rate  Contract,  due or to become due to the  Agent,  any
Lender,  any Person  required to be  indemnified  under any Loan Document or any
other Person and shall  include (i) all  liability for principal of and interest
on any  Advances,  (ii) all  liability  for  principal  of and  interest  on any
reimbursement  owed to the LC Bank for a  payment  made by it under a Letter  of
Credit,  and (iii) all liability  under the Loan  Documents  for any  additional
interest, fees, taxes,  compensation,  costs, losses, expense reimbursements and
indemnification.

     "OECD" means the Organization for Economic Cooperation and Development.

     "OTHER TAXES" is defined in Section 2.16(b).

     "OUTSTANDING   REVOLVING   CREDIT"  means  the  sum,  as  of  any  date  of
determination,  of  (i)  the  aggregate  outstanding  principal  amount  of  the
Advances, and (ii) the LC Exposure.

     "PARTIAL  DISPOSITION  LIMIT"  means,  in respect of any proposed  Retained
Interest Sale in which the Retained  Interest Criteria are not met, that (i) the
sum of (A)  that  portion  of  EBITDAR  of the  Borrower  and  its  Subsidiaries
(determined for the four Quarters most recently ended prior to the  consummation
of such Retained  Interest  Sale) that is  attributable  to the  businesses  and
entities that are to be sold or disposed of in such Retained  Interest Sale, and
(B) the amount of such portion of EBITDAR of the Borrower and such  Subsidiaries
so computed  as of the time of each prior  Retained  Interest  Sale in which the
Retained  Interest Criteria were not met is less than (ii) 15% of EBITDAR of the
Borrower and such  Subsidiaries  for the four Quarters most recently ended prior
to the consummation of such proposed Retained Interest Sale.




<PAGE>


                                       19


     "PBGC"  means  the  Pension  Benefit  Guaranty  Corporation  or any  entity
succeeding to any of its functions under ERISA.

     "PENSION  PLAN" means any Plan which is (i) an  "employee  pension  benefit
plan" as defined in Section 3(2) of ERISA and (ii) not a Multiemployer Plan.

     "PERMITTED CASH INVESTMENTS" means:

          (a)  securities  issued or fully  guaranteed  or insured by the United
     States  Government  or any agency  thereof and backed by the full faith and
     credit of the United  States  maturing not more than one year from the date
     of acquisition;

          (b) certificates of deposit, time deposits,  Eurodollar time deposits,
     bankers'  acceptances or deposit  accounts  having in each case a remaining
     term to  maturity  of not more than one year,  which are  either  (i) fully
     insured by the Federal Deposit Insurance  Corporation or (ii) issued by any
     Lender  or by any  commercial  bank  under  the  laws of any  State  or any
     national  banking  association that has combined capital and surplus of not
     less than  $800,000,000 and whose short-term  securities are rated at least
     A-1 by S&P or P-1 by Moody's;

          (c)  commercial  paper  that is rated  at  least  A-1 by S&P or P-1 by
     Moody's,  issued by a company  that is  incorporated  under the laws of the
     United States or of any State and directly issues its own commercial paper,
     and has a remaining term to maturity of not more than one year;

          (d) a  repurchase  agreement  with  (i) any  commercial  bank  that is
     organized or licensed  under the laws of any State or any national  banking
     association and that has total assets of at least  $1,000,000,000,  or (ii)
     any investment  bank that is organized under the laws of any State and that
     has total assets of at least  $1,000,000,000,  if such agreement is secured
     by any one or more of the securities and  obligations  described in clauses
     (a),  (b) or (c) of this  definition  having a market value  (exclusive  of
     accrued  interest  and  valued  at least  monthly)  at  least  equal to the
     principal amount of such investment;

          (e) any money market or other investment fund the investments of which
     are limited to  investments  described in clauses (a),  (b), (c) and (d) of
     this  definition  and which is  managed  by (i) a  commercial  bank that is
     organized under the laws of any State or any national  banking  association
     and that has total assets of at least $1,000,000,000, or (ii) an investment
     bank  that is  organized  under  the laws of any  State  and that has total
     assets of at least $1,000,000,000;



<PAGE>


                                       20

          (f)  obligations,  debentures,  notes,  bonds  or other  evidences  of
     indebtedness  rated  at least  A- by S&P or A3 by  Moody's,  so long as the
     aggregate  amount of investments held under this clause (f) does not exceed
     25% of the total amount then invested by the Borrower and its  Subsidiaries
     in Permitted Cash Investments;

          (g)  investments in investment  grade auction rate and adjustable rate
     preferred  equities for issuers  whose actual or implied  senior  long-term
     debt is rated at least A- by S&P or A3 by Moody's;

          (h) investments in investment grade fixed rate preferred  equities for
     issuers whose actual or implied senior  long-term debt is rated at least A-
     by S&P or A3 by Moody's,  so long as the  aggregate  amount of  investments
     held under this clause (h) does not exceed 10% of the total amount invested
     by the Borrower and its Subsidiaries in Permitted Cash Investments;

          (i) adjustable rate  mortgage-backed  securities  rated at least AA by
     S&P or Aa by Moody's; and

          (j) fixed rate mortgage-backed  securities rated at least AA by S&P or
     Aa by Moody's,  so long as the aggregate  amount of investments  held under
     this  clause (j) does not exceed 25% of the total  amount  invested  by the
     Borrower and its Subsidiaries in Permitted Cash Investments.

     "PERMITTED LIENS" means Liens permitted under Section 5.03(a).

     "PERSON" means an individual,  partnership,  corporation, limited liability
company, business trust, joint stock company, trust, unincorporated association,
joint venture or other entity,  or a government or any political  subdivision or
agency thereof.

     "PLAN"  means any  "employee  benefit  plan" as defined in Section  3(3) of
ERISA (i) which the  Borrower  or any ERISA  Affiliate  maintains,  administers,
contributes  to or is required to contribute  to, or, within the six years prior
to the Closing Date, maintained, administered, contributed to or was required to
contribute to, or under which the Borrower or any ERISA  Affiliate may incur any
liability and (ii) which covers any employee or former  employee of the Borrower
or any ERISA Affiliate (with respect to their relationship with such entities).

     "PLEDGE AND SECURITY  AGREEMENTS" means the pledge and security  agreements
executed  by the  Borrower  and  certain  of  the  Borrower's  Subsidiaries  and
delivered  pursuant  to Section  3.01(a) and each  joinder  therein by any other
Subsidiary  of the  Borrower  and  each  other  security  agreement  at any time
delivered  by the  Borrower or any  Subsidiary  of the Borrower to create a Lien
that secures any of the Obligations.




<PAGE>


                                       21

     "POTENTIAL  DEFAULT" means any event or condition described in Section 6.01
which,  with any  notice or  passage of time (or both)  expressly  described  in
Section 6.01, would constitute an Event of Default.

     "PRICING  CERTIFICATE"  means a certificate  in  substantially  the form of
Exhibit B-4.

     "PRICING  PERIOD"  means the period that  commences on the Closing Date and
ends on August 20, 1996, and each consecutive  period  thereafter that commences
on the  expiration  of the  prior  period  and  ends on the 20th day of the next
following November, February, May or August.

     "PRICING RATIO" means, for any Pricing Period, the Debt/EBITDAR Ratio as of
the Pricing Test Date for such Pricing Period. If a Pricing  Certificate for the
Pricing Test Date for a particular  Pricing Period is not delivered prior to the
commencement  of such Pricing  Period,  then until (but only until) the Business
Day on which such Pricing  Certificate  is  delivered to the Agent,  the Pricing
Ratio  shall be deemed to be the  Pricing  Ratio for the  immediately  preceding
Pricing Period.

     "PRICING TEST DATE" means, for a particular Pricing Period, the last day of
the Quarter  most  recently  ended  prior to the  commencement  of such  Pricing
Period.

     "PRO RATA SHARE"  means,  in respect of any  Lender,  the ratio of (i) such
Lender's commitment to participate in the extension of credit hereunder, to (ii)
all such commitments,  expressed as a percentage, as set forth in Schedule I or,
if such Lender has entered into one or more Assignments and Acceptances,  in the
Register.

     "PURCHASE LIMIT" is defined in Section 5.03(h).

     "PURCHASERS' AGGREGATE NET INVESTMENT" means the net unrecovered investment
in the accounts  receivable of the Borrower and its  Subsidiaries,  and proceeds
thereof,  held by the  purchasers  in any  Receivables  Sale  Program  or  their
transferees, without counting any Receivables Program Charges.

     "QUALIFIED PLAN" means a pension plan (as defined in Section 3(2) of ERISA)
intended  to be  tax-qualified  under  Section  401(a) of the Code and which the
Borrower or any ERISA Affiliate sponsors,  maintains, or to which it makes or is
obligated to make contributions,  or in the case of a multiple employer plan (as
described in Section 4064(a) of ERISA) has made contributions at any time during
the  immediately  preceding  period  covering  at least  five  plan  years,  but
excluding any Multiemployer Plan.

     "QUARTER"  means,  with  respect to any  Person,  a fiscal  quarter of such
Person.



<PAGE>


                                       22

     "QUARTER-END  EXCESS CASH" means the excess,  determined as of the last day
of any Quarter (but only if it is a positive number),  of (i) cash and Permitted
Cash Investments held by the Borrower and its Subsidiaries,  less (ii) 2% of the
sum of the following operating expenses of the Borrower and its Subsidiaries for
the 12-month period then ending,  determined and recorded in accordance with the
Borrower's  current  practice:   "salaries,  wages  and  benefits,"  "corporate,
administrative and general" and "other operating expenses."

     "RATE  CONTRACT"  means any interest  rate swap  agreement,  cap,  floor or
collar  agreement,  interest rate  insurance or other  agreement or  arrangement
designed to provide  protection  against  fluctuations in interest rates entered
into by the Borrower and the Agent or any Lender.

     "RECEIVABLES   PROGRAM   CHARGES"  means  the  discount  or  yield  of  any
Receivables  Sale Program and all program and  administrative  costs,  back-stop
costs and other related costs,  fees and expenses  incurred by or charged to the
Borrower or any of its  Subsidiaries,  and when  determined for any period shall
include all such discount,  yield, costs, fees and expenses accrued or amortized
during such period.

     "RECEIVABLES SALE PROGRAM" means a sale or other disposition of an interest
in  the  accounts  receivable  of any of the  Borrower's  Subsidiaries  and  the
proceeds  thereof  and  records  related  thereto to one or more  purchasers  or
investors,  if the sale or other disposition (i) is made without recourse to the
seller,  (ii) is not  guaranteed  by the  Borrower  or any of its  Subsidiaries,
except a guaranty that the seller will perform its obligations in respect of its
representations and warranties, indemnities and servicing commitments, and (iii)
is structured so that the Purchasers' Aggregate Net Investment in respect of any
and all such accounts  receivable and proceeds  outstanding at any one time will
not exceed $100,000,000.

     "REFERENCE  BANKS"  means  Citibank,   Bank  of  America,   N.T.&S.A.   and
NationsBank, N.A. (Carolinas).

     "REGISTER" is defined in Section 8.07(c).

     "REPORTABLE  EVENT" means any of the events set forth in Section 4043(b) of
ERISA or the  regulations  thereunder,  a  withdrawal  from a plan  described in
Section 4063 of ERISA or a cessation of operations  described in Section 4062(e)
of ERISA.

     "REQUISITE LENDERS" means Lenders at the time in the aggregate holding more
than 66 2/3% in Pro Rata Shares.

     "RETAINED INTEREST" means the stock or equity, ownership or profit interest
which the Borrower or any  Subsidiary of the Borrower  retains,  acquires or has
the right to acquire in any Retained Interest Sale.



<PAGE>


                                       23

     "RETAINED INTEREST CRITERIA" means, in respect of any Retained Interest and
the assets, operations, governance, income and profits of any business or entity
to which such Retained Interest directly or indirectly relates,  each and all of
the following requirements:

          (i) The Borrower or a  wholly-owned  Subsidiary  of the Borrower  must
     have the exclusive  right and power,  subject to duties  imposed by law, to
     manage and  control the  ordinary  business  operations  and assets of such
     business or entity and freely to control and distribute  the cash,  income,
     profits,  and asset sale proceeds of such entity or business and, as to any
     such  entity  that is a  Subsidiary  of the  Borrower,  to borrow from such
     entity;

          (ii) The Borrower or a  wholly-owned  Subsidiary  of the Borrower must
     effectively  have the exclusive right and power,  subject to duties imposed
     by law,  to  determine  whether,  when and on what terms such  business  or
     entity shall be financed, sold, dissolved, liquidated or merged and to make
     all other  decisions  requiring  approval of the owners of such business or
     entity,  either  by  reason of lawful  and  enforceable  provisions  in the
     governing documents for such entity or under a voting trust arrangement, an
     irrevocable  proxy, an option to acquire or sell the interests of all other
     Persons  that hold or have the  right to  acquire  an  equity or  ownership
     interest in such business or entity, or other similar arrangements;

          (iii) The  exercise of such  rights and powers by the  Borrower or its
     wholly-owned  Subsidiary  must not be  barred,  limited  or  restricted  by
     contract or  agreement,  except for  provisions  requiring  performance  of
     duties imposed by law;

          (iv) The terms on which the  requirements  in  clauses  (i),  (ii) and
     (iii)  herein  are met must be such  that the  Borrower  or a  wholly-owned
     Subsidiary  of the Borrower has the  exclusive  right and power to maintain
     such  conditions  for as  long as the  Borrower  or any  Subsidiary  of the
     Borrower holds such Retained Interest;

          (v) At the  consummation  of the  transaction  in which such  Retained
     Interest was kept or  acquired,  each  Subsidiary  of the Borrower to which
     such Retained  Interest  directly or  indirectly  relates must reaffirm its
     liability under the Guaranty by executing a Guarantor  Confirmation setting
     forth its Guarantor Liability Limit after giving effect to such transaction
     and each other Guarantor must confirm its consent and agreement  thereto by
     executing such Guarantor Confirmation;

          (vi) No later than the tenth  Business Day following the  consummation
     of the  transaction  in which such Retained  Interest was kept or acquired,
     the Borrower  must deliver to the Agent and Lenders  written  notice of the
     structure and material terms of the agreements and arrangements relating to
     the foregoing and the Retained Interest and related Retained Interest Sale,
     accompanied by:




<PAGE>


                                       24

               (A) A  certificate  of an  Authorized  Officer  of  the  Borrower
          stating that at the time of such  consummation  the Retained  Interest
          Criteria were met in respect of such transaction, and

               (B) A Guarantor  Confirmation  signed by the Guarantors,  setting
          forth the Guarantor  Liability  Limit of each  Subsidiary  affected by
          such transaction, after giving effect to such transaction; and

          (vii) The Borrower must not receive from the Requisite Lenders, within
     20 Business Days after such notice,  certificate and Guarantor Confirmation
     were delivered to the Agent and Lenders,  a written statement to the effect
     that,  in the  opinion of the  Lenders  giving  such notice and for reasons
     generally set forth in such statement (which opinion, reasons and statement
     shall be conclusive  and binding on the Borrower and the other Loan Parties
     if held, determined and presented by such Lenders in good faith), either:

               (A) The Retained Interest Criteria are not met in respect of such
          transaction, or

               (B) Such Lenders  notified  the  Borrower at least five  Business
          Days prior to the date of such statement that the Guarantor  Liability
          Limit of any  Subsidiary  affected by such  transaction,  after giving
          effect to such transaction,  was not properly determined, set forth or
          acknowledged  in  the  Guarantor  Confirmation  so  delivered,  and  a
          Guarantor   Confirmation  properly  determining,   setting  forth  and
          acknowledging  such Guarantor  Liability Limit,  duly executed by such
          Subsidiary and all other Guarantors, was not received by the Agent and
          Lenders  within five  Business Days after such notice was given to the
          Borrower.

     "RETAINED INTEREST SALE" means a sale or other disposition of less than all
of the stock of or other equity,  ownership or profit  interest in a Subsidiary,
or less than the entire  ownership of any  business,  asset or entity,  that was
directly or indirectly  owned by the Borrower or any of its  Subsidiaries on the
Closing  Date or any Asset Sale,  merger,  consolidation,  sale and  repurchase,
exchange or other transaction in which,  after giving effect to such transaction
and all related  transactions,  the Borrower or any of its Subsidiaries directly
or  indirectly  retains or  acquires or has the right to acquire any stock of or
any equity, ownership or profit interest in any such Subsidiary, business, asset
or entity.

     "SCHEDULE  1.01(B) ASSETS" means the assets  described in Schedule  1.01(b)
and owned by the Borrower or any wholly-owned  Subsidiary thereof and designated
for sale thereby.

     "SCHEDULE  1.01(C) ASSETS" means the assets  described in Schedule  1.01(c)
and owned by the Borrower or any wholly-owned  Subsidiary thereof and designated
for sale thereby.



<PAGE>


                                       25

     "S&P" means  Standard & Poor's  Ratings  Group,  a division of  McGraw-Hill
Corporation, and its successors.

     "SPECIFIED  LEASE  EXPENSE"  means,  with  respect to any  Person,  for any
period,  Lease  Expense of such Person for such period less that portion of such
Lease Expense representing  payments for real estate and personal property taxes
and insurance.

     "STATE" means the District of Columbia or any state of the United States of
America.

     "SUBORDINATED  DEBT" means the Debt outstanding under the Subordinated Debt
Indentures.

     "SUBORDINATED DEBT INDENTURES" means the 1992 Convertible Subordinated Debt
Indenture,   the  1993  Convertible   Subordinated  Debt  Indenture,   the  1994
Subordinated Debt Indenture,  the 1995 Subordinated Debt Indenture and, upon the
effectiveness thereof, the 1996 Subordinated Debt Indenture.

     "SUBSIDIARY"   means,   with  respect  to  any  Person,   any  corporation,
association,  partnership,  joint venture or other business entity of which more
than 50% of the voting  stock or other equity  interests is owned or  controlled
directly or indirectly by such Person or one or more Subsidiaries of such Person
or a combination thereof.

     "TANGIBLE  ASSETS" means the difference,  as of any date of  determination,
between (i) the total  consolidated  assets of the Borrower and its Subsidiaries
as determined in accordance  with GAAP and required  under GAAP to be shown on a
consolidated  balance sheet of the Borrower and its  Subsidiaries,  and (ii) all
such assets that are Intangible Assets.

     "TAXES" is defined in Section 2.16(a).

     "TERMINATION  DATE" means the  Maturity  Date or such  earlier  date as the
commitments  of the  Lenders  to extend  credit  under this  Agreement  shall be
terminated in whole pursuant to Section 2.05 or the obligation of each Lender to
make  Advances and the LC Bank to issue  Letters of Credit  shall be  terminated
pursuant to Section 6.01.

     "'34 ACT COMPANY" means a Person that is a reporting company under the 1934
Act.

     "UNFUNDED  LC EXPOSURE"  means the maximum  amount which the LC Bank may be
required,   under  all  Letters  of  Credit   outstanding  as  of  any  date  of
determination, to pay on such date or at any future time.



<PAGE>


                                       26

     "UNFUNDED  PENSION  LIABILITY" means, with respect to any Pension Plan that
is  subject  to Title IV of ERISA,  the excess of such  Pension  Plan's  accrued
benefits,  as defined in Section 3(23) of ERISA,  over the current value of such
Pension Plan's assets,  as defined in Section 3(26) of ERISA (but excluding from
the definition of "current value" of "assets" of such Pension Plan,  accrued but
unpaid contributions).

     "UNITED STATES" and "U.S." mean the United States of America.

     "WELFARE PLAN" means any Plan which is an "employee  welfare  benefit plan"
as defined in Section 3(1) of ERISA.

     "WITHDRAWAL LIABILITIES" means the aggregate amount of the liabilities,  if
any,  pursuant to Section 4201 of ERISA if the Borrower and each ERISA Affiliate
made a complete  withdrawal  from all  Multiemployer  Plans and any  increase in
contributions pursuant to Section 4243 of ERISA.

     SECTION 1.02.  Accounting Terms. All accounting terms not expressly defined
herein shall be construed,  except where the context otherwise requires, and all
financial computations required under this Agreement shall be made in accordance
with GAAP applied on a consistent basis. If GAAP changes during the term of this
Agreement  so as to affect the  calculation  of any term  defined  herein or any
measure of financial  performance or financial condition employed or referred to
herein,  the Borrower and the Lenders agree to negotiate in good faith toward an
amendment of this Agreement which shall approximate, to the extent possible, the
economic effect of the original provisions hereof after taking into account such
change in GAAP,  but until the parties are able to agree upon such amendment (i)
the Borrower shall be deemed in compliance  with the  provisions  hereof only if
and to the extent it would have been in  compliance  if such  change in GAAP had
not  occurred  and (ii) the  Borrower  shall  deliver  to the  Agent,  with each
financial report delivered by the Borrower hereunder,  information sufficient to
confirm such compliance as if such change in GAAP had not occurred.

     SECTION 1.03. Other Definitional Provisions. (a) Unless otherwise specified
herein or therein,  all terms defined in this  Agreement  shall have the defined
meanings  when used in any other Loan  Document or in any  certificate  or other
document made or delivered pursuant hereto.

     (b) The words  "hereof,"  "herein"  and  "hereunder"  and words of  similar
import when used in this Agreement refer to this Agreement as a whole and not to
any particular  provision of this Agreement,  and section,  schedule and exhibit
references  are to this Agreement  unless  otherwise  specified.  The meaning of
defined  terms shall be equally  applicable  to the singular and plural forms of
the defined terms.  The term  "including"  is not limiting and means  "including
without limitation."




<PAGE>


                                       27

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

     (d) References to agreements and other documents shall be deemed to include
all  subsequent  amendments  and other  modifications  thereto,  but only to the
extent such amendments and other  modifications  are not prohibited by the terms
of any Loan Document.

     (e) References to statutes or  regulations  shall be construed as including
all statutory and regulatory provisions consolidating, amending or replacing the
statute or regulation.

     (f) The captions  and headings of this  Agreement  are for  convenience  of
reference only and shall not affect the construction of this Agreement.


                                   ARTICLE II

                        AMOUNTS AND TERMS OF THE ADVANCES

     SECTION 2.01.  Revolving Facility.  (a) Advances.  Subject to the terms and
conditions  herein,  each Lender severally agrees to lend to the Borrower,  from
time to time on any  Borrowing  Date until the  Termination  Date,  an amount in
Dollars  equal to such  Lender's  Pro  Rata  Share  of a  Borrowing  that (i) is
requested by the Borrower for such Borrowing Date and (ii) when  aggregated with
all other Lenders' Pro Rata Shares,  does not exceed the Loan Availability as of
such Borrowing Date.

     (b)  Borrowings.  Each Borrowing  shall be in an aggregate  amount not less
than $1,000,000 or an integral  multiple of $500,000 in excess thereof and shall
consist of either Base Rate Advances or Eurodollar  Rate Advances.  The Borrower
may reborrow under Section 2.01(a) any Advances that it has voluntarily  prepaid
pursuant to Section 2.11 or was required to prepay pursuant to Section 2.06(e).

     (c) Notice of Borrowing. To request a Borrowing, the Borrower shall deliver
a Notice of  Borrowing to the Agent not later than 11:00 a.m. New York City time
(i) three  Business Days prior to the requested  Borrowing  Date, in the case of
Eurodollar  Rate  Advances,  and (ii) one  Business  Day prior to the  requested
Borrowing  Date,  in the case of Base Rate  Advances.  The Agent shall give each
Lender  prompt  notice  thereof  by  telecopier,  telex or cable.  The Notice of
Borrowing shall specify (A) the requested  Borrowing Date, (B) the amount of the
Borrowing and whether it will consist of Base Rate  Advances or Eurodollar  Rate
Advances,  and (C) in the  case of a  Borrowing  comprised  of  Eurodollar  Rate
Advances, the initial Interest Period for such Eurodollar Rate Advances.



<PAGE>


                                       28

     (d)  Telephonic  Notice  of  Borrowing.  The  Borrower  may give the  Agent
telephonic  notice of any proposed  Borrowing by the time required under Section
2.01(c)  and in such  event  shall  promptly  (but in no  event  later  than the
Borrowing Date for the requested  Borrowing)  deliver a  confirmatory  Notice of
Borrowing to the Agent.  The Agent shall give each Lender prompt notice  thereof
by telecopier,  telex or cable. If the telephonic request differs in any respect
from the written  Notice of Borrowing  subsequently  delivered,  the  telephonic
request  shall govern as to the terms of all Advances  made in  accordance  with
such  telephonic  request.  The  Agent's  determination  of the  contents of any
telephonic  request shall,  absent  manifest error, be conclusive and binding on
all parties hereto.

     (e) Funding of Advances.  Upon fulfillment of the applicable conditions set
forth in Article III, each Lender shall, before 12:00 noon New York City time on
the Borrowing  Date,  make available for the account of its  Applicable  Lending
Office to the Agent at its  address  referred  to in Section  8.02,  in same day
funds,  such  Lender's Pro Rata Share of a Borrowing.  After the Agent  receives
such funds,  the Agent will,  not later than 5:00 p.m. New York City time on the
Borrowing  Date,  make such  funds  available  to the  Borrower  at the  Agent's
aforesaid address.

     (f)  Notice  of  Borrowing  Irrevocable.   Each  Notice  of  Borrowing  and
telephonic request shall be irrevocable and binding on the Borrower.

     (g) Assumption of Funding.  Unless the Agent receives  notice from a Lender
prior to any  Borrowing  Date that such  Lender will not make  available  to the
Agent such Lender's Pro Rata Share of the Borrowing to be made on such Borrowing
Date,  the  Agent  may  assume  that  such  Lender  has made its Pro Rata  Share
available to the Agent on such Borrowing Date in accordance with Section 2.01(e)
and the Agent may, in  reliance  upon such  assumption,  make  available  to the
Borrower on such Borrowing  Date a  corresponding  amount.  If and to the extent
that such Lender fails to make its Pro Rata Share  available to the Agent,  such
Lender  and the  Borrower  severally  agree to repay to the Agent  forthwith  on
demand such  corresponding  amount together with interest thereon,  for each day
from the date such amount is made  available to the Borrower until the date such
amount is repaid to the Agent, at (i) in the case of the Borrower,  the interest
rate  applicable  at the  time to such  Borrowing  and  (ii) in the case of such
Lender,  the Federal Funds Rate until the third Business Day after demand by the
Agent to such Lender for such repayment and thereafter at the rate applicable at
the  time to such  Borrowing.  If such  Lender  shall  repay to the  Agent  such
corresponding  amount,  such amount so repaid  shall  constitute  such  Lender's
Advance  as  part of such  Borrowing  for  purposes  of this  Agreement  and the
Borrower shall  thereupon be excused from making the repayment  described in the
preceding sentence.

     (h) Failure of Lender to Fund.  All  obligations  of the Lenders  hereunder
shall be several,  but not joint.  The failure of any Lender to make the Advance
to be made by it as part of any Borrowing  shall not relieve any other Lender of
its obligation, if any, hereunder to make



<PAGE>


                                       29

its Advance as part of such  Borrowing,  but no Lender shall be responsible  for
the failure of any other Lender to make an Advance on any Borrowing Date.

     SECTION 2.02. Letter of Credit Subfacility.  (a) Issuance of the Letters of
Credit. Subject to the terms and conditions set forth herein, the LC Bank agrees
to issue one or more  Letters of Credit,  at the  request and for the account of
the Borrower,  on any Business Day on or after the Closing Date and prior to the
Termination  Date,  so long as (i) after  giving  effect to the  issuance of any
Letter of Credit so requested,  (A) the  Outstanding  Revolving  Credit does not
exceed the then  Facility  Amount,  and (B) the LC Exposure  does not exceed the
then LC Subcommitment, and (ii) the LC Bank has not received written notice from
the Agent or Requisite  Lenders that an Event of Default or Potential Default is
continuing.

     (b) LC Application. The Borrower may request issuance of a Letter of Credit
by  delivering an LC  Application  to the Agent not later than two Business Days
prior to the date the Letter of Credit is to be issued. The Agent shall promptly
deliver a copy of the LC Application to the LC Bank and each Lender.

     (c)  Reimbursement.  Any payment made by the LC Bank of a draft drawn under
any Letter of Credit shall  constitute  for all purposes of this  Agreement  the
making by the LC Bank of an Advance in the amount of such draft,  which  Advance
shall (i)  constitute a Base Rate Advance  until  converted,  at the  Borrower's
election,  into a Eurodollar  Rate Advance  pursuant to Section  2.10,  and (ii)
satisfy the  Borrower's  obligation  to reimburse the LC Bank under this Section
2.02 . With respect to each Advance made pursuant to this Section  2.02(c),  the
Borrower shall be deemed to have  certified the statements  contained in Section
3.02(b) as of the date the payment  constituting such Advance was made by the LC
Bank;  provided that in the event any such statement was not true and correct as
of such date, such Advance shall be repayable on demand;  provided  further that
upon any such repayment on demand,  the failure of any such statement to be true
and  correct as of such date  shall not  constitute  an Event of  Default  under
Section 6.01, unless the failure of any such statement to be true and correct as
of such date would have  constituted an Event of Default under Section 6.01 even
if such repaid Advance had never been made.

     (d) Reimbursement  Obligation  Absolute.  The obligation of the Borrower to
reimburse  the LC Bank for each  payment made by the LC Bank under any Letter of
Credit,  and to pay  interest  thereon as provided  herein,  shall be  absolute,
unconditional and irrevocable and shall be performed strictly in accordance with
the terms of this  Agreement  under  and  without  regard to any  circumstances,
including  (i)  any  lack  of  validity  or  enforceability  of any of the  Loan
Documents;  (ii) any amendment or waiver of or any consent to departure from all
or any terms of any of the Loan  Documents;  (iii) the  existence  of any claim,
setoff,  defense or other right which the  Borrower may have at any time against
any  beneficiary  or any  transferee of any Letter of Credit (or any Persons for
whom any such beneficiary or transferee may be acting),  the LC Bank, the Agent,
any Lender or any other Person, whether in connection with this Agreement, the



<PAGE>


                                       30

transactions  contemplated herein or any unrelated transaction;  (iv) any breach
of contract or dispute  among or between the Borrower,  the Agent,  the LC Bank,
any Lender, or any other Person; (v) any demand, statement,  certificate,  draft
or other  document  presented  under any Letter of Credit  proving to be forged,
fraudulent,  invalid or  insufficient  in any respect or any  statement  therein
being untrue or inaccurate in any respect; (vi) payment by the LC Bank under any
Letter of Credit against  presentation  of any demand,  statement,  certificate,
draft or other  document  which does not  strictly  comply with the terms of any
Letter of Credit; (vii) any non-application or misapplication by any beneficiary
or  transferee  of the proceeds of any amount paid under  anyLetter of Credit or
any other act or omission of such  beneficiary or such  transferee in connection
with any Letter of Credit; (viii) any extension of time for or delay, renewal or
compromise of or other indulgence or modification granted or agreed to by the LC
Bank,  the Agent or any  Lender,  with or without  notice to or  approval by the
Borrower; (ix) any failure to preserve or protect any Collateral, any failure to
perfect or preserve the  perfection of any Lien  thereon,  or the release of any
Collateral;  or (x) any other  circumstance or event whatsoever  relating to the
Borrower or such Letter of Credit or the reimbursement due therefor,  whether or
not similar to any of the foregoing.

     (e) Lender Participation.  Each Lender severally agrees to participate with
the LC Bank in the  extension of credit  arising from the issuance of any Letter
of  Credit in  conformity  with  Section  2.02(a),  in an  amount  equal to such
Lender's Pro Rata Share of the amount available for payment under such Letter of
Credit.  Upon written  demand by the LC Bank,  with a copy of such demand to the
Agent,  each Lender shall  promptly fund its  participation  by paying to the LC
Bank Dollars in an amount  equal to such  Lender's Pro Rata Share of the payment
made by the LC Bank  under any  Letter of  Credit,  together  with all  interest
accrued  and unpaid  thereon for the period from the day on which the payment to
be  reimbursed  was demanded by the LC Bank until the Business Day on which such
funding  from such Lender is received by the LC Bank at the rate per annum equal
to the Federal Funds Rate until the second  Business Day following  such demand,
and  thereafter the rate per annum then  applicable to Base Rate Advances.  Upon
funding its  participation in accordance with this Section 2.02(e),  each Lender
shall be deemed to have made an  Advance as of the date the  relevant  Letter of
Credit was drawn,  and the Advance  deemed  pursuant to Section  2.02(c) to have
been made by the LC Bank upon any such  payment  shall be reduced,  in an amount
equal to such  Lender's  participation.  Each  Lender's  obligation to make such
payment to the LC Bank shall be  absolute,  unconditional  and  irrevocable  and
shall not be affected by any circumstance  whatsoever,  including the occurrence
or continuance of any Potential Default or Event of Default, the failure to meet
any condition that otherwise must be met for the funding of any Advance,  or the
failure of any other Lender to make any payment under this Section 2.02(e),  and
each Lender  further  agrees that such payment shall be made without any offset,
abatement, withholding or reduction whatsoever. If after receipt of such funding
from any Lender the LC Bank  receives  payment  from the  Borrower  or any other
source on account of the  reimbursement  obligation  that was so funded,  or the
interest accrued  thereon,  the LC Bank shall promptly remit such payment to the
Agent  for  prompt   distribution   to  the  Lenders  to  the  extent  of  their
participation therein.




<PAGE>


                                       31

     (f)  Commercial  Practices.  The Borrower  assumes all risks of the acts or
omissions of any  beneficiary or transferee of any Letter of Credit with respect
to the use of any Letter of Credit.  The Borrower  agrees that the LC Bank,  the
Agent, the Lenders and their respective  directors,  officers or employees shall
not be liable or responsible  for (i) the use which may be made of any Letter of
Credit  or for  any  acts or  omissions  of any  beneficiary  or  transferee  in
connection therewith;  (ii) any reference which may be made to this Agreement or
to any Letter of Credit in any agreements, instruments or other documents; (iii)
the validity,  sufficiency or genuineness of any document other than a Letter of
Credit,  or of any  endorsement  thereon,  even if such document or  endorsement
should  in  fact  prove  to be in  any or all  respects  invalid,  insufficient,
fraudulent or forged or any  statement  therein prove to be untrue or inaccurate
in any respect whatsoever;  (iv) payment by the LC Bank against  presentation of
documents  which do not strictly  comply with the terms of any Letter of Credit;
or (v) any other  circumstances  whatsoever in making or failing to make payment
under any Letter of Credit,  except only that the LC Bank shall be liable to the
Borrower for acts or events  described in clauses (i) through (v) above,  to the
extent,  but only to the extent, of any direct (as opposed to indirect,  special
or  consequential)  damages  suffered by the Borrower which the Borrower  proves
were  caused by (A) the LC Bank's  willful  misconduct  or gross  negligence  in
determining  whether a draft or  demand  presented  under  any  Letter of Credit
strictly  complies with the terms and conditions  therefor stated in such Letter
of  Credit  or (B) the LC  Bank's  willful  failure  to pay any  draft or demand
presented  under any Letter of Credit that strictly  complies with the terms and
conditions thereof. The LC Bank may accept any document that appears on its face
to  be  in  order,  without  responsibility  for  further   investigation.   The
determination  whether a draft or demand is properly  presented under any Letter
of Credit prior to its expiration or whether a draft or demand  presented  under
any Letter of Credit is in proper and sufficient form may be made by the LC Bank
in its sole discretion,  and such determination  shall be conclusive and binding
upon the Borrower to the extent permitted by law. The Borrower hereby waives any
right to object to any payment  made under any Letter of Credit on  presentation
of any draft or demand that is in the form  provided in the Letter of Credit but
varies with respect to punctuation,  capitalization, spelling or similar matters
of form.

     (g)  Replacement  of LC Bank.  The Borrower may at any time,  upon at least
five Business Days' prior written notice to the Agent and Lenders,  designate as
a  replacement  LC Bank any Lender that has agreed in writing to act as LC Bank.
Thereupon,  (i) the  obligation,  right and  authority  of the  Lender  that was
previously  acting  as LC Bank to issue  Letters  of Credit  hereunder  shall be
terminated,  (ii) such Lender  shall remain  entitled to enforce all  provisions
hereof  applicable to all Letters of Credit  theretofore  issued by or requested
from such Lender,  and (iii) the Lender  designated as the  replacement  LC Bank
shall  thenceforth  issue  Letters  of Credit on the  terms and  subject  to the
conditions herein.

     SECTION 2.03. Promissory Notes. (a) Notes. The Advances made by each Lender
shall be evidenced by the Notes delivered pursuant to Section 3.01(a).



<PAGE>


                                       32

     (b) Recording of Amounts.  Each Lender is hereby  authorized (but shall not
be obligated),  at its option, to either (i) endorse the date and amount of each
Advance made by such Lender and each  payment of  principal of Advances  made on
such Lender's Note on a schedule annexed to and constituting a part of such Note
or (ii) record such  Advances and  payments in its books and  records,  and such
schedule or such books and records,  as the case may be, shall  constitute prima
facie evidence of the accuracy of the information contained therein.

     SECTION 2.04.  Fees.  (a) Closing  Fees. On the Closing Date,  the Borrower
will pay to the Agent, for account of the Lenders, the closing fees described in
Schedule 2.04(a).

     (b) Commitment  Fees. On the first day of each Quarter,  commencing July 1,
1996 and continuing  thereafter until the Facility Amount is permanently reduced
to zero, and on the Termination  Date, the Borrower shall pay to the Agent,  for
the  account  of the  Lenders  in  accordance  with  their  Pro Rata  Shares,  a
commitment fee computed by applying the  Commitment Fee Rate to the  difference,
from day to day in the prior  Quarter  or partial  Quarter,  as the case may be,
between (i) the sum of (A) the then Facility Amount and (B) the then Purchasers'
Aggregate Net Investment, less (ii) the then Outstanding Revolving Credit.

     (c) Letter of Credit  Fees.  On the first day of each  Quarter,  commencing
July 1, 1996 and continuing thereafter until the Facility Amount and Unfunded LC
Exposure  have both been  reduced  to zero,  and on the  Termination  Date,  the
Borrower  shall pay to the Agent for the  account of the  Lenders in  accordance
with their Pro Rata Shares a letter of credit fee  computed  by applying  the LC
Fee Rate to the  Unfunded  LC Exposure  from day to day in the prior  Quarter or
partial Quarter, as the case may be.

     (d) Facing Fees. On the first day of each Quarter,  commencing July 1, 1996
and  continuing  thereafter  until the Facility  Amount and Unfunded LC Exposure
have both been reduced to zero, and on the Termination  Date, the Borrower shall
pay to the  Agent  for the  account  of the LC Bank a  facing  fee  computed  by
applying  0.125% per annum to the  Unfunded LC  Exposure  from day to day in the
prior Quarter or partial Quarter, as the case may be.

     (e) Letter of Credit  Administration.  The Borrower shall pay the LC Bank's
usual and  customary  charges for  opening,  amending or honoring  any Letter of
Credit and for any wire transfers.

     (f) Agent's  Fees.  The Borrower  shall pay when due all fees payable under
the Fee Letter.

     (g) Contingent  Fees. The Borrower shall pay to the Agent,  for the account
of the Lenders, when due the contingent fees payable under the Fee Letter.



<PAGE>


                                       33

     SECTION 2.05. Voluntary and Scheduled Facility Reductions. (a) The Borrower
at any time may terminate in whole,  and from time to time may reduce ratably in
part,  the unused  portions of the  commitments  of the Lenders to extend credit
hereunder,  by giving the Agent at least  three  Business  Days'  prior  written
notice  that,  effective  as of a  Business  Day set  forth in the  notice,  the
Facility  Amount shall be reduced by an amount that (i) does not exceed the Loan
Availability  as of such  Business  Day and (ii) is equal to either (A) the then
Facility  Amount or (B) an integral  multiple of $1,000,000.  Such notice,  once
given, shall be irrevocable,  and the Facility Amount, once reduced,  may not be
increased under any circumstances.

     (b) The Facility Amount shall be automatically and permanently  reduced (i)
on June 30,  2000 to  $560,000,000,  (ii) on June 30, 2001 to  $315,000,000  and
(iii) on the Termination Date as provided in Section 2.06(a) below.

     SECTION 2.06. Principal Payments. The Borrower agrees to repay the Advances
and reduce the Facility Amount as follows:

          (a) Final Maturity.  On the Termination Date, all outstanding Advances
     shall be due and payable and the Facility Amount and LC Subcommitment shall
     be automatically and permanently reduced to zero.

          (b) Excess Revolving Credit Exposure. If at any time, by reason of any
     voluntary or mandatory  Facility  Reduction  or for any other  reason,  the
     Outstanding Revolving Credit exceeds the then Facility Amount, the Borrower
     shall  immediately,  without  notice or demand,  repay  Advances  or, if no
     Advances  are  outstanding,  deposit  Dollars  to  the LC  Cash  Collateral
     Account, in an amount equal to such excess.

          (c) Excess LC Exposure.  If at any time, by reason of any voluntary or
     mandatory  Facility  Reduction  or for any other  reason,  the LC  Exposure
     exceeds the then LC Subcommitment,  the Borrower shall immediately  deposit
     Dollars  in an  amount  equal  to such  excess  to the LC  Cash  Collateral
     Account.

          (d)  Payment  on Date of Change of  Control.  If,  within  the  period
     commencing  on the date of a Change of Control and ending 30 Business  Days
     after  the  Borrower  gives  the Agent  written  notice  of such  Change of
     Control,  the  Requisite  Lenders shall demand in writing that the Borrower
     repay all  Advances,  then on the 30th day  following  such  demand (i) all
     Advances then  outstanding  shall be due and payable in full,  and (ii) the
     Facility  Amount  and  the LC  Subcommitment  shall  be  automatically  and
     permanently  reduced to zero; and if any LC Exposure remains outstanding on
     such day the  Borrower  on such day shall  deposit  Dollars  to the LC Cash
     Collateral  Account as necessary to cause the amount on deposit  therein to
     be equal to the then LC Exposure.



<PAGE>


                                       34

          (e) Facility  Reduction for  Receivables  Sale  Program.  Whenever any
     Receivables Sale Program is in effect, the Facility Amount shall be reduced
     (but in no event  by more  than  $100,000,000)  by an  amount  equal to the
     Purchasers'  Aggregate  Net  Investment,  as  certified  from  time to time
     pursuant to Section  5.02(c)(xv) or 5.02(c)(xvi)  for as long, but only for
     as long,  as the  Receivables  Sale  Program is in effect.  If after giving
     effect to any such reduction the Outstanding  Revolving  Credit exceeds the
     reduced  Facility  Amount,  prepayment  shall be made  pursuant  to Section
     2.06(b) when such reduction becomes effective.

          (f)  Application  of LC  Cash  Collateral.  With  respect  to  Dollars
     deposited to the LC Cash Collateral Account:

               (i) At any time when no Event of Default or Potential Default has
          occurred and is continuing,  the Agent may (and shall,  if so directed
          in  writing  by the  Borrower  or the  Requisite  Lenders)  cause such
          deposit to be applied to repay any or all Funded LC  Exposure,  in any
          order of application;

               (ii)   Whenever   any  Event  of  Default  has  occurred  and  is
          continuing,  the Agent may (and shall if so directed in writing by the
          Requisite Lenders) cause such deposit to be applied to repay or retire
          any or all of the  Obligations,  whether or not then due, in any order
          of application;

               (iii)  If at any  time  when no Event  of  Default  or  Potential
          Default is continuing the Dollars on deposit in the LC Cash Collateral
          Account exceed the then LC Exposure,  the Agent shall,  if so directed
          in writing by the  Borrower,  cause such deposit to be released to the
          Borrower to the extent,  but only to the extent,  such deposit exceeds
          the then LC Exposure; and

               (iv)  Interest  shall accrue and be payable on deposits to the LC
          Cash Collateral Account.

     SECTION 2.07.  Interest.  The Borrower agrees to pay interest on the unpaid
principal  amount of each  Advance  made by each  Lender  (or, in the case of an
Advance made pursuant to Section 2.02(c),  by the LC Bank) from the date of such
Advance  until such  principal  amount shall be repaid in full, at the following
rates per annum:

          (a) Base Rate Advances.  Whenever such Advance is a Base Rate Advance,
     a rate per annum equal on each day to the sum of the Base Rate as in effect
     on such day plus the Base Rate  Margin  determined  for such day,  with all
     such interest  accrued in any one month payable monthly on the first day of
     the next following  month and in any case when the Facility Amount has been
     reduced to zero and all Advances are repaid in full.




<PAGE>

                                       35

          (b) Eurodollar  Rate  Advances.  Whenever such Advance is a Eurodollar
     Rate Advance, a rate per annum equal on each day during the Interest Period
     for such Eurodollar Rate Advance to the sum of the Eurodollar Rate for such
     Interest  Period plus the Eurodollar  Rate Margin  determined for such day,
     with all  interest  so  accrued  payable  on the last day of such  Interest
     Period  and,  if such  Interest  Period has a  duration  of more than three
     months,  on the day which  occurs  three months after the first day of such
     Interest Period.

          (c) Default Interest.  For any period of time during which an Event of
     Default under Section 6.01(a), (b), (d), (e), (f), (g), (h), (i), (j), (k),
     (l) (with respect to Material Subsidiaries only) or (m) has occurred and is
     continuing,  the principal  amount of all Advances then  outstanding  shall
     bear  interest  payable upon demand at a rate per annum equal to the sum of
     (i) 2.0%  per  annum  plus  (ii) the rate  otherwise  payable  pursuant  to
     subsection  (a) or (b) above,  but not to exceed the maximum rate permitted
     by applicable law.

     SECTION 2.08. Additional Interest on Eurodollar Rate Advances. The Borrower
shall pay each Lender additional interest on the unpaid principal amount of each
Advance  of such  Lender  for each day that such  Advance  is  outstanding  as a
Eurodollar Rate Advance,  at a rate per annum equal to the remainder obtained by
subtracting (i) the Eurodollar Rate for such Interest Period for such Eurodollar
Rate Advance from (ii) the rate determined by dividing such Eurodollar Rate by a
percentage  equal to 100% minus the Eurodollar  Rate Reserve  Percentage of such
Lender  for such day.  Such  additional  interest  shall be  determined  by such
Lender,  notified to the  Borrower  through  the Agent and  payable  when and as
interest is payable on such Eurodollar Rate Advance or, if later,  five Business
Days after the Borrower  receives notice  thereof.  If the Borrower so requests,
such Lender shall provide the Borrower  through the Agent a certificate  setting
forth the calculation and supporting  information for such additional  interest,
which shall be conclusive and binding for all purposes, absent manifest error.

     SECTION 2.09. Interest Rate Determination and Protection. (a) Determination
of Eurodollar  Rate. The Eurodollar Rate for each Interest Period for Eurodollar
Rate Advances  comprising  part of the same Borrowing shall be determined by the
Agent on the basis of  applicable  rates  furnished to and received by the Agent
from the Reference Banks two Business Days before the first day of such Interest
Period.

     (b) Notice of  Eurodollar  Rate.  The Agent shall give prompt notice to the
Borrower and the Lenders of the  Eurodollar  Rate for any  Interest  Period when
determined by the Agent.

     (c) Failure to Provide Information.  If any one of the Reference Banks does
not furnish to the Agent timely  information  sufficient  to enable the Agent to
determine a Eurodollar Rate, the Agent shall determine such interest rate on the
basis of timely information



<PAGE>


                                       36

furnished by the remaining  Reference  Banks.  If fewer than two Reference Banks
furnish timely  information to the Agent for determining the Eurodollar Rate for
any Eurodollar  Rate  Advances,  the Agent shall  determine the Eurodollar  Rate
based on  information  furnished  by  Citibank.  If Citibank is unable to obtain
timely  information  for determining the Eurodollar Rate for any Eurodollar Rate
Advances, the Agent shall forthwith notify the Borrower and the Lenders that the
interest rate cannot be  determined  for such  Eurodollar  Rate Advances and the
obligation  of the Lenders to make or  continue,  or to convert  Advances  into,
Eurodollar  Rate  Advances  shall be suspended  until the Agent shall notify the
Borrower  and the Lenders that the  circumstances  causing  such  suspension  no
longer exist.

     (d)  Suspension  of  Eurodollar  Rate  Advances.  If,  with  respect to any
Eurodollar Rate Advances, the Requisite Lenders notify the Agent that either (i)
the Eurodollar Rate for any Interest Period for such Eurodollar Rate Advances is
at least two basis points less than the cost to such Lenders of obtaining  funds
in Dollars in the London interbank market in the amounts  substantially equal to
such Lenders'  Eurodollar  Rate Advances and for a period equal to such Interest
Period or (ii)  funding  is not  available  to such  Lenders  in such  market in
Dollars,  then the Agent shall  forthwith so notify the Borrower and the Lenders
and thereupon (A) each Eurodollar Rate Advance will  automatically,  on the last
day of the then  existing  Interest  Period  therefor,  convert into a Base Rate
Advance,  and (B) the  obligation  of the  Lenders  to make or  continue,  or to
convert  Advances into,  Eurodollar  Rate Advances shall be suspended  until the
Agent shall notify the Borrower and the Lenders that the  circumstances  causing
such suspension no longer exist.

     (e) Failure to Specify Duration.  If the Borrower fails,  prior to the date
the  Eurodollar  Rate for any Interest  Period is  determined  by the Agent,  to
specify the duration of any Interest  Period for any  Eurodollar  Rate Advances,
the Interest Period shall be one month.

     (f) Agent's Determination Conclusive. Each determination by the Agent of an
interest rate hereunder shall be conclusive and binding for all purposes, absent
manifest error.

     SECTION   2.10.   Voluntary   Conversion   of   Advances.   (a)  Notice  of
Continuance/Conversion. Subject to the provisions of Sections 2.09 and 2.14, the
Borrower   may  on  any   Business   Day,  by  giving  the  Agent  a  Notice  of
Continuance/Conversion  not later than  11:00  a.m.  (New York City time) on the
third preceding Business Day, (i) convert Base Rate Advances comprising the same
Borrowing into Eurodollar Rate Advances,  (ii) convert  Eurodollar Rate Advances
comprising  the same  Borrowing  into  Base  Rate  Advances  or  (iii)  continue
Eurodollar Rate Advances as Eurodollar  Rate Advances,  but (A) the Borrower may
convert a Eurodollar  Rate Advance into a Base Rate Advance only on the last day
of an Interest  Period for such  Eurodollar  Rate Advance,  (B) the Borrower may
continue a Eurodollar  Rate Advance as a Eurodollar  Rate Advance only as of the
last day of an Interest  Period for such  Eurodollar  Rate  Advance,  and (C) no
Advance may be converted into or continued as a



<PAGE>


                                       37

Eurodollar  Rate  Advance  at any time  when an Event of  Default  or  Potential
Default has occurred and is continuing.

     (b)   Telephonic    Notice.   In   lieu   of   delivering   a   Notice   of
Continuance/Conversion, the Borrower may give the Agent telephonic notice of any
proposed  conversion or continuance  by the time required under Section  2.10(a)
and in such event  shall  promptly  (but in no event  later than the date of the
requested   conversion  or  continuance)   deliver  a  confirmatory   Notice  of
Continuance/Conversion  to the Agent.  If the telephonic  request differs in any
respect  from  the  written   Notice  of   Continuance/Conversion   subsequently
furnished,  the telephonic  request shall govern as to the terms of such notice.
The Agent's  determination  of the  contents of any  telephonic  request  shall,
absent manifest error, be conclusive and binding on all parties hereto.

     (c)  Requirements.  Each  Notice of  Continuance/Conversion  or  telephonic
request shall specify (i) the date of the  continuance or  conversion,  (ii) the
Advances to be converted or continued and (iii) when Advances are converted into
or continued as Eurodollar  Rate Advances,  the duration of the Interest  Period
for such Advances.

     (d) Base Rate Advances.  Unless a Eurodollar Rate has been determined for a
particular Advance and applies to such Advance on a particular day in accordance
with the provisions hereof,  such Advance shall be a Base Rate Advance and shall
accrue interest at the rate then applicable to Base Rate Advances.

     SECTION  2.11.  Prepayments.  The  Borrower  from time to time may  prepay,
without  premium or  penalty,  the  outstanding  principal  amounts of  Advances
comprising part of the same  Borrowing,  in whole or ratably in part, so long as
(i) the Borrower  gives one  Business  Day's prior  written  notice to the Agent
stating the proposed date and aggregate principal amount of the prepayment, (ii)
each partial  prepayment is made in an aggregate  principal amount of $1,000,000
or an integral  multiple of $500,000 in excess thereof,  (iii) if any Eurodollar
Rate  Advance  is paid  prior to the last day of the  Interest  Period  for such
Advances, all unpaid interest accrued to the date of prepayment on the principal
amount prepaid and all Breakage Costs incurred as a result of the prepayment are
also paid,  and (iv) all unpaid  interest  accrued to the date of  prepayment is
paid concurrently with any prepayment in full. Notice of prepayment, once given,
shall be irrevocable,  and the amount of the prepayment  specified in the notice
shall accordingly be due and payable on the prepayment date specified therein.

     SECTION 2.12.  Funding Losses. If (i) any Eurodollar Rate Advance is repaid
or  converted  to a Base Rate  Advance  on any day other than the last day of an
Interest  Period for such  Eurodollar  Rate Advance  (whether as a result of any
optional prepayment, mandatory prepayment, payment upon acceleration,  mandatory
conversion or otherwise),  (ii) the Borrower fails to borrow any Eurodollar Rate
Advance  in  accordance  with a Notice  of  Borrowing  or a  telephonic  request
delivered to the Agent (whether as a result of the failure to satisfy any



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                                       38

applicable  conditions  or  otherwise),  (iii)  any  Base  Rate  Advance  is not
converted into a Eurodollar  Rate Advance or any Eurodollar  Rate Advance is not
continued  as  a  Eurodollar  Rate  Advance  in  accordance  with  a  Notice  of
Continuance/Conversion  or telephonic request delivered to the Agent (whether as
a result of the failure to satisfy any applicable  conditions or otherwise),  or
(iv) the Borrower fails to make any prepayment in accordance  with any notice of
prepayment  delivered  to the Agent,  the  Borrower  shall,  upon  demand by any
Lender,  reimburse such Lender for all costs and losses  incurred by such Lender
as a  result  of such  repayment,  prepayment  or  failure  ("BREAKAGE  COSTS"),
including  costs  and  losses  incurred  by a  Lender  as a  result  of  funding
arrangements  or contracts  entered into by such Lender to fund  Eurodollar Rate
Advances.  Breakage Costs shall be payable only if demanded within 90 days after
the end of the applicable Interest Period and shall be due 30 days after demand.
Demand shall be made by delivery to the Borrower and the Agent of a  certificate
of the  Lender  making  the  demand,  setting  forth in  reasonable  detail  the
calculation  of the Breakage  Costs for which demand is made.  Such  certificate
shall,  in the  absence of  manifest  error,  be  conclusive  and binding on the
Borrower.

     SECTION 2.13.  Increased Costs. (a) Increase in Cost. If, due to either (i)
the introduction of or any change (other than any change by way of imposition or
increase  of reserve  requirements,  in the case of  Eurodollar  Rate  Advances,
included in the Eurodollar Rate Reserve  Percentage) in or in the interpretation
of any law or  regulation or (ii) the  compliance  with any guideline or request
from any central bank or other Governmental Authority (whether or not having the
force of law),  there  shall be any  increase  in the cost to any  Lender or any
participant  under  Section  8.07(e) of agreeing  to make or making,  funding or
maintaining Eurodollar Rate Advances,  then the Borrower shall from time to time
pay to the Agent  for the  account  of such  Lender  or  participant  additional
amounts  sufficient to compensate  such Lender or participant for such increased
cost.  Such costs shall be payable only if demanded within six months after they
were  incurred  and shall be due 30 days after  demand.  Demand shall be made by
delivery  to the  Borrower  and the  Agent of a  certificate  of the  Lender  or
participant   making  the  demand,   setting  forth  in  reasonable  detail  the
calculation of the costs for which demand is made.  Such  certificate  shall, in
the absence of manifest error, be conclusive and binding on the Borrower.

     (b)  Increase  in  Capital  Requirements.  If any  Lender  determines  that
compliance  with any law or  regulation  or any  guideline  or request  from any
central bank or other Governmental Authority (whether or not having the force of
law)  affects or would  affect the amount of capital  required or expected to be
maintained by such Lender or any  corporation  controlling  such Lender and that
the amount of such capital is  increased by or based upon the  existence of such
Lender's  commitment  to lend or  funding  hereunder  and other  commitments  or
funding of this type,  then,  upon demand by such Lender,  the  Borrower  shall,
within 30 days after demand from time to time by such  Lender,  pay to the Agent
for the account of such Lender additional  amounts sufficient to compensate such
Lender or such  corporation  in the light of such  circumstances,  to the extent
that such Lender  determines  such  increase in capital to be  allocable  to the
existence of such Lender's  commitment to lend or funding hereunder.  Demand for
such payment may be made at any time but must be made in writing, with a copy to
the Agent. No



<PAGE>


                                       39

such compensation may be demanded as to increased capital maintained by a Lender
more than 12 months before  compensation was first demanded by such Lender under
this Section 2.13(b).  Demand for such compensation shall be made by delivery to
the Borrower  and the Agent of a  certificate  of the Lender  making the demand,
setting forth the amount  demanded.  Such  certificate  shall, in the absence of
manifest error, be conclusive and binding on the Borrower.

     (c) Replacement  Lenders and  Participants.  If, and on each occasion that,
(i) a  Lender  or a  participant  under  Section  8.07(e)  makes  a  demand  for
compensation  pursuant to Section 2.08,  Section 2.13(a) or Section 2.13(b) with
respect to  Eurodollar  Rate  Advances or (ii) a Lender is excused  from funding
Eurodollar  Rate Advances  pursuant to Section 2.14 or (iii) Taxes are required,
pursuant to Section  2.16(a),  to be deducted from or with respect to any amount
payable  to any  Lender or the  Agent,  the  Borrower  may in whole  permanently
replace  such  Lender  or  participant,  as the  case may be,  with an  Eligible
Assignee willing to become a Lender hereunder, on the following terms:

          (A) The replacement  Lender must be satisfactory to the LC Bank in its
     reasonable discretion;

          (B) The  Borrower  shall give the Agent and the Lender or  participant
     being  replaced at least five Business  Days' prior  written  notice of the
     replacement. The notice must be given within 180 days after the date of the
     event  specified in clause (i),  (ii) or (iii)  above,  as the case may be,
     pursuant to which such  replacement  is made, and must state the day (which
     must be a Business  Day not more than 10 days after the notice is given) on
     which the replacement will be effective.

          (C) On the  effective  date of the  replacement,  (1) the  replacement
     Lender  shall  purchase  the  Advances  owed to  such  replaced  Lender  or
     participant for a purchase price equal to the principal  amount thereof and
     all interest accrued thereon as of such effective date,  payable in cash on
     such  effective  date,  (2) an  Assignment  and  Acceptance  covering  such
     Advances shall be delivered to the  replacement  Lender by the Lender being
     replaced or by the participant  being replaced and the Lender from which it
     holds its  participation,  and (3) the Borrower  shall pay to the Agent for
     the  account of the  replaced  Lender or  participant  all  Breakage  Costs
     resulting  from  the  replacement  and  all  additional   interest,   fees,
     compensation, costs, losses, taxes, expense reimbursements, indemnities and
     other Obligations due to the Lender or participant being replaced.

          (D) The  Borrower  will  remain  liable  to each  replaced  Lender  or
     participant for all Obligations that survive the repayment of the Advances.

     SECTION  2.14.  Illegality.  Notwithstanding  any other  provision  of this
Agreement,  if any Lender shall notify the Agent that the introduction of or any
change in or in the  interpretation  of any law or regulation makes it unlawful,
or any central bank or other



<PAGE>


                                       40

Governmental  Authority  asserts  that it is  unlawful,  for any  Lender  or its
Eurodollar  Lending  Office  to  perform  its  obligations   hereunder  to  make
Eurodollar  Rate  Advances  or to  fund or  maintain  Eurodollar  Rate  Advances
hereunder,  then (i) the  obligation  of such Lender to make or continue,  or to
convert  Advances into,  Eurodollar  Rate Advances shall be suspended  until the
Agent shall notify the Borrower and the Lenders that the  circumstances  causing
such suspension no longer exist,  and (ii) the Borrower shall  forthwith  either
(A) prepay in full all Eurodollar Rate Advances of such Lender then outstanding,
together with interest accrued thereon and Breakage Costs related thereto or (B)
convert all Eurodollar Rate Advances of such Lender then  outstanding  into Base
Rate Advances and pay all interest accrued thereon to the date of conversion and
all Breakage Costs related thereto.

     SECTION 2.15. Payments and Computations.  (a) Payments.  The Borrower shall
make each payment  hereunder  and under the Notes not later than 11:00 a.m. (New
York City time) on the day payment is due,  in Dollars  received by the Agent at
its address  referred to in Section 8.02 in same day funds. Any payment due to a
Lender  shall be paid to the Agent for  account of such  Lender.  When the Agent
receives a payment for account of a Lender,  the Agent will promptly  cause like
funds to be  distributed  to such Lender for account of its  Applicable  Lending
Office.

     (b)  Charging of  Accounts.  If and to the extent any  payment  owed to the
Agent or any Lender is not made within three Business Days after the date it was
due  hereunder  or under  the Note  held by such  Lender,  the  Borrower  hereby
authorizes  the Agent and such  Lender to setoff  and  charge  any amount so due
against any deposit  account  maintained  by the Borrower with the Agent or such
Lender, whether or not the deposit therein is then due.

     (c)  Computations.  All computations of interest,  additional  interest and
fees  accruing  at a per annum  rate  shall be made on the  basis of the  actual
number of days (including the first day but excluding the last day) occurring in
the period for which such interest,  additional  interest or commitment fees are
payable and a year of 360 days.

     (d) Payment on Business  Day.  Whenever any payment  hereunder or under the
Notes is due on a day other than a Business  Day,  such payment shall be made on
the next  succeeding  Business Day, and such extension of time shall be included
in the computation of interest or fees. If, however,  such extension would cause
payment of interest on or principal of  Eurodollar  Rate  Advances to be made in
the  next  following  calendar  month,  such  payment  shall be made on the next
preceding Business Day.

     (e)  Presumption  of  Payment.  Unless the Agent  receives  notice from the
Borrower  prior to the date on which  any  payment  is due to the  Agent for the
benefit of the Lenders hereunder that the Borrower will not make such payment in
full,  the Agent may assume that the  Borrower  has made such payment in full to
the Agent on such date and the Agent  may,  in  reliance  upon such  assumption,
cause to be distributed to each Lender on such due date an



<PAGE>


                                       41

amount  equal to the  amount  then due such  Lender.  If and to the  extent  the
Borrower  does not make such payment to the Agent in full when due,  each Lender
shall repay to the Agent  forthwith  on demand such amount  distributed  to such
Lender,  together with  interest  thereon for each day from the date such amount
was  distributed  to such Lender until the Business Day such Lender  repays such
amount to the Agent,  at the  Federal  Funds Rate until the third  Business  Day
after such demand and thereafter at the rate applicable to Base Rate Advances.

     SECTION 2.16. Taxes. (a) Net Payments. Any and all payments by the Borrower
hereunder  or under  the  Notes  shall be made  free  and  clear of and  without
deduction for any and all present or future taxes, levies, imposts,  deductions,
charges or withholdings, and all liabilities with respect thereto, excluding, in
the case of each  Lender and the Agent,  taxes  imposed on its net  income,  and
franchise taxes imposed on it, by the jurisdiction  under the laws of which such
Lender  or the  Agent  (as  the  case  may  be) is  organized  or any  political
subdivision  thereof and, in the case of each Lender,  taxes  imposed on its net
income,  and franchise taxes imposed on it, by the jurisdiction of such Lender's
Applicable  Lending  Office  or any  political  subdivision  thereof  (all  such
non-excluded  taxes,  levies,  imposts,  deductions,  charges,  withholdings and
liabilities,  collectively,  are "TAXES"). If the Borrower is required by law to
deduct any Taxes from or in respect of any sum  payable  hereunder  or under any
Note to any Lender or the Agent,  (i) the sum payable  shall be increased as may
be necessary so that after making all required deductions  (including deductions
applicable  to  additional  sums payable under this Section 2.16) such Lender or
the Agent (as the case may be) receives an amount equal to the sum it would have
received if no such  deductions had been made, (ii) the Borrower shall make such
deductions,  and (iii) the  Borrower  shall pay the full amount  deducted to the
relevant  taxation  authority or other  authority in accordance  with applicable
law.

     (b) Payment of Other  Taxes.  In addition,  the Borrower  agrees to pay any
present or future  stamp or  documentary  taxes or any other  excise or property
taxes,  charges or similar levies which arise from any payment made hereunder or
under the Notes or from the execution, delivery or registration of, or otherwise
similarly with respect to, this Agreement,  the Notes or any other Loan Document
("OTHER TAXES").

     (c) Indemnification.  The Borrower will indemnify each Lender and the Agent
for the full amount of Taxes or Other Taxes  (including any Taxes or Other Taxes
imposed by any  jurisdiction on amounts payable under this Section 2.16) paid by
such  Lender  or the  Agent  (as the case may be) and any  liability  (including
penalties,  interest and expenses,  but excluding any liability arising from the
gross negligence or willful misconduct of such Person) arising therefrom or with
respect  thereto,  whether or not such Taxes or Other  Taxes were  correctly  or
legally  asserted.  Payment  under  this  indemnity  shall be due 30 days  after
written demand therefor.  Any Person entitled to indemnification by the Borrower
pursuant to this Section  2.16(c) shall give the Borrower  written notice of any
matter  which  such  Person  has  determined  has  given  rise  to  a  right  of
indemnification  hereunder  within 120 days after the earlier of (i) the date on
which such Person makes  payment of the Taxes or Other Taxes giving rise to such
right or



<PAGE>


                                       42

(ii) the date on which such Person  receives  written demand for payment of such
Taxes or Other  Taxes  from the  applicable  Governmental  Authority;  provided,
however,  that the failure by any Person timely to provide such notice (A) shall
not release the Borrower from any of its obligations  under this Section 2.16(c)
except to the extent the Borrower is materially  prejudiced by such failure,  or
such  notice was  provided  more than 240 days after the latest date such notice
could have been timely  given,  and (B) shall not relieve the Borrower  from any
other  obligation or liability  that it may have to such Person  otherwise  than
under this Section 2.16(c).

     (d) Evidence of  Payments.  Within 30 days after the date of any payment of
Taxes hereunder by the Borrower,  the Borrower will furnish to the Agent, at its
address  referred to in Section  8.02,  the original or a certified  copy of any
receipt issued to the Borrower evidencing payment thereof.

     (e) Withholding Tax Exemption.  If any Lender is a "foreign  person" within
the meaning of the Code,  such Lender shall deliver to the Agent (i) (A) if such
Lender  qualifies  for an  exemption  from,  or a reduction  of,  United  States
withholding tax under a tax treaty, a properly  completed and executed  Internal
Revenue  Service Form 1001 (or applicable  successor form) before the payment of
any interest in the first  calendar year and in each third  succeeding  calendar
year during which interest may be paid under this Agreement,  (B) if such Lender
qualifies for an exemption from United States  withholding tax for interest paid
under this Agreement  because it is  effectively  connected with a United States
trade or business of such Lender,  two properly completed and executed copies of
Internal  Revenue  Service Form 4224 (or applicable  successor  form) before the
payment of any interest is due in the first taxable year of such Lender,  and in
each succeeding  taxable year of such Lender,  during which interest may be paid
under  this  Agreement,  or (C) if such  Lender  is not a "bank" as  defined  in
Section  881(c)(3)(A)  of the Code, a properly  completed and executed  Internal
Revenue  Service Form W- 8 (or applicable  successor form) before the payment of
any  interest  is due in the  first  taxable  year of such  Lender,  and in each
succeeding taxable year of such Lender,  during which interest may be paid under
this  Agreement,   certifying  that  such  Lender  is  a  foreign   corporation,
partnership,  estate or trust,  together with a certificate of a duly authorized
officer  representing  that such Lender is not a "bank" for  purposes of Section
881(c) of the Code,  is not a 10%  shareholder  (within  the  meaning of Section
871(h)(3)(B)  of the  Code)  of the  Borrower  and is not a  controlled  foreign
corporation  related to the Borrower (within the meaning of Section 864(d)(4) of
the Code),  and (ii) such other form or forms as may be required  or  reasonably
requested by the Agent to establish or substantiate exemption from, or reduction
of,  United  States  withholding  tax under the Code or other laws of the United
States.  Each Lender  agrees to notify the Agent of any change in  circumstances
which would modify or render invalid any claimed exemption or reduction.  If any
form or document  referred to in this  subsection (e) requires the disclosure of
information,  other than  information  necessary  to compute the tax payable and
information  required on the date hereof by Internal  Revenue Service Form 1001,
4224  or W-8  (or  applicable  successor  forms)  (or  the  related  certificate
described above), that the Lender reasonably considers



<PAGE>


                                       43

to be  confidential,  the Lender  shall give notice  thereof to the Borrower and
shall not be  obligated  to include in such form or document  such  confidential
information.

     (f)  Withholding  Taxes.  Where any Lender  which is a "foreign  person" is
entitled  to a  reduction  in the  applicable  withholding  tax,  the  Agent may
withhold  from any interest  payment to such Lender an amount  equivalent to the
applicable  withholding  tax after taking into account  such  reduction.  If the
forms or other  documentation  required by Section  2.16(e) are not delivered to
the Agent,  then the Agent may withhold from any interest  payment to any Lender
not providing  such forms or other  documentation,  an amount  equivalent to the
applicable withholding tax.

     (g)  Indemnification  of the Agent. If the Internal  Revenue Service or any
authority of the United  States or other  jurisdiction  asserts a claim that the
Agent did not  properly  withhold tax from amounts paid to or for the account of
any Lender which is a "foreign  person"  (because the  appropriate  form was not
delivered,  was not properly  executed,  or because such Lender failed to notify
the Agent of a change in  circumstances  which  rendered the exemption  from, or
reduction of, withholding tax ineffective,  or for any other reason) such Lender
shall indemnify the Agent fully for all amounts paid, directly or indirectly, by
the Agent as tax or otherwise,  including penalties and interest,  together with
all  reasonable  expenses  incurred,  including  reasonable  legal  expenses and
allocated staff costs and any other reasonable out-of-pocket expenses.

     (h)  Subsequent  Lenders.  For  purposes  of this  Section  2.16,  the term
"Lender" shall include any assignee  pursuant to, and after  compliance with the
requirements   of,  Section  8.07;   provided  that  no  Person   acquiring  any
participation  pursuant  to  Section  8.07(e)  shall be  deemed a  "Lender"  for
purposes of this Section 2.16 unless and until the Borrower has been notified of
such  participation.  If  any  Lender  grants  participations  in  or  otherwise
transfers its rights under this Agreement,  the participant or transferee  shall
be bound by the terms of  Sections  2.16(e),  (f) and (g) as though it were such
Lender.

     (i) Refund, Deduction or Credit of Taxes. If any Lender determines,  in its
sole good faith discretion, that it has actually and finally realized, by reason
of a refund, deduction or credit of any Taxes paid or reimbursed by the Borrower
pursuant to  subsection  (a), (b) or (c) above in respect of payments  under the
Loan  Documents,  a current  monetary  benefit that it would  otherwise not have
obtained,  and that would result in the total  payments  under this Section 2.16
exceeding the amount needed to make such Lender whole,  such Lender shall pay to
the Borrower, with reasonable promptness following the date on which it actually
realizes  such  benefit,  an amount  equal to the  lesser of the  amount of such
benefit  or the  amount  of such  excess,  in each  case  net of all  reasonable
out-of-pocket expenses in securing such refund, deduction or credit.




<PAGE>


                                       44

     (j) Exclusion of Certain Taxes. Notwithstanding any other provision of this
Agreement, the Borrower shall not be required to pay any amount hereunder to any
Lender or the Agent in  respect  of any Taxes to the  extent  that,  on the date
hereof or any other  date such  Lender  became a party to (or  participant  with
respect to) this Agreement or (with respect to payments to an Applicable Lending
Office) the date such Lender  designated  such  Applicable  Lending  Office with
respect to this  Agreement or any Notes,  the obligation to withhold or pay such
Taxes existed or would exist upon the payment of an amount by the Borrower under
this Agreement or any Note;  provided,  however,  that this paragraph  shall not
apply (i) to any Lender or  Applicable  Lending  Office  that became a Lender or
Applicable Lending Office as a result of an assignment, transfer, or designation
made at the  request  of the  Borrower,  or (ii) to the  extent  that the amount
otherwise  payable by the  Borrower  pursuant to this Section 2.16 to any Lender
that is an assignee  pursuant to (and in compliance  with the  requirements  of)
Section 8.07 does not exceed the amount that would have been payable  under this
Section 2.16 to the assigning Lender in the absence of such assignment.

     (k) Additional  Cooperation.  Any Lender  claiming any amount pursuant this
Section 2.16 shall use reasonable efforts  (consistent with legal and regulatory
restrictions)  to file any certificate or document  reasonably  requested by the
Borrower  or to change the  jurisdiction  of such  Lender's  Applicable  Lending
Office if such a filing or change  would avoid the need for or reduce the amount
payable by the Borrower under this Section 2.16 and would not, in the good-faith
determination of such Lender, otherwise be disadvantageous to such Lender.

     SECTION 2.17.  Sharing of Payments.  If after the occurrence and during the
continuance of any Event of Default any Lender shall obtain any payment (whether
voluntary,  involuntary,  through  the  exercise  of any  right of  set-off,  or
otherwise) on account of any Advances owed to it in excess of its Pro Rata Share
of all such  payments,  such  Lender  shall  forthwith  purchase  from the other
Lenders such  participations  in the Advances made by them as shall be necessary
to cause such purchasing Lender to share the excess payment ratably with each of
them. If all or any portion of such excess payment is thereafter  recovered from
such purchasing Lender,  such purchase from the other Lenders shall be rescinded
and each such other  Lender  shall repay to the  purchasing  Lender the purchase
price to the extent of its allocable  share of such  recovery  together with its
allocable share of any interest  required to be paid by the purchasing Lender on
the amount so  recovered.  The  Borrower  agrees  that any Lender  purchasing  a
participation  from  another  Lender  pursuant to this  Section 2.17 may, to the
fullest extent permitted by law, exercise collection rights (including the right
of set-off) with respect to such  participation  as fully as if such Lender were
the direct creditor of the Borrower in the amount of such participation.





<PAGE>


                                       45

                                   ARTICLE III

                              CONDITIONS OF LENDING

     SECTION  3.01.  Conditions  Precedent on the Closing Date.  This  Agreement
shall become  effective and binding upon the parties  hereto only if each of the
following conditions precedent is satisfied no later than May 15, 1996:

          (a) Loan  Documents.  The Agent must have  received,  with  sufficient
     copies for each Lender:

               (i) this Agreement  duly executed by the Borrower,  the Agent and
          each of the Lenders;

               (ii) a promissory note, in  substantially  the form of Exhibit A,
          payable to the order of each  Lender in an original  principal  amount
          equal to such  Lender's Pro Rata Share of the  Facility  Amount on the
          Closing Date, duly executed by the Borrower;

               (iii) a guaranty,  in substantially the form of Exhibit C-1, duly
          executed  by each  Subsidiary  of the  Borrower  that  is not,  on the
          Closing Date, an Inactive Subsidiary;

               (iv) a pledge and security  agreement duly executed and delivered
          in  substantially  the  form of  Exhibit  C-2 by the  Borrower  and in
          substantially  the  form  of  Exhibit  C-3 by each  Subsidiary  of the
          Borrower that owns, as of the Closing Date, any shares of the stock of
          or other equity, ownership or profit interest in any Subsidiary of the
          Borrower,  together  with (A)  certificates  representing  the Pledged
          Shares  referred  to in  Schedule A to each such  Pledge and  Security
          Agreement,  other than  shares in respect  of  Inactive  Subsidiaries,
          accompanied  by  undated  stock  powers  executed  in  blank,  and (B)
          evidence  satisfactory to the Lenders that all other actions necessary
          or, in the opinion of the  Lenders,  desirable  to perfect and protect
          the security  interests created by the Pledge and Security  Agreements
          have been taken,  including  delivery to the Agent of all  instruments
          constituting   Collateral,   duly  endorsed,  and  delivery  of  UCC-1
          financing  statements duly executed by each Grantor under a Pledge and
          Security Agreement and in form sufficient for filing in all offices in
          which the Agent or any Lender may consider  filing to be  appropriate;
          and

               (v) the schedules to this Agreement and the Loan Documents.




<PAGE>


                                       46

          (b) Corporate Documents. The Agent must have received, with sufficient
     copies for each Lender:

               (i) copies of the articles or  certificate of  incorporation  and
          by-laws or other  governing  documents of each Loan Party as in effect
          on the Closing  Date,  certified as of the Closing Date by a Secretary
          or an Assistant Secretary of such Loan Party;

               (ii) copies of resolutions of the Board of Directors of each Loan
          Party approving the transactions  contemplated  hereby and authorizing
          the execution, delivery and performance of each Loan Document to which
          it is a party,  certified  as of the Closing Date by a Secretary or an
          Assistant Secretary of such Loan Party;

               (iii) a certificate of the Secretary or an Assistant Secretary of
          each  Loan  Party  certifying  the names  and true  signatures  of the
          officers of such Loan Party  authorized  to sign each Loan Document to
          which it is a party and,  in the case of the  Borrower,  to request an
          extension of credit hereunder; and

               (iv) a good standing  certificate for each Loan Party,  issued as
          of a recent date by the  Secretary of State of the state in which such
          Loan  Party is  incorporated  or formed  and each state in which it is
          qualified to do business.

          (c)  Governmental  Consents.  Each Loan Party must have  obtained  all
     consents,  approvals  and  authorizations  required  from any  Governmental
     Authority in connection with the execution, delivery and performance of its
     obligations under the Loan Documents.

          (d) No Injunction.  No law or regulation shall prohibit, and no order,
     judgment or decree of any Governmental Authority shall enjoin,  prohibit or
     restrain,  and no litigation  shall be pending or  threatened  which in the
     reasonable  judgment  of the  Agent  or  Requisite  Lenders  would  enjoin,
     prohibit or restrain (i) the making of the  Advances,  (ii) the issuance of
     any  Letter  of  Credit  or  (iii)  the  consummation  of the  transactions
     contemplated by the Loan Documents.

          (e) Other  Deliveries.  The Agent must have received,  with sufficient
     copies for each Lender:

               (i) a copy of the  Borrower's  financial  statements on Form 10-K
          for the year ended December 31, 1995, certified in a manner acceptable
          to the Requisite Lenders by KPMG Peat Marwick;




<PAGE>


                                       47

               (ii) a certificate dated as of the Closing Date and signed by the
          Chairman,  Chief  Executive  Officer  or  Authorized  Officer  of  the
          Borrower,   certifying   that,  as  of  the  Closing  Date,   (A)  the
          representations  and  warranties  contained  in  Article  IV  of  this
          Agreement  are true and  correct  on and as of the  Closing  Date,  as
          though  made  on and as of such  date,  (B) no  Event  of  Default  or
          Potential  Default has occurred and is continuing,  (C) since December
          31, 1995, there has been no Material  Adverse Change,  and (D) each of
          the other conditions  precedent set forth in this Article III has been
          satisfied;

               (iii) all documents  evidencing other necessary  corporate action
          and governmental  approvals, if any, with respect to this Agreement or
          any other Loan Document; and

               (iv)  such   other   certificates,   agreements,   documents   or
          instruments  as the  Agent or the  Requisite  Lenders  may  reasonably
          request in writing.

          (f) Legal  Opinions.  The Agent must have  received,  with  sufficient
     copies for each Lender:

               (i) an opinion of Hunton & Williams, counsel for the Borrower and
          the Guarantors, substantially in the form of Exhibit D-1 hereto and as
          to such other matters as any Lender  through the Agent may  reasonably
          request; and

               (ii)  an  opinion  of  special  local  counsel  for  each  of the
          Guarantors  substantially  in the form of Exhibit D-2 hereto and as to
          such  other  matters as any Lender  through  the Agent may  reasonably
          request.

          (g) Payout and Release  Agreement.  The Agent must have received (with
     sufficient  copies for each  Lender) a payout  and  release  agreement,  in
     substantially  the form of Exhibit E-3,  duly  executed by the Borrower and
     its Subsidiaries and the other parties identified therein.

          (h) Payment of Existing  Facility.  The first Borrowing must have been
     requested  by the  Borrower,  in an  amount  sufficient  to pay in full the
     "Amount  Outstanding"  set  forth  in  the  payout  and  release  agreement
     delivered  pursuant  to  Section  3.01(g),  the Agent  must  have  received
     irrevocable  instructions  from the  Borrower to apply  proceeds  from such
     Borrowing to pay such Amount  Outstanding  in full, and the Agent must have
     received an LC Application for all Letters of Credit  outstanding under the
     Existing  Facility  duly  executed by the  Borrower  and accepted by the LC
     Bank,  confirming  that all such Letters of Credit shall be deemed  applied
     for, issued and



<PAGE>


                                       48

     outstanding  under this  Agreement and that all  participation  obligations
     arising in respect thereof under the Existing Facility are discharged.

          (i) Payment of Fees and Expenses.  All fees and expense reimbursements
     due to the Agent and the Lenders  under this  Agreement  and the Fee Letter
     must have been paid.

          (j)  Section  3.02  Conditions.  Each of the  conditions  set forth in
     Section 3.02 must be satisfied.

     SECTION  3.02.  Conditions  Precedent  to Each  Extension  of  Credit.  The
obligation  of each Lender to make an Advance on the  occasion of any  Borrowing
and the  obligation  of the LC Bank to issue any  Letter of Credit is subject to
the conditions  precedent that on the date the Borrowing is to be made or Letter
of Credit is to be issued:

          (a) Notice. The Borrower shall have delivered a fully completed Notice
     of Borrowing or LC Application, as the case may be, dated such date.

          (b) Certification. Each of the following statements shall be true, and
     the Agent shall have  received for the account of each Lender a certificate
     dated such date and signed by an Authorized Officer, certifying that:

               (i) the representations and warranties contained in Article IV of
          this  Agreement  and  in  Article  III  of  the  Pledge  and  Security
          Agreements are correct on and as of such date, before and after giving
          effect to the  extension  of credit to be made  hereunder on such date
          and the application of the proceeds  therefrom,  as though made on and
          as of such date;

               (ii) no event has  occurred  and is  continuing,  or would result
          from such extension of credit or from the  application of the proceeds
          therefrom,  which  constitutes  an Event  of  Default  or a  Potential
          Default; and

               (iii) the  incurrence  of  indebtedness  by the  Borrower  in the
          amount of such  Borrowing  or for the LC Exposure  resulting  from the
          issuance  of such  Letter  of Credit is  permitted  under  each of the
          Subordinated  Debt  Indentures (and if after such Borrowing is made or
          Letter of Credit is issued the aggregate  principal amount of Advances
          and LC  Exposure  outstanding  under this  Agreement  is greater  than
          $154,000,000  (or such  other  amount as  determined  pursuant  to the
          Consent  Solicitation),  such  certificate  shall include  information
          sufficient to confirm  specifically  that such incurrence is permitted
          under  Section  4.9 of the 1994  Subordinated  Debt  Indenture,  under
          Section 3.9 of the 1995



<PAGE>


                                       49

          Subordinated Debt Indenture and, upon the effectiveness thereof, under
          of the terms of the 1996 Subordinated Debt Indenture).

The delivery of a Notice of Borrowing or LC  Application  and the  acceptance by
the  Borrower  of the  proceeds of a  Borrowing  or of a Letter of Credit  shall
constitute a representation  and warranty by the Borrower that, on the date such
Advance  is made or Letter of Credit is issued,  the  foregoing  statements  are
true.


                                   ARTICLE IV

                         REPRESENTATIONS AND WARRANTIES

     SECTION 4.01.  Representations and Warranties of the Borrower. The Borrower
represents and warrants as follows:

          (a) Organization. Each Loan Party is a corporation or partnership duly
     organized,  validly existing and in good standing (except where the failure
     of one or more Loan  Parties,  other  than the  Borrower  and its  Material
     Subsidiaries,  to be in good  standing  after the  Closing  Date  could not
     reasonably  be expected to result in a Material  Adverse  Change) under the
     laws of the  jurisdiction in which it is organized and is duly qualified to
     do business in each  jurisdiction  where the character of its properties or
     the nature of its activities makes such qualification necessary.

          (b)  Power  and  Authority.  Each  Loan  Party  has the  corporate  or
     partnership  power (i) to carry on its business as now being  conducted and
     as proposed  to be  conducted  by it, (ii) to execute,  deliver and perform
     each Loan  Document  to which it is a party,  and (iii) to take all  action
     necessary  to  consummate  the  transactions  contemplated  under each Loan
     Document to which it is a party.

          (c) Due Authorization. The execution, delivery and performance by each
     Loan  Party of each Loan  Document  to which it is or will be a party  have
     been duly authorized by all necessary action of its board of directors (or,
     in case of a partnership, of its governing authority) and do not contravene
     (i)  its  certificate  or  articles  of  incorporation  (or,  in  case of a
     partnership,  governing agreements) or (ii) any law or any indenture, lease
     or written  agreement  binding on or  affecting  it and do not result in or
     require the  creation of any Lien  (other than  pursuant to the  Collateral
     Documents) upon any of its property or assets.

          (d) Subsidiaries and Ownership of Capital Stock. Set forth in Schedule
     4.01(d), as such schedule may be amended pursuant to Section 5.02(c)(xiii),
     is a  complete  list,  as of the  latest of (i) the date  hereof,  (ii) the
     Closing Date, (iii) the date of



<PAGE>


                                       50

     delivery to the Agent of the then most recently  required  amended Schedule
     4.01(d) pursuant to Section 5.02(c)(xiii), and (iv) in the event an amended
     Schedule  4.01(d) is not timely  delivered to the Agent pursuant to Section
     5.02(c)(xiii),  the date of the last day on  which  such  amended  schedule
     could have been timely delivered,  of all direct and indirect  Subsidiaries
     of the  Borrower.  Such  schedules  also set forth the number of issued and
     authorized  shares of each  class of  capital  stock of and  other  equity,
     ownership or profit  interests in such  Subsidiary  and the identity of the
     holders  of all such  shares.  Except  as set forth in such  schedules,  no
     capital stock of or other equity,  ownership or profit interest in any such
     Subsidiary  is subject to  issuance  or sale under any  warrant,  option or
     purchase right,  conversion or exchange right, call, commitment or claim of
     any right,  title or interest therein or thereto.  The outstanding  capital
     stock of each such Subsidiary is duly  authorized,  validly  issued,  fully
     paid and  nonassessable  and is not "margin stock," as that term is defined
     in  Regulations  G, T, U and X of the  Board of  Governors  of the  Federal
     Reserve System.

          (e) Health Care  Facilities.  Set forth in Schedule  4.01(e),  as such
     schedule  may be amended  pursuant to Section  5.02(c)(xiv),  is a complete
     list, as of the latest of (i) the date hereof, (ii) the Closing Date, (iii)
     the  date of  delivery  to the  Agent of the then  most  recently  required
     amended Schedule  4.01(e) pursuant to Section  5.02(c)(xiv) and (iv) in the
     event an amended  Schedule  4.01(e) is not  timely  delivered  to the Agent
     pursuant  to Section  5.02(c)(xiv),  the date of the last day on which such
     amended  schedule  could have been  timely  delivered,  of each Health Care
     Facility  owned,  leased,  managed  or  operated  by  the  Borrower  or any
     Subsidiary of the Borrower which is a skilled nursing  facility,  hospital,
     assisted living facility or retirement  facility,  and Schedule 4.01(e), as
     it may be so amended,  specifically  sets forth,  with respect to each such
     Health  Care  Facility,  whether  such  Health  Care  Facility  is a leased
     facility or an owned facility.

          (f)  Governmental  Approval.  No  authorization  or  approval or other
     action by, and no notice to or filing with, any  Governmental  Authority is
     required for the due  execution,  delivery and  performance  by each of the
     Loan Parties of any Loan Document to which it is or will be a party, except
     for those listed on Schedule 4.01(f),  each of which has been duly obtained
     or made and is in full force and effect.

          (g) Binding and  Enforceable.  This  Agreement is, and each other Loan
     Document to which any Loan Party will be a party is or when  delivered will
     be, legal,  valid and binding  obligations of the Loan Parties  enforceable
     against the Loan Parties in accordance with their respective terms, subject
     to laws generally affecting the enforcement of creditors' rights.

          (h) Financial  Information.  The  consolidated  balance  sheets of the
     Borrower and its Subsidiaries as at December 31, 1994 and December 31, 1995
     and their



<PAGE>


                                       51

     related income and cash flow  statements  for the periods then ended,  each
     other financial statement of the Borrower and its Subsidiaries delivered to
     the Agent or Lenders on or prior to the Closing  Date,  and each  financial
     statement delivered to the Lenders pursuant to Section 5.02(c), as and when
     delivered  to  the  Agent  or  Lenders  fairly  presents  the  consolidated
     financial  condition of the Borrower  and its  Subsidiaries  as at the date
     thereof and the  consolidated  results of their  operations  for the period
     then ended, all in accordance with GAAP consistently applied.

          (i) Material  Adverse Change.  Since December 31, 1995, there has been
     no Material Adverse Change.

          (j)  Compliance.  Except as permitted  pursuant to Section 5.02(k) and
     Section 5.03(n),  each Loan Party is in compliance in all material respects
     with all material applicable laws, rules, regulations and orders.

          (k)  Litigation.  Set forth on Schedule  4.01(k) is a list,  as of the
     Closing Date, of all pending or overtly  threatened  actions or proceedings
     affecting  any  Loan  Party  before  any  court,   governmental  agency  or
     arbitrator,  and all loss  contingencies  within the meaning of GAAP, other
     than any action or  proceeding  that would not subject the Loan  Parties to
     liability  in excess  of  $5,000,000  individually  or  $30,000,000  in the
     aggregate in the case of two or more related actions or proceedings. Except
     as  identified  on  Schedule  4.01(k),  there  is  no  pending  or  overtly
     threatened action or proceeding  affecting any Loan Party before any court,
     governmental  agency or arbitrator,  which would, if adversely  determined,
     result in a Material Adverse Change or which relates to or could reasonably
     be expected to affect the legality,  validity or enforceability of any Loan
     Document.

          (l) No Conflict. The execution,  delivery and performance by each Loan
     Party of each of the Loan  Documents to which it is a party do not and will
     not (i)  conflict  with,  result  in a breach  of, or  constitute  (with or
     without  notice  or the  lapse  of  time  or  both) a  default  under,  any
     instrument,  lease,  indenture,  agreement or other contractual  obligation
     issued by any Loan Party or  enforceable  against it or any of its property
     or assets,  except  under  immaterial  agreements  for supplies or services
     which are readily replaceable without any adverse effect on such Loan Party
     or its business or (ii) require any approval of its stockholders.

          (m)  No  Default.  No  event  has  occurred  and is  continuing  which
     constitutes an Event of Default or a Potential Default.

          (n) Payment of Taxes. Each Loan Party has filed all federal income tax
     returns and all other tax  returns  required to be filed by it and has paid
     all taxes and



<PAGE>


                                       52

     assessments  payable by it which have become due except to the extent being
     contested in accordance with the provisions of Section 5.02(h).

          (o) Margin Regulations. No proceeds of any Advance or Letter of Credit
     will be used for any purpose that  requires any Lender to deliver or obtain
     any certification  under, or to comply with any margin requirement or other
     provision  of,  Regulations  G, T, U or X of the Board of  Governors of the
     Federal Reserve System.

          (p) Conduct of  Business.  The Borrower is a holding  company  engaged
     primarily  in the business of (i) holding  stock of and claims  against its
     Subsidiaries;  (ii) managing and developing corporate opportunities related
     to the business of its Subsidiaries;  (iii)  administering and coordinating
     the overall  operating  business of its Subsidiaries and other  investments
     permitted  hereunder;  (iv)  obtaining of financing for the business of its
     Subsidiaries; and (v) holding interests in and title to assets and property
     necessary or appropriate  to conduct such business in the ordinary  course.
     The Subsidiaries of the Borrower (other than any such Subsidiaries  engaged
     in the insurance  business as permitted  under Section  5.03(c)(xiii))  are
     principally  engaged in the  business of a  Healthcare  Company,  including
     making   Investments  in   Subsidiaries  or  Persons  that  are  Healthcare
     Companies.

          (q) Health Care Permits.  (i) Except as permitted  pursuant to Section
     5.02(k) and Section 5.03(n), (A) each Loan Party now has, and has no reason
     to  believe it will not be able to  maintain  in  effect,  all Health  Care
     Permits  necessary  for the lawful  conduct of its  business or  operations
     wherever  now  conducted  and as planned  to be  conducted,  including  the
     ownership  and  operation  of its Health Care  Facilities,  pursuant to all
     applicable laws and all  requirements of  Governmental  Authorities  having
     jurisdiction  over such Loan Party or over any part of its operations;  (B)
     all such Health Care Permits are in full force and effect and have not been
     amended  or  otherwise  modified  (except  for  modifications  which do not
     constitute  and  cannot  reasonably  be  expected  to result in a  Material
     Adverse Change),  rescinded,  revoked or assigned;  (C) no Loan Party is in
     default in any  material  respect  under,  or in  violation in any material
     respect of, any such Health Care Permit (and to the best  knowledge  of the
     Borrower,  no event has occurred,  and no condition exists, which, with the
     giving of notice or passage  of time or both,  would  constitute  a default
     thereunder  or violation  thereof)  that has caused or could  reasonably be
     expected to cause the loss of any such Health Care Permit;  (D) neither the
     Borrower nor any other Loan Party has received any notice of any  violation
     of  applicable  laws which has caused or could  reasonably  be  expected to
     cause any such Health Care Permit to be modified (except for  modifications
     not amounting to a Material Adverse Change),  rescinded or revoked;  (E) to
     the best  knowledge  of the  Borrower,  no  condition  exists  or event has
     occurred  which could  reasonably be expected to result in the  suspension,
     revocation,  impairment,  forfeiture  or  non-renewal  of such  Health Care
     Permit;  and (F) the  continuation,  validity and effectiveness of all such
     Health



<PAGE>


                                       53

     Care Permits will not in any way be adversely  affected by the transactions
     contemplated  by this  Agreement,  except that the exercise by the Agent of
     its rights and  remedies  in  respect of the  Collateral  is subject to the
     licensing power of health care regulatory authorities.

        (ii)  Except as  permitted  pursuant  to  Section  5.02(k)  and  Section
     5.03(n), all Health Care Facilities owned,  leased,  managed or operated by
     any Loan Party are entitled to participate  in, and receive  payment under,
     the appropriate Medicare,  Medicaid and related reimbursement  programs and
     in any similar state or local  government-sponsored  program, to the extent
     that such Loan Party has decided to  participate in any such state or local
     program,  and to receive  reimbursement  from private and commercial payors
     and health maintenance organizations to the extent applicable thereto.

          (r) Environmental Matters. Except as set forth in Schedule 4.01(r), as
     it may  from  time to time be  amended  by the  Borrower,  (i) no  Material
     Environmental  Claim is  pending  or,  to the  knowledge  of the  Borrower,
     overtly threatened against the Borrower or any of its Subsidiaries,  or any
     property  or  assets  currently  owned or leased  thereby,  and (ii) to the
     knowledge of the Borrower,  no Material  Environmental  Claim is pending or
     overtly  threatened  against  any  property or assets  previously  owned or
     leased by the Borrower or any of its  Subsidiaries.  Except as set forth in
     Schedule 4.01(r),  and except in respect of matters that, in the aggregate,
     are  not  and  cannot  reasonably  be  expected  to  result  in a  Material
     Environmental  Claim or a Material  Adverse  Change,  the operations of the
     Borrower  and its  Subsidiaries  comply and have  complied in all  material
     respects with all applicable Environmental Laws.

          (s) ERISA  Compliance.  (i) Each Plan is in compliance in all material
     respects  with the  applicable  provisions  of  ERISA,  the Code and  other
     applicable Federal or state law.

        (ii) Each  Pension  Plan which is  intended  to be  tax-qualified  under
     Section 401(a) of the Code has been  determined by the IRS to qualify under
     Section  401 of the  Code,  and the  trusts  created  thereunder  have been
     determined to be exempt from tax under the provisions of Section 501 of the
     Code, and to the best knowledge of the Borrower  nothing has occurred which
     would cause the loss of such qualification or tax-exempt status.

        (iii) Except as set forth in Schedule  4.01(s),  (A) none of the Pension
     Plans  which is  subject  to Title IV of ERISA  has any  material  Unfunded
     Pension Liability as to which the Borrower or any ERISA Affiliate is or may
     be  liable;  (B)  neither  the  Borrower  nor any ERISA  Affiliate  has nor
     reasonably  expects  to incur  any  material  liability  (and no event  has
     occurred  which,  with the giving of notice  under  Section  4219 of ERISA,
     would  result in such  material  liability)  under  Section 4201 or 4243 of
     ERISA with respect to any



<PAGE>


                                       54

     Multiemployer  Plan;  (C) no  ERISA  Event  has  occurred  or,  to the best
     knowledge of the Borrower, is reasonably expected to occur; and (D) neither
     the Borrower nor any ERISA  Affiliate has maintained any Welfare Plan which
     provides,  or  requires  the  Borrower or any ERISA  Affiliate  to provide,
     medical or other welfare benefits to any participant  after the termination
     of such participant's  employment with the Borrower or such ERISA Affiliate
     (except  to the extent  required  by the  provisions  of Part 6 of Title I,
     Subtitle B of ERISA or Sections 162(k) and 4980B of the Code).

        (iv) Each  Welfare  Plan which is a "group  health  plan," as defined in
     Section 607(1) of ERISA, has been operated in compliance with provisions of
     Part 6 of Title I of ERISA and Sections 162(k) and 4980B of the Code at all
     times.

        (v) Neither the Borrower nor any ERISA  Affiliate has engaged,  directly
     or indirectly,  in a prohibited  transaction (as defined in Section 4975 of
     the Code or Section 406 of ERISA) for which no statutory or  administrative
     exemption is  applicable in connection  with any Plan the  consequences  of
     which, in the aggregate, constitute or can reasonably be expected to result
     in a Material Adverse Change.

          (t) Title to Assets. Each Loan Party has title, as of the date of each
     of its financial  statements  delivered  hereunder,  to all of its material
     assets reflected therein, except assets leased to it under a Capital Lease,
     free and clear of all Liens except Permitted Liens.

          (u)  Collateral  Documents.  On and after the Closing  Date and,  with
     respect to perfection upon the filing of the financing statements delivered
     pursuant to Section 3.01(a), the provisions of each Collateral Document are
     effective to create in favor of the Agent,  for the benefit of the Lenders,
     legal,  valid and  perfected  security  interests  in all right,  title and
     interest in the Collateral described therein, enforceable against each Loan
     Party that owns an interest in such  Collateral,  subject to laws generally
     affecting the enforcement of creditors' rights.

          (v) Senior  Indebtedness.  This Agreement is a "Bank Credit Agreement"
     within the meaning of the 1992 Convertible  Subordinated Debt Indenture and
     the 1993 Convertible  Subordinated Debt Indenture and a "Credit  Agreement"
     within  the  meaning  of the 1994  Subordinated  Debt  Indenture,  the 1995
     Subordinated Debt Indenture and, upon the effectiveness  thereof,  the 1996
     Subordinated Debt Indenture.  The Obligations when incurred will be "Senior
     Indebtedness" within the meaning of the Subordinated Debt Indentures.





<PAGE>


                                       55

                                    ARTICLE V

                            COVENANTS OF THE BORROWER

     SECTION  5.01.  Financial  Covenants.  So  long as any  Obligation  remains
unpaid,  any Letter of Credit remains  outstanding or any Lender is obligated to
extend credit  hereunder,  unless the  Requisite  Lenders  otherwise  consent in
writing the Borrower will:

          (a)  Maximum  Debt/EBITDAR  Ratio.   Maintain  a  Debt/EBITDAR  Ratio,
     determined  as of the last day of each  Quarter,  at an amount not  greater
     than that set forth for such Quarter below:


            Quarter(s) Ended                        Debt/EBITDAR Ratio
            ----------------                        ------------------
             March 31, 1996                                6.00
             June 30, 1996                                 6.50
           September 30, 1996                              6.50
           December 31, 1996                               6.00
             March 31, 1997                                5.75
             June 30, 1997                                 5.75
           September 30, 1997                              5.50
           December 31, 1997                               5.35
             March 31, 1998                                5.25
             June 30, 1998                                 5.25
           September 30, 1998                              5.00
           December 31, 1998                               4.75
         In 1999 and thereafter                            4.50


          (b) Minimum Cash Flow  Coverage  Ratio.  Maintain a Cash Flow Coverage
     Ratio, determined as of the last day of each Quarter, at an amount not less
     than that set forth for such Quarter below:




<PAGE>


                                       56


                                                        Cash Flow
            Quarter(s) Ended                          Coverage Ratio
            ----------------                          --------------
                In 1996                                    1.10
             March 31, 1997                                1.25
             June 30, 1997                                 1.25
           September 30, 1997                              1.50
           December 31, 1997                               1.50
             March 31, 1998                                1.60
             June 30, 1998                                 1.60
           September 30, 1998                              1.70
           December 31, 1998                               1.70
         In 1999 and thereafter                            2.00


          (c) Minimum  Interest&Rent  Coverage Ratio.  Maintain an Interest&Rent
     Coverage Ratio, determined as of the last day of each Quarter, at an amount
     not less than that set forth for such Quarter below:

                                                      Interest & Rent
            Quarter(s) Ended                          Coverage Ratio
            ----------------                          --------------
                In 1996                                    1.50
                In 1997                                    1.75
                In 1998                                    2.10
                In 1999                                    2.50
         In 2000 and thereafter                            3.00

          (d)  Minimum  Net  Worth.  Maintain  Adjusted   Stockholders'  Equity,
     determined as of the last day of each  Quarter,  at an amount not less than
     the then Minimum Net Worth.

     SECTION 5.02.  Affirmative  Covenants.  So long as any  Obligation  remains
unpaid,  any Letter of Credit remains  outstanding or any Lender is obligated to
extend credit  hereunder,  unless the  Requisite  Lenders  otherwise  consent in
writing the Borrower will, and will cause its Subsidiaries to:




<PAGE>


                                       57

          (a)  Compliance  with Laws.  Comply in all material  respects with all
     applicable laws, rules, regulations and orders.

          (b)  Inspection of Property and Books and Records.  Except in the case
     of Inactive Subsidiaries,  (i) maintain proper books of record and account,
     in  which  full,   true  and  correct   entries  in  conformity  with  GAAP
     consistently  applied  shall  be made  of all  financial  transactions  and
     matters involving its assets and business,  and (ii) permit representatives
     of the Agent or any Lender to visit and inspect any of its  properties,  to
     examine its  corporate,  financial  and  operating  records and make copies
     thereof or abstracts  therefrom,  and to discuss its affairs,  finances and
     accounts with its officers,  employees and independent public  accountants,
     all at the expense of the Borrower, in the case of visits or inspections by
     the Agent and,  if an Event of Default is then  continuing,  by any Lender,
     and at such  reasonable  times during normal business hours and as often as
     may  be  reasonably  requested,  upon  reasonable  advance  notice  to  the
     Borrower,  except  that when an Event of  Default  exists  the Agent or any
     Lender may take any such  action at any time during  business  hours and on
     same-day notice.

          (c) Reporting Requirements. Furnish to the Lenders:

               (i) as soon as  available  and in any event  within 50 days after
          the end of each of the first three  Quarters in each fiscal year,  the
          consolidated  balance sheet of the Borrower and its Subsidiaries as at
          the end of such  Quarter and their  consolidated  income and cash flow
          statements for such Quarter and for the fiscal year to date, certified
          by an Authorized Officer;

               (ii) as soon as  available  and in any event within 95 days after
          the end of each  fiscal  year of the  Borrower,  a copy of the  annual
          report  on  Form  10-K  for  such  year  for  the   Borrower  and  its
          Subsidiaries,  containing financial statements for such year certified
          in a manner  acceptable to the Requisite  Lenders by KPMG Peat Marwick
          or other independent  public  accountants  acceptable to the Requisite
          Lenders;

               (iii) as soon as  possible  and in any event  within 10  Business
          Days after becoming aware of any (A) Change of Control or (B) Event of
          Default or Potential Default continuing on the date of such statement,
          a  statement  of an  Authorized  Officer or the office of the  General
          Counsel  of the  Borrower  setting  forth  details  of such  Change of
          Control or Event of Default or Potential Default,  as the case may be,
          and the action  which the Borrower has taken and proposes to take with
          respect thereto;




<PAGE>


                                       58

               (iv) promptly after the filing thereof, copies of all reports and
          all  registration  statements for the sale of newly issued stock filed
          with the Securities and Exchange Commission or any national securities
          exchange;

               (v) notice  when,  but in no event later than ten days after,  it
          becomes aware of any Material  Environmental  Claim or the presence of
          any  Hazardous  Material in, on or under any of its  property  that is
          likely   to   prohibit   or   restrict   materially   the   occupancy,
          transferability or use of such property under any Environmental Laws;

               (vi) notice upon, but in no event later than ten days after,  the
          occurrence  of any ERISA  Event  affecting  the  Borrower or any ERISA
          Affiliate, together with (A) a copy of any notice with respect to such
          ERISA Event that may be required to be filed with the PBGC and (B) any
          notice  delivered by the PBGC to the  Borrower or any ERISA  Affiliate
          with respect to such ERISA Event;

               (vii) concurrently with the delivery of the financial  statements
          referred to in clause (i) and (ii) above, a compliance  certificate of
          an  Authorized  Officer in  substantially  the form of Exhibit E-1 (A)
          stating that, to the best of such officer's  knowledge,  the Borrower,
          during such  period,  has  observed or  performed  all  covenants  and
          agreements and satisfied all conditions  required under this Agreement
          to be  observed,  performed  or satisfied by it, and that such officer
          has obtained no knowledge of any Event of Default or Potential Default
          except as  specified  in such  certificate,  (B) showing in detail the
          calculations supporting such statement in respect of Section 5.01, and
          (C) setting forth, and showing in detail the calculations  supporting,
          the Pricing Ratio  determined as of the most recent  Pricing Test Date
          in the period covered by such certificate;

               (viii)  within 50 days after the end of each  Quarter,  a Pricing
          Certificate  setting  forth the Pricing  Ratio as calculated as of the
          last day of such Quarter;

               (ix) prior to the  consummation  of any  acquisition  of a Health
          Care Company or Health Care  Facility for aggregate  consideration  of
          $50,000,000  or  more,  a  term  sheet  describing  such  acquisition;
          provided  that the  Borrower  shall not be  required to deliver a term
          sheet  hereunder  with  respect  to the  First  American  Merger;  and
          promptly, and in any case within 10 Business Days of any such request,
          any additional  information  relating to such  acquisition  reasonably
          requested by the Agent or the Requisite Lenders;

               (x) prior to the consummation of any acquisition of a Health Care
          Company or Health Care Facility for which a pro forma  calculation  of
          the

<PAGE>


                                       59

          Interest&Rent Coverage Ratio is required under Section 5.03(c)(xi),  a
          term sheet describing such acquisition, and such pro forma calculation
          of the  Interest&Rent  Coverage Ratio;  and promptly,  and in any case
          within  10  Business  Days  of  any  such  request,   any   additional
          information  relating to such acquisition  reasonably requested by the
          Agent or the Requisite Lenders;

               (xi)  within  10  Business  Days  after the  consummation  of any
          acquisition  of a Health  Care  Company or Health  Care  Facility  for
          aggregate  consideration  of less than $50,000,000 and for which a pro
          forma calculation of the Interest&Rent  Coverage Ratio is not required
          under Section  5.03(c)(xi),  a term sheet describing such acquisition;
          and  promptly,  and in any case  within 10  Business  Days of any such
          request,  any  additional  information  relating  to such  acquisition
          reasonably requested by the Agent or the Requisite Lenders;

               (xii) as soon as possible,  and in any event within five Business
          Days (A) after becoming aware thereof, notice of the occurrence of any
          event that is or would (with the passage of time, notice or both) be a
          default  under or a violation of any Health Care Permit  necessary for
          the lawful  conduct of the business or  operations  of any Loan Party,
          including the  ownership and operation of its Health Care  Facilities,
          and that is or can  reasonably  be  expected  to result in a  Material
          Adverse Change; (B) after receipt thereof, any notice of any violation
          of  applicable  laws that  causes or could  reasonably  be expected to
          cause  any  such  Health  Care  Permit  to  be  modified  (except  for
          modifications  which  do  not  constitute  and  cannot  reasonably  be
          expected  to  result  in a  Material  Adverse  Change),  rescinded  or
          revoked;  and  (C)  after  becoming  aware  thereof,   notice  of  the
          occurrence of any event that constitutes or can reasonably be expected
          to result in a Material Adverse Change;

               (xiii) concurrently with the delivery of the financial statements
          referred to in clause (i) and (ii) above, Schedule 4.01(d), as amended
          to reflect the formation, acquisition or disposition of any Subsidiary
          of the Borrower during the Quarter then ended;

               (xiv) concurrently with the delivery of the financial  statements
          referred to in clause (i) and (ii) above, Schedule 4.01(e), as amended
          to reflect the  acquisition or disposition of any Health Care Facility
          which  is  a  skilled  nursing  facility,  hospital,  assisted  living
          facility or retirement facility during the Quarter then ended;

               (xv) at  least  10  Business  Days  prior  to  entering  into any
          Receivables Sale Program, a written  description of the material terms
          and  provider  of  such  program,   the  method  of  determining   the
          Purchasers'  Aggregate

<PAGE>


                                       60

          Net Investment and the  Receivables  Program  Charges of such program,
          the maximum amount of the Purchasers'  Aggregate Net Investment  under
          such program, and the amount and due date of any Facility Reduction or
          repayment required under Section 2.06(e) in respect of such program;

               (xvi)  no later  than the  effective  date of any  change  in the
          Purchasers'  Aggregate  Net  Investment  under  any  Receivables  Sale
          Program,  written  notice of the  amount  and  effective  date of such
          change  and  the  amount  of any  Facility  Reduction  and  prepayment
          required under Section 2.06(e) after giving effect to such change; and

               (xvii)  such  other  information   respecting  the  condition  or
          operations,  financial  or  otherwise,  of the  Borrower or any of its
          Subsidiaries as the Agent or any Lender through the Agent from time to
          time may reasonably request.

          (d)  Preservation  of  Corporate  Existence,  Etc.  Subject to Section
     5.03(i) and except in the case of Inactive  Subsidiaries,  (i) preserve and
     maintain in full force and effect its  corporate or  partnership  existence
     and  good  standing  under  the  laws  of  its  State  or  jurisdiction  of
     incorporation or organization and all rights,  privileges,  qualifications,
     permits,  licenses  and  franchises  necessary  or  desirable in the normal
     conduct  of its  business  (provided  that the  failure  at any one time to
     maintain  Health  Care  Permits  with  respect  to any  three  Health  Care
     Facilities owned or leased by any one or more  Subsidiaries of the Borrower
     shall not  constitute  a failure to comply with this  Section  5.02(d)(i)),
     (ii) use its reasonable efforts, in the ordinary course and consistent with
     past  practice,  to preserve  its  business  organization  and preserve the
     goodwill and business of the customers, suppliers and others doing business
     with it,  and (iii)  preserve  or renew all of its  registered  trademarks,
     trade names and services marks, the  non-preservation  of which constitutes
     or could reasonably be expected to result in a Material Adverse Change.

          (e) New  Subsidiaries.  Promptly,  and in any event within 10 Business
     Days,  of (i) the  formation  or  acquisition  of a new  Subsidiary  of the
     Borrower  (other than an Inactive  Subsidiary),  (ii) the date a Subsidiary
     ceases  to be an  Inactive  Subsidiary,  or (iii)  the  date on  which  any
     Subsidiary of the Borrower that has not executed and delivered a Pledge and
     Security  Agreement  acquires  any stock of or other  equity,  ownership or
     profit  interest in, or debt or liability  of or other claim  against,  any
     other Subsidiary,  (A) notify the Agent of such event; (B) amend Schedule A
     of the relevant  Pledge and Security  Agreement as  appropriate in light of
     such event;  (C) cause such  Subsidiary to execute and deliver a Pledge and
     Security  Agreement  in  substantially  the  form  of  Exhibit  C-3 and all
     financing statements and other documents required thereunder or appropriate
     to perfect the security interest created thereby;  (D) deliver to the Agent
     all  stock  certificates  and  other  instruments  added to the  Collateral
     thereby,  accompanied  by

<PAGE>


                                       61

     an undated  stock power or  transfer  document  executed in blank;  and (E)
     cause such  Subsidiary to deliver an executed  counterpart  of the Guaranty
     and  deliver  to the  Agent a  Guarantor  Confirmation  setting  forth  the
     Guarantor Liability Limit as to such Subsidiary.

          (f)  Maintenance  of Property.  Maintain and preserve all its property
     which is  necessary  for use in its  business  in good  working  order  and
     condition,  except  ordinary  wear and tear and except as  permitted  under
     Section  5.03(b),  and use the  standard of care typical in the industry in
     the operation of the Health Care Facilities.

          (g) Insurance. Maintain insurance with financially sound and reputable
     insurers with respect to its properties and business against loss or damage
     of the kinds customarily  insured against by Persons engaged in the same or
     similar  business,  of such types and in such  amounts  as are  customarily
     carried  under  similar  circumstances  by such  other  Persons,  including
     workers' compensation insurance, public liability and property and casualty
     insurance, except that (i) the Borrower shall be permitted to maintain self
     insurance  with respect to health care  benefits  provided to employees and
     with  respect to workers'  compensation  insurance  so long as the Borrower
     also maintains,  with financially sound and reputable  insurers,  stop loss
     insurance  of the type and in  amounts  customarily  maintained  by Persons
     engaged in the same or similar  business as are  customarily  carried under
     similar  circumstances by such other Persons and (ii) insurance need not be
     maintained by or for the benefit of Inactive Subsidiaries.  Upon request of
     the Agent,  the  Borrower  shall  furnish  the Agent,  with copies for each
     Lender, at reasonable intervals (but not more than once per calendar year),
     a certificate of an Authorized Officer (and, if requested by the Agent, any
     insurance  broker of the  Borrower)  setting forth the nature and extent of
     all insurance maintained by the Borrower and its Subsidiaries in accordance
     with this Section  5.02(g) (and which,  in the case of a  certificate  of a
     broker, was placed through such broker).

          (h) Payment of  Obligations.  Pay and discharge all of its obligations
     and liabilities, including:

               (i)  as  they  become  due  and  payable,   all  claims  for  tax
          liabilities, assessments and governmental charges or levies against it
          or upon its properties or assets;

               (ii) as they become due and payable,  all lawful claims which, if
          unpaid,  would,  with the  passage  of time or notice or both,  by law
          become a Lien upon its property;

               (iii)  before   expiration  of  any  period  of  grace  expressly
          provided, all claims for payments due under any lease of a Health Care
          Facility or any equipment therein; and

<PAGE>


                                       62

               (iv) before expiration of any period of grace expressly provided,
          all  claims  for  Debts as and when due and  payable  (subject  to any
          subordination  provisions contained in any instrument  evidencing,  or
          indenture or agreement governing, such Debt);

     except  that it may  contest  in good  faith any  claims and may permit the
     claims so contested to remain unpaid during any period,  including appeals,
     when it is in good  faith  contesting  the  same,  so long as (A)  adequate
     reserves  have been  established  to the extent  required  by GAAP or other
     adequate  provision for the payment  thereof has been made, (B) enforcement
     of the contested  claim is  effectively  stayed for the entire  duration of
     such contest,  and (C) any claim  determined  to be due,  together with any
     interest or penalties  thereon,  is paid promptly,  and in any event within
     three Business Days, after resolution of such contest.

          (i) Environmental  Laws.  Conduct its operations and keep and maintain
     its property in  compliance in all material  respects  with all  applicable
     Environmental Laws and Environmental Permits; and prepare at the Borrower's
     sole cost and expense and deliver to the Agent and the Lenders such updates
     as the Agent or the Requisite  Lenders may reasonably  request  relating to
     any Material Environmental Claim.

          (j) Use of Proceeds. Use the proceeds of the Advances first to pay all
     obligations under the Existing Facility and from time to time to retire all
     Funded LC Exposure and other  Obligations then due hereunder and thereafter
     for working  capital,  acquisitions  (provided that any such acquisition is
     approved by the board of  directors  or  equivalent  governing  body of the
     target of such acquisition at the time of the initial offer by the Borrower
     or one or more of its Subsidiaries) and other general corporate purposes of
     the Borrower and its  Subsidiaries  not in contravention of any law or this
     Agreement.

          (k) Health Care Permits and Approvals.  Take all action  necessary (i)
     to maintain in full force and effect all Health Care Permits  necessary for
     the lawful conduct of its business or operations wherever now conducted and
     as planned to be  conducted,  including  the ownership and operation of its
     Health  Care   Facilities,   pursuant  to  all  applicable   laws  and  all
     requirements of Governmental Authorities having jurisdiction over it or any
     part of its  operations;  and (ii) ensure  that all Health Care  Facilities
     owned or leased by it are entitled to participate  in, and receive  payment
     under,  the  appropriate  Medicare,   Medicaid  and  related  reimbursement
     programs,  and any similar state or local  government-sponsored  program to
     the extent  that it has decided to  participate  in any such state or local
     program,  and to receive  reimbursement  from private and commercial payors
     and health  maintenance  organizations  to the extent  applicable  thereto;
     provided  that the failure at any one time to maintain  Health Care Permits
     with respect to any three Health Care Facilities owned or leased by any one
     or more

<PAGE>


                                       63

     Subsidiaries  of the Borrower shall not constitute a failure to comply with
     this Section 5.02(k).

          (l) Further  Assurances.  (i) Promptly and in no event later than five
     Business  Days after  becoming  aware  thereof,  notify the  Lenders if any
     written information,  exhibits and reports furnished to the Lenders contain
     any untrue  statement of a material fact or omit to state any material fact
     or any  fact  necessary  to  make  the  statements  contained  therein  not
     misleading  in light of the  circumstances  in which made,  and correct any
     defect  or  error  that  may be  discovered  therein  or in the  execution,
     acknowledgement or recordation of any Loan Document.

        (ii)  Promptly  upon  request  by the  Agent or the  Requisite  Lenders,
     execute, deliver, acknowledge,  file, re-file, register and re-register any
     and all such  further  acts,  security  agreements,  assignments,  estoppel
     certificates,  financing statements and continuations thereof,  termination
     statements, notices of assignment, transfers, certificates,  assurances and
     other  instruments  as the Agent or the  Requisite  Lenders may  reasonably
     require  from time to time in order (A) to carry out more  effectively  the
     purposes of this  Agreement or any other Loan  Document,  (B) to subject to
     the Liens created by any of the Collateral Documents any of the properties,
     rights  or  interests  described  in or  intended  to  be  covered  by  any
     Collateral  Document,  (C) to comply with Section 5.03(1), (D) to establish
     and maintain the validity,  effectiveness,  perfection  and priority of any
     Collateral  Document or any Liens intended to be created thereby, or (E) to
     better assure,  convey,  grant,  assign,  transfer,  preserve,  protect and
     confirm to the Agent and the Lenders the rights granted or now or hereafter
     intended to be granted to the Lenders  under any Loan Document or under any
     other instrument executed in connection therewith.

     SECTION 5.03. Negative Covenants. So long as any Obligation remains unpaid,
any Letter of Credit  remains  outstanding  or any Lender is obligated to extend
credit  hereunder,  without the  written  consent of the  Requisite  Lenders the
Borrower  will not, and will not cause or permit any  Subsidiary of the Borrower
to:

          (a) Liens.  Directly or  indirectly  make,  create,  incur,  assume or
     suffer to exist any Lien upon or with  respect to any part of its  property
     or assets,  whether now owned or  hereafter  acquired,  or become or remain
     bound by any agreement to do so, except:

               (i) any Lien (other than a Lien on the  Collateral)  (A) existing
          on the Closing Date and described in Schedule  5.03(d),  securing Debt
          permitted  under  Section  5.03(d)(ii),  or (B)  granted to secure any
          extension, renewal, refinancing or replacement of any such Debt if (1)
          the  principal  amount  secured  thereby is not  increased and (2) the
          property  subject to the Lien so  granted  is

<PAGE>


                                       64

          limited to the property  that was subject to the original Lien and any
          accessions,  fixtures,  improvements or equipment added thereto in the
          ordinary course of business;

               (ii) any Lien created under any Loan Document;

               (iii) any Lien for taxes, fees, assessments or other governmental
          charges which are not delinquent and remain payable without penalty or
          which are being contested as permitted under Section 5.02(h);

               (iv)  any  carriers',  warehousemen's,   mechanics',  landlords',
          materialmen's,  repairmen's  or  other  similar  Lien  arising  in the
          ordinary course of business which is not delinquent or remains payable
          without penalty or which is being contested as permitted under Section
          5.02(h);

               (v) any Lien (other than a Lien imposed by Environmental  Laws or
          by ERISA) on the property of the  Borrower or any of its  Subsidiaries
          imposed by law,  or pledges or deposits  required  by law  pursuant to
          worker's   compensation,   unemployment  insurance  and  other  social
          security legislation;

               (vi) any easement,  right-of-way,  restriction  and other similar
          encumbrance  with  respect to real  property  incurred in the ordinary
          course  of  business  if,  in  the  aggregate,   such  items  are  not
          substantial in amount and do not  constitute and cannot  reasonably be
          expected to result in a Material Adverse Change;

               (vii) any Lien arising out of any  judgment or award  against it,
          if (A)  such  Lien is  being  contested  as  permitted  under  Section
          5.02(h),  (B) there is no material likelihood of the sale,  forfeiture
          or loss of any  part of its  properties,  and (C) such  Lien  does not
          materially  interfere  with  the  use  of  any  material  part  of its
          properties;

               (viii)  any  Lien  on  property  of  a  Person  which  becomes  a
          Subsidiary  after the date of this  Agreement  if such Lien existed at
          the time such Person  became a Subsidiary  of the Borrower and was not
          created in anticipation thereof;

               (ix) any Lien  upon  property  of a  Subsidiary  of the  Borrower
          securing Debt of such Subsidiary  permitted under Section 5.03(d)(iv),
          if with  respect  to such  Lien  each of the  conditions  set forth in
          Section 5.03(d)(iv) is satisfied;

<PAGE>


                                       65

               (x) the interest of the purchasers, and their transferees,  under
          any  Receivables  Sale  Program  in  the  accounts  receivable  of the
          Borrower's  Subsidiaries  and  proceeds  thereof and  records  related
          thereto;  provided that the Facility  Reduction required under Section
          2.06(e) is in effect;

               (xi) any Lien upon  property of the  Borrower  or any  Subsidiary
          thereof securing Debt permitted under Section 5.03(d)(iii)(A); and

               (xii) any Lien held by a third party insurance company with which
          the Borrower or any  Subsidiary  thereof has  established  a dedicated
          cash collateral  account and deposited therein an amount not in excess
          of $15,000,000  less the aggregate  amount of any Investments  made by
          the   Borrower  or  any   Subsidiary   thereof   pursuant  to  Section
          5.03(c)(xiii);  provided that such account shall not collateralize any
          obligations  of any Person other than the  Borrower  and  wholly-owned
          Subsidiaries thereof;

     or become or remain  bound by any  agreement  restricting  its  ability  to
     grant,  create,  incur,  assume  or  suffer  to exist any Lien upon or with
     respect  to any  part of its  property  or  assets,  whether  now  owned or
     hereafter  acquired,   except  (A)  restrictions  set  forth  in  the  Loan
     Documents,  (B) restrictions set forth in the Subordinated Debt Indentures,
     (C)  restrictions on the enforcement of junior Liens on property secured by
     a Lien permitted under clauses (i) or (ix) of this Section 5.03(a), if such
     restrictions are enforceable solely by the holder of the Lien so permitted,
     (D) restrictions on the creation of a Lien on the lessee's interest under a
     lease, if such  restrictions  are enforceable  solely by the lessor (or any
     lender to such lessor  providing  financing  secured by  assignment of such
     lease) under such lease,  and (E) restrictions on the creation of a Lien on
     the accounts  receivable  subject to a Receivables  Sale  Program,  and the
     proceeds  thereof and records related  thereto,  if such  restrictions  are
     enforceable  solely by the purchasers  under such  Receivables Sale Program
     and their transferees.

          (b)  Disposition  of  Assets.  Engage in any Asset  Sale or  otherwise
     directly or indirectly sell, assign,  lease, convey,  transfer or otherwise
     dispose of all or any portion of its assets, business or property, or agree
     to do any of the foregoing, except:

               (i) the  disposition  of inventory  or used,  worn-out or surplus
          property or equipment or Permitted  Cash  Investments  in the ordinary
          course of business;

               (ii) the sale of equipment for credit  against the purchase price
          of similar  replacement  equipment  or if the proceeds of the sale are
          reasonably   promptly   applied  to  the  purchase  price  of  similar
          replacement equipment;

<PAGE>


                                       66

               (iii) the  disposition  of accounts  receivable of the Borrower's
          Subsidiaries pursuant to a Receivables Sale Program; provided that the
          Facility Reduction required under Section 2.06(e) is in effect;

               (iv)  the sale of  Schedule  1.01(b)  Assets,  so long as (A) the
          entire  consideration for such Asset Sale consists of cash received at
          the closing thereof, (B) the consideration received for such assets is
          not less than the sales price specified  therefor in Schedule  1.01(b)
          and (C) at the time of or after giving  effect to such Asset Sale,  no
          Event of Default or Potential Default exists;

               (v) the sale of Schedule  1.01(c)  Assets  which is made for fair
          market value,  so long as (A) at least 70% of the total  consideration
          for such Asset Sale consists of cash received at the closing  thereof,
          (B) the  Agent  concurrently  acquires,  on the terms set forth in the
          Pledge and Security Agreements,  a legal, valid and perfected security
          interest in any and all non-cash  consideration received in such Asset
          Sale, (C) at the time of or after giving effect to such Asset Sale, no
          Event of Default or Potential  Default  exists,  and (D) if such Asset
          Sale is a Retained  Interest Sale,  then,  after giving effect to such
          transaction  and all  related  transactions,  either (1) the  Retained
          Interest  Criteria shall be met with respect to such  transactions  at
          the time of consummation thereof, or (2) the Partial Disposition Limit
          shall not be exceeded;

               (vi) any other Asset Sale which is made for fair market value, so
          long as (A) the sum of the aggregate  consideration  received pursuant
          to such Asset Sale plus the aggregate  consideration received pursuant
          to all such  other  Asset  Sales  in any  calendar  year is less  than
          $30,000,000,  (B) the Agent  concurrently  acquires,  on the terms set
          forth in the  Pledge  and  Security  Agreements,  a legal,  valid  and
          perfected  security  interest  in any and all  non-cash  consideration
          received in such Asset Sale, (C) at the time of or after giving effect
          to such Asset Sale, no Event of Default or Potential  Default  exists,
          and (D) if such Asset Sale is a Retained  Interest Sale,  then,  after
          giving effect to such transaction and all related transactions, either
          (1) the Retained  Interest  Criteria shall be met with respect to such
          transactions at the time of consummation  thereof,  or (2) the Partial
          Disposition Limit shall not be exceeded; and

               (vii) the sale for fair market value or liquidation of any assets
          acquired or  Investments  made pursuant to Section  5.03(c)(xiii),  so
          long as the entire consideration therefor consists of cash received at
          the closing thereof.

          (c)  Investments.  Directly  or  indirectly  make,  acquire,  carry or
     maintain  any  Investment,  or become or remain  bound by any  agreement to
     make, acquire, carry or maintain any Investment, except:

<PAGE>


                                       67

               (i) Investments in Permitted Cash Investments;

               (ii)  Investments in accounts or notes receivable or other claims
          arising  from the sale or lease of goods or services  in the  ordinary
          course of business;

               (iii) Investments by the Borrower in a wholly-owned Subsidiary of
          the  Borrower,  for purposes  related to the  business and  operations
          conducted by such Subsidiary in the ordinary course and not to acquire
          any new business, Health Care Facility or Health Care Company;

               (iv) loans and advances,  in an aggregate amount not greater than
          $10,000,000  in any calendar  year, to employees of the Borrower or of
          any Subsidiary of the Borrower;

               (v)  Investments  held  on the  Closing  Date  and  described  in
          Schedule 5.03(c);

               (vi) loans made to the Borrower,  any wholly-owned  Subsidiary of
          the Borrower or any  Subsidiary  of the Borrower then  satisfying  the
          Retained Interest Criteria by a Subsidiary of the Borrower;

               (vii)  Investments in the construction or improvement of a Health
          Care Facility and other Investments in assets added to property, plant
          or  equipment,  but (A) only if the Hard  Costs  associated  with such
          Investments  are counted as Capital  Expenditures  and (B) excluding a
          purchase or other acquisition of a Health Care Facility;

               (viii)  Investments (A) in the common stock of companies that are
          '34 Act Companies if the aggregate  amount so invested at any one time
          does not exceed $50,000,  or (B) in the stock of Health Care Companies
          that are '34 Act Companies if the aggregate  amount so invested at any
          one  time  does not  exceed  $20,000,000;  provided  that,  except  as
          otherwise  permitted under Sections  5.03(c)(x) and 5.03(c)(xiv),  the
          Borrower  and its  Subsidiaries  shall  not hold more than 4.9% of the
          outstanding stock of any '34 Act Company at any one time;

               (ix)   Investments   in  promissory   notes  and  other  non-cash
          consideration  received in  connection  with any Asset Sale  permitted
          under Section 5.03(b)(v) or Section 5.03(b)(vi);

               (x) Investments in Persons that are not wholly-owned Subsidiaries
          of the Borrower (including, without limitation, joint ventures) and

<PAGE>


                                       68

          that are not '34 Act  Companies  at the  time of any such  Investment;
          provided  that (A) the  aggregate  amount of such  Investments  in any
          calendar year shall not exceed (1) $40,000,000  plus the lesser of (x)
          $40,000,000 minus the amount so invested in the prior calendar year or
          (y) $15,000,000,  or (2) in the event that the  Debt/EBITDAR  Ratio is
          less  than 5.50 for two  consecutive  Quarters,  $60,000,000  plus the
          lesser of (x)  $60,000,000  minus the amount so  invested in the prior
          calendar year or (y) $20,000,000; provided, however, that in the event
          that the  Debt/EBITDAR  Ratio is thereafter  greater than 5.50 for any
          two  consecutive  Quarters,  the limitation set forth in subclause (1)
          above shall apply until the Debt/EBITDAR Ratio is again less than 5.50
          for two  consecutive  Quarters;  provided  further  that  neither  the
          Borrower nor any  Subsidiary  thereof shall be obligated to dispose of
          any Investment  permitted  under this clause (A) in the event that the
          aggregate amount of Investments hereunder in any calendar year exceeds
          the  limitation  set  forth in  subclause  (1)  above,  so long as any
          Investments  made in excess of such limitation  were, at the time such
          Investments were made,  permitted under and made within the limitation
          set forth in subclause  (2) above;  (B) any such  Investment  shall be
          made by the Borrower through a wholly-owned Subsidiary of the Borrower
          that (1) is engaged only in activities  related to the Person in which
          such  Investment  is made  and (2)  complies  with the  provisions  of
          Section 5.02(e)  (except that any such Investment  which is a loan may
          be made directly by the Borrower so long as the Borrower complies with
          Section 5.03(1) and Section 5.02(l)), and neither the Borrower nor any
          of its  Subsidiaries  nor any of their  properties  shall be or become
          bound by or subject to any contractual  obligation that is or would be
          violated or put in default by reason of such  compliance  or by reason
          of the  enforcement  of the claims and Liens of the Agent and  Lenders
          arising from such  compliance;  and (C) at the time of or after giving
          effect  to any  such  Investment,  no Event of  Default  or  Potential
          Default exists or would result;  provided further that the Borrower or
          any  Subsidiary  thereof may continue to carry such  Investment in the
          event such Person becomes a '34 Act Company;

               (xi)   Investments   by   existing,   newly-formed   or  acquired
          wholly-owned  Subsidiaries  of the Borrower in one or more Health Care
          Companies or Health Care  Facilities;  provided that (A) the aggregate
          cash portion of the aggregate  consideration  for all such Investments
          shall not exceed an amount  equal to 50% of the Net Cash  Proceeds  of
          Sale of (1) Schedule  1.01(b) Assets,  (2) Schedule 1.01(c) Assets and
          (3) assets sold  pursuant  to Section  5.03(b)(vi);  provided  further
          that,  notwithstanding the foregoing limitations,  the Borrower or any
          wholly-owned  Subsidiary  thereof  may  make  Investments  under  this
          Section  5.03(c)(xi) for consideration  (exclusive of the value of any
          equity interests of the Borrower or such Subsidiary  thereof issued as
          part  of  such  Investments)  of up  to  an  aggregate  for  all  such
          Investments of $150,000,000 if, on a pro forma basis,

<PAGE>


                                       69

          after giving effect to any such Investment (including Interest Expense
          arising from Debt  incurred in connection  with any such  Investment),
          the Interest&Rent Coverage Ratio for the 12-month period ending at the
          end of the most recently ended Quarter exceeds:

                  Year                           Minimum Pro Forma Ratio
                  ----                           -----------------------
                  1996                                     1.75
                  1997                                     2.00
                  1998                                     2.25
                  1999                                     2.65
          2000 and thereafter                              3.15

          (B) at the time of or after giving effect to any such  Investment,  no
          Event of Default or Potential Default exists or results;  and (C) each
          entity that becomes a Subsidiary of the Borrower in connection with or
          as a result of any such Investment shall comply with the provisions of
          Section 5.02(e),  and neither the Borrower nor any of its Subsidiaries
          nor any of their  properties shall be or become bound by or subject to
          any  contractual  obligation  that is or would be  violated  or put in
          default by reason of such  compliance or by reason of the  enforcement
          of the claims  and Liens of the Agent and  Lenders  arising  from such
          compliance;

               (xii)  The  First  American  Merger;  provided  that  (A) (x) the
          Settlement   Releases  (as  defined  in  the  First  American   Merger
          Agreement)  shall have been received and (y) the order  confirming the
          plan of reorganization in the bankruptcy  proceeding of First American
          shall be final and  nonappealable and the terms and conditions of such
          order,  plan of  reorganization  and any  amendment,  modification  or
          waiver of any provision of the First American  Merger  Agreement after
          the  date  hereof  shall  be  satisfactory  to the  Agent  in its sole
          discretion; provided further that, to the extent any term or condition
          of any such  order,  plan of  reorganization  or any  such  amendment,
          modification or waiver (x) increases (1) the aggregate  purchase price
          payable by the Borrower or any of its  Subsidiaries in connection with
          such merger,  (2) the cash portion of such  purchase  price payable by
          the Borrower or any of its  Subsidiaries at the closing of such merger
          or  (3)  by  more  than   $10,000,000  the  aggregate  amount  of  any
          obligations  assumed by the  Borrower  or any of its  Subsidiaries  in
          connection  with such  merger,  or (y)  accelerates  the timing of any
          payment of consideration (deferred, contingent or otherwise) in excess
          of  $10,000,000  in the  aggregate  under  the First  American  Merger
          Agreement,  such terms or  conditions or  amendment,  modification  or
          waiver shall be  satisfactory  to the Requisite  Lenders in their sole
          discretion;  (B) at the time of or after  giving  effect  to the First
          American Merger,  no Event of

<PAGE>


                                       70

          Default  or  Potential  Default  shall  exist or  result;  and (C) the
          Borrower  shall comply with the  provisions  of Section  5.02(e),  and
          neither  the  Borrower  nor any of its  subsidiaries  nor any of their
          properties  shall be or become bound by or subject to any  contractual
          obligation that is or would be violated or put in default by reason of
          such  compliance  or by reason of the  enforcement  of the  claims and
          Liens of the Agent and Lenders arising from such compliance;

               (xiii) Investments in one or more insurance company  Subsidiaries
          in an aggregate amount not greater than $15,000,000 less the aggregate
          amount of all deposits by the Borrower or any subsidiary  thereof with
          one or more third party insurance companies, and with respect to which
          deposits  Liens  are  permitted  pursuant  to  Section   5.03(a)(xii);
          provided  that  (A)  in  the  case  of  any  such  insurance   company
          Subsidiary,  it shall be formed as an insurance  company  solely to do
          business as such under and in accordance  with all laws,  regulations,
          directives and administrative orders applicable to insurance companies
          in its  jurisdiction of  organization;  (B) no such  Subsidiary  shall
          insure   obligations  of  any  Person  other  than  the  Borrower  and
          wholly-owned  Subsidiaries  thereof;  and (C) the aggregate  potential
          liability of the Borrower and its subsidiaries in connection with such
          Investment  shall not  exceed  the  aggregate  amount  of  Investments
          permitted under this Section 5.03(c)(xiii);

               (xiv) Investments carried or maintained in Affiliates arising out
          of Retained Interest Sales,  including any such Investment  carried or
          maintained in a Person that becomes a '34 Act Company; and

               (xv) The acquisitions described in Schedule 5.03(c)(xv); provided
          that (A) the aggregate cash portion of the  consideration for any such
          acquisition  shall  not  exceed  the  cash  purchase  price  specified
          therefor in Schedule  5.03(c)(xv);  (B) at the time of or after giving
          effect  to any such  acquisition,  no Event of  Default  or  Potential
          Default shall exist or result;  and (C) the Borrower shall comply with
          the provisions of Section 5.02(e), and neither the Borrower nor any of
          its  Subsidiaries nor any of their properties shall be or become bound
          by or  subject  to any  contractual  obligation  that is or  would  be
          violated or put in default by reason of such  compliance  or by reason
          of the  enforcement  of the claims and Liens of the Agent and  Lenders
          arising from such compliance.

          (d) Limitation on Indebtedness.  Directly or indirectly create, incur,
     assume,  guarantee  or  suffer  to  exist,  or  otherwise  become or remain
     directly or indirectly liable with respect to, any Debt, except:

               (i) the Obligations;

<PAGE>


                                       71

               (ii) Debt  existing on the Closing Date and described in Schedule
          5.03(d) and any extension, renewal or refinancing of such Debt so long
          as either (A) the  principal  amount of such Debt is not  increased or
          (B) any  increase in the  principal  amount of such Debt is  permitted
          pursuant to another clause of this Section 5.03(d);

               (iii)  any  intercompany  loan  made (A) by the  Borrower  or any
          wholly-owned  Subsidiary thereof to any Person that is a Subsidiary of
          the  Borrower  at the time such loan is made;  provided  that any such
          loan made by the Borrower or any  wholly-owned  Subsidiary  thereof to
          any Person that is a  wholly-owned  Subsidiary  of the Borrower at the
          time such loan is made shall be repayable on demand;  provided further
          that, in the case of any loan to a non-wholly-owned  Subsidiary of the
          Borrower,  (1) the Investment in such loan is permitted  under Section
          5.03(c)  and (2) such loan  shall be  subject  to the  limitations  on
          Investments  provided  for  therein;  or (B) to  the  Borrower  or any
          wholly-owned Subsidiary thereof by any Subsidiary of the Borrower;

               (iv)  Debt (A)  owed by a  Health  Care  Company  acquired  in an
          acquisition permitted under Section 5.03(c)(xi),  Section 5.03(c)(xii)
          or  Section  5.03(c)(xv),  if such Debt was  outstanding  prior to the
          acquisition,  (B)  owed  by a  Subsidiary  of  the  Borrower,  if  the
          Subsidiary makes an acquisition  permitted under Section  5.03(c)(xi),
          Section  5.03(c)(xii) or Section  5.03(c)(xv) and incurs and uses such
          Debt  for  the  purpose  of  paying  the   purchase   price  or  other
          consideration  for the  acquisition,  or (C)  incurred  or used by any
          Subsidiary  of the  Borrower  to  purchase  or  otherwise  acquire any
          equipment for its business,  but such Debt shall be permitted  only if
          and so long as the following conditions are met:

                    (1)  such  Debt (I) may be  secured  only by  assets  of the
               Subsidiary  that  incurred it, (II) may be incurred and owed only
               by a  single  Subsidiary  that,  if it  owes  Debt  of  the  type
               described at (A) and (B) in this clause (iv),  has no significant
               assets except those acquired in such acquisition,  and equipment,
               fixtures  and   improvements   thereon,   replacements   thereof,
               inventory  therefor,  and assets generated by operation  thereof,
               (III) must not be subject to terms that are violated, or pursuant
               to which such Debt is put into default,  by reason of any breach,
               default  or event of default  under any  indenture  or  agreement
               governing  any other Debt or lease binding on the Borrower or any
               of its other Subsidiaries, (IV) must permit the Borrower and such
               Subsidiary  to comply with Section  5.02(e),  and (V) must not be
               violated  or put  into  default  or  require  any  prepayment  or
               repurchase  of such Debt by reason of any change in control  over
               the Borrower or such Subsidiary except, if required by the holder
               of

<PAGE>


                                       72

               such Debt despite best efforts by the Borrower to the contrary, a
               right to consent to a change of ownership of such  Subsidiary  if
               such consent may not unreasonably be withheld; and

                    (2) the aggregate principal amount of all such Debt incurred
               at any time after the  Closing  Date and  outstanding  at any one
               time in a particular year must not exceed:

                  Year                                Maximum Amount
                  ----                                --------------
                  1996                                 $45,000,000
                  1997                                 $55,000,000
                  1998                                 $65,000,000
          1999 and thereafter                          $75,000,000

          ; and

               (v) Subordinated  Debt incurred under the 1996  Subordinated Debt
          Indenture,  and any extension,  renewal or refinancing of such Debt so
          long as either (A) the principal  amount of such Debt is not increased
          or (B) any increase in the principal  amount of such Debt is permitted
          pursuant to another clause of this Section 5.03(d);  provided that the
          terms and conditions of such 1996 Subordinated Debt Indenture shall be
          (1) substantially similar to the terms and conditions contained in the
          1994  Subordinated  Debt  Indenture  and the  1995  Subordinated  Debt
          Indenture and (2) satisfactory to the Agent in its sole discretion.

          (e)  Transactions  with  Affiliates.  Enter or agree to enter into any
     transaction  with any Affiliate of the Borrower or of any Subsidiary of the
     Borrower except (i) under the Loan Documents or (ii) in the ordinary course
     of business and pursuant to the reasonable  requirements of the business of
     the Borrower or such Subsidiary and upon fair and reasonable  terms no less
     favorable  to the  Borrower or such  Subsidiary  than the  Borrower or such
     Subsidiary  would obtain in a comparable  arm's-length  transaction  with a
     Person  not  an  Affiliate  of  the  Borrower  or  such   Subsidiary.

          (f)  Accommodation  Obligations.  Create,  incur,  assume or suffer to
     exist any Accommodation Obligations except:

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

<PAGE>


                                       73

               (ii)   Accommodation   Obligations   of  the   Borrower  and  its
          Subsidiaries existing as of the Closing Date and described in Schedule
          5.03(f);

               (iii) the Obligations;

               (iv) a guaranty by the Borrower of Debt of a Subsidiary permitted
          under Section 5.03(d)(iv);

               (v) a guaranty by the Borrower of the obligations of a Subsidiary
          under a lease agreement permitted under Section 5.03(g);

               (vi) a guaranty of the  performance  of the  representations  and
          warranties,  indemnities and servicing commitments of a Subsidiary (A)
          to  the  purchasers   under  a  Receivables  Sale  Program  and  their
          transferees,  (B) contained in any purchase or sale agreement  entered
          into in connection  with any Investment or Asset Sale permitted  under
          this Agreement,  and (C) contained in any management agreement entered
          into in the ordinary course of such Subsidiary's business; and

               (vii) any other  Accommodation  Obligation to the extent the same
          does not cause an Event of Default under Section 5.01(a).

          (g) Leases of Health Care  Facilities.  Enter into or become obligated
     as lessee under any lease of a Health Care Facility, whether or not it is a
     Capital  Lease,  unless (i) the lease is free from  provisions  pursuant to
     which the lease is  violated  or put into  default by reason of any breach,
     default or event of default under any indenture or agreement  governing any
     Debt of,  or other  lease  binding  on,  the  Borrower  or any of its other
     Subsidiaries,  except  another  lease entered into by the same lessor or by
     one of its  Affiliates,  (ii)  the  lease  permits  the  Borrower  and such
     Subsidiary  to  comply  with  Section  5.02(e)  and  does not  include  any
     provision  that is or would be violated or put in default by reason of such
     compliance or by reason of the  enforcement  of the claims and Liens of the
     Agent and Lenders arising from such compliance, and (iii) the lease is free
     from provisions  pursuant to which the lease is or would be violated or put
     into default, or any prepayment would be required,  by reason of any change
     in control of the Borrower or such  Subsidiary  except,  if required by the
     lessor  despite best efforts by the  Borrower to the  contrary,  a right to
     consent to a change of ownership of such Subsidiary if such consent may not
     unreasonably be withheld; provided that at any one time the Borrower or any
     of its  Subsidiaries  may be obligated as a lessee under one or more leases
     of Health  Care  Facilities  not  otherwise  permitted  under this  Section
     5.03(g) so long as the aggregate annual rent payment  obligations under all
     such leases is less than $10,000,000.

<PAGE>


                                       74

          (h) Restricted Junior Payments.  Directly or indirectly (i) declare or
     make any  dividend  payment or other  distribution  of assets,  properties,
     cash,  rights,  obligations  or  securities on account of any shares of any
     class of its  capital  stock  or any  other  equity,  ownership  or  profit
     interests;  (ii) purchase, redeem or otherwise acquire for value any shares
     of any class of  capital  stock of, or other  equity,  ownership  or profit
     interests  in, the  Borrower or any of its  Subsidiaries  or any  warrants,
     rights or options to acquire any such shares or interests, now or hereafter
     outstanding;  (iii) enter into any agreement restricting the ability of any
     Subsidiary of the Borrower to declare or make any dividend payment or other
     distribution of assets, properties, cash, rights, obligations or securities
     to its stockholders;  (iv) agree to or permit any amendment or modification
     of, or change in,  any of the terms of the  Subordinated  Debt  Indentures,
     except as contemplated by and pursuant to the Consent Solicitation;  or (v)
     pay,  prepay,  redeem,  or purchase or otherwise  acquire any  Subordinated
     Debt,  or make any deposit to provide  for the payment of any  Subordinated
     Debt when due, or exchange  any  Subordinated  Debt,  or give any notice in
     respect thereof; except that:

               (A) the Borrower may declare and pay cash dividends on its common
          stock,  so long as (1) no Event of  Default  or  Potential  Default is
          continuing  at the time any such dividend is declared or paid or would
          result from the payment and (2) the aggregate  amount of all such cash
          dividends  paid in any one calendar year does not exceed the lesser of
          (x) $0.05 per share and (y) $10,000,000 in the aggregate;

               (B) the  Borrower  from  time to time  may  purchase  outstanding
          shares of the  Borrower's  common stock,  so long as (1) the aggregate
          amount  expended for all such  purchases at any time after the Closing
          Date does not exceed  $20,000,000  (the "PURCHASE  LIMIT") and (2) the
          purchase  is  made in  compliance  with  all  applicable  laws  and no
          Potential  Default or Event of Default exists at the time of, or would
          result from,  any such purchase  (and,  for this purpose,  the amounts
          counted  toward  the  Purchase  Limit  shall not be  reduced  by or on
          account of any subsequent resale of the Borrower's common stock);

               (C) the Borrower  may declare and make any  dividend  payments or
          other distributions  payable solely by the Borrower in common stock of
          the Borrower;

               (D) so long as no Event of Default  exists or would  result,  any
          Subsidiary  may (1) make any  lawful  distribution  to the  holders of
          shares of its stock or other equity, ownership or profit interests and
          (2) purchase,  acquire or retire any such shares or interests that are
          not held by the Borrower or a wholly-owned Subsidiary of the Borrower,
          if the Investment in such shares or

<PAGE>


                                       75

          interests  is  permitted  at  the  time  under   Section   5.03(c)(x),
          5.03(c)(xi) or Section 5.03(c)(xii);

               (E)  the   Borrower   may  pay  when  due  the  interest  on  the
          Subordinated Debt if such interest is permitted to be paid at the time
          under the subordination  provisions of the governing Subordinated Debt
          Indenture;

               (F) the Borrower may give notice of a redemption  with respect to
          any issue of  Convertible  Subordinated  Debt,  if and only if (1) the
          purpose of such  notice is to force the  holders  of such  Convertible
          Subordinated Debt to convert their Convertible  Subordinated Debt into
          common stock of the Borrower and (2) at the time of the giving of such
          notice no Event of Default or  Potential  Default has  occurred and is
          continuing;   provided,  however,  that  the  Borrower  may  make  any
          redemption payment by reason of tenders actually made pursuant to such
          notice  only  if  either  (x)  the  conversion  of  such   Convertible
          Subordinated  Debt to common  stock is  underwritten  by a third party
          acceptable  to  the  Agent  and  the  Requisite  Lenders  or  (y)  any
          redemption  payment  required to be made pursuant to such notice would
          not cause  Adjusted  Stockholders'  Equity to be less than Minimum Net
          Worth and no Event of Default or Potential  Default is  continuing  at
          the  time  of,  or  would  exist  after  giving  effect  to,  any such
          redemption payment; and

               (G) so long as no Event of  Default  exists or would  result  and
          unless otherwise prohibited under this Agreement, the 1993 Convertible
          Subordinated  Debt Indenture or the 1995  Subordinated Debt Indenture,
          the   Borrower   may  pay  on  January  1,  2001  and  May  15,  2002,
          respectively, any principal amount then due and payable under the 1993
          Convertible Subordinated Debt Indenture and the 1995 Subordinated Debt
          Indenture.

          (i) Mergers,  Etc. Merge or consolidate with or into or enter into any
     agreement to merge or consolidate with or into any Person except that:

               (i) a  wholly-owned  Subsidiary  of the  Borrower may engage in a
          merger  or  consolidation  with  any  one or more  other  wholly-owned
          Subsidiaries  of  the  Borrower  if  the  surviving  corporation  is a
          wholly-owned  Subsidiary  of the  Borrower  (A) that has  executed the
          Guaranty and (B) all the stock of which is held by the Agent in pledge
          pursuant to the Collateral Documents;

               (ii) a non-wholly-owned  Subsidiary of the Borrower may engage in
          a merger or consolidation with any one or more other non-wholly- owned
          Subsidiaries of the Borrower;  provided that the surviving corporation
          is a Subsidiary  of the  Borrower,  (A) that has executed the Guaranty
          and (B) the stock

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                                       76

          of  which,  to the  extent  owned by the  Borrower  or any  Subsidiary
          thereof,  is held by the Agent in pledge  pursuant  to the  Collateral
          Documents;  and provided further that, after giving effect to any such
          merger  or  consolidation,   (1)  the  Borrower  shall,   directly  or
          indirectly,  own  an  equity  interest  in the  surviving  corporation
          substantially  equivalent  in  aggregate  value  to its  prior  equity
          interests in the non-wholly-owned Subsidiaries party to such merger or
          consolidation,  and (2) the  surviving  corporation  shall satisfy the
          Retained Interest Criteria as if such merger or consolidation had been
          a Retained Interest Sale;

               (iii) a  wholly-owned  Subsidiary of the Borrower may engage in a
          merger or  consolidation  in connection with an acquisition  permitted
          under Section  5.03(c)(xi)  or Section  5.03(c)(xii),  but only if the
          surviving corporation is a wholly-owned Subsidiary of the Borrower (A)
          that has  executed the Guaranty and (B) all the stock of which is held
          by the Agent in pledge pursuant to the Collateral Documents; and

               (iv) a  Subsidiary  of the  Borrower  may  engage  in a merger or
          consolidation   if  the  purpose  and  effect  thereof  is  solely  to
          consummate a transaction permitted under Section 5.03(b)(iv),  Section
          5.03(b)(v) or Section 5.03(b)(vi).

          (j)  Capital  Expenditures.   Make  Capital  Expenditures  during  any
     calendar year in an amount in excess of the amount set forth below opposite
     such year:


                    Year                                    Amount
                    ----                                    ------
                    1996                                 $100,000,000
                    1997                                 $ 90,000,000
              1998 and thereafter                        $ 80,000,000

     plus in each  calendar  year the  lesser  of (i)  $10,000,000  and (ii) the
     excess,  if any,  of (A) the amount set forth above for the prior year over
     (B) the Capital Expenditures made in the prior year.

          (k)  Conduct  of  Business.  Engage  in any  business  other  than the
     businesses  of the  Borrower  and its  Subsidiaries  described  in  Section
     4.01(p) and any business or activity substantially similar thereto.

          (l) Unpledged  Assets.  In the case of the  Borrower,  own or hold any
     assets, Investments or property upon which the Agent does not hold a valid,
     perfected  and  sole  Lien as  security  for the  Obligations,  except  (i)
     Investments  permitted under clauses (i) and (iv) of Section 5.03(c),  (ii)
     Investments permitted under Section  5.03(c)(xiii),  but

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                                       77

     only  to the  extent  that  the  perfection  of the  Agent's  Lien  on such
     Investments  is  prohibited  by  applicable  law,  (iii)  other  assets and
     property having an aggregate value not greater than  $30,000,000,  and (iv)
     shares of Inactive Subsidiaries.

          (m) Compliance with ERISA. Directly or indirectly (or permit any ERISA
     Affiliate  directly or  indirectly  to) (i)  terminate  any Plan subject to
     Title IV of ERISA so as to result in liability to the Borrower or any ERISA
     Affiliate  in excess of  $2,000,000;  (ii) permit any ERISA Event to exist;
     (iii) make a complete  or partial  withdrawal  (within the meaning of ERISA
     Section 4201) from any  Multiemployer  Plan so as to result in liability to
     the Borrower or any ERISA Affiliate in excess of $2,000,000; or (iv) permit
     the total Unfunded  Pension  Liabilities  (using the actuarial  assumptions
     utilized by the PBGC) for all Pension Plans (other than Pension Plans which
     have no Unfunded Pension Liabilities) to exceed $2,000,000.

          (n) Health Care Permits and Approvals. Engage in any activity that (i)
     is or could reasonably be expected to result in a material default under or
     violation of any Health Care Permit necessary for the lawful conduct of its
     business or  operations  or (ii) causes or could  reasonably be expected to
     cause the loss by any Health Care  Company or Health Care  Facility  owned,
     leased,  managed  or  operated  by it of the right to  participate  in, and
     receive  payment  under,  the  appropriate  Medicare,  Medicaid and related
     reimbursement programs, and any similar state or local government-sponsored
     program to the extent that it has decided to  participate in any such state
     or local program,  or to receive  reimbursement from private and commercial
     payors  and  health  maintenance  organizations  to the  extent  applicable
     thereto;  provided that the failure at any one time to maintain Health Care
     Permits with respect to any three Health Care Facilities owned or leased by
     one or more  Subsidiaries of the Borrower shall not constitute a failure to
     comply with this Section 5.03(n).

          (o) Retained  Interest  Criteria.  Cause,  permit or suffer any of the
     Retained Interest Criteria not to be met and maintained  continuously after
     the consummation of any transaction  permitted under Section  5.03(b)(v)(D)
     or Section  5.03(b)(vi)(D),  for as long as the Retained Interest surviving
     such transaction, or any portion thereof or non-cash proceeds therefrom, is
     held by the Borrower or any of its subsidiaries.

          (p) Payment  Restrictions  Affecting  Subsidiaries.  Cause,  permit or
     suffer  any  Subsidiary  to  become or remain  subject  to any  contractual
     obligation  that  in any  manner  limits  or  restricts  its  right  to pay
     dividends or make  distributions,  whether in cash or in  property,  to its
     stockholders  or to make loans or sell assets to the Borrower or any of its
     Subsidiaries  or to  enter  into  any  other  lawful  transaction  with the
     Borrower or any of its  Subsidiaries,  except  limitations and restrictions
     set forth in the Subordinated Debt Indentures or the Loan Documents.



<PAGE>


                                       78


                                   ARTICLE VI

                                EVENTS OF DEFAULT

     SECTION 6.01. Events of Default. If any of the following events ("EVENTS OF
DEFAULT") shall occur and be continuing:

          (a)  Non-Payment of Principal.  The Borrower fails to pay when due any
     principal of any Advance; or

          (b)  Non-Payment  of Interest or Fees.  The Borrower fails to pay when
     due any interest  payable  under  Section  2.07,  any  additional  interest
     payable under Section 2.08, any fee payable under Section 2.04 or any other
     amount payable  hereunder and such failure  continues for five days or such
     other period of grace provided for herein; or

          (c)  Representations  and Warranties.  Any  representation or warranty
     made by any Loan Party under or in connection with any Loan Document proves
     to have been  incorrect  in any  material  respect when made and either (i)
     such   representation   or  warranty   cannot  be  remedied  or  (ii)  such
     representation  or  warranty  continues  to be  incorrect  in any  material
     respect for ten days after either (A) such incorrectness is acknowledged in
     writing  by the  Borrower  or (B)  written  notice  thereof is given to the
     Borrower by the Agent or any Lender; or

          (d) Financial,  Lien and Debt Covenants. The Borrower fails to perform
     or observe  any term,  covenant  or  agreement  set forth in Section  5.01,
     Section 5.03(a) or Section 5.03(d); or

          (e) Reporting and Negative Covenants. The Borrower fails to perform or
     observe any term,  covenant or  agreement  set forth in Section  5.02(c) or
     Section  5.03 (other than  Sections  5.03(a) or 5.03(d))  and such  failure
     continues  for ten days after either (i) it is  acknowledged  in writing by
     the Borrower or (ii) written notice thereof is given to the Borrower by the
     Agent or any Lender; or

          (f)  Covenants.  The  Borrower  or any Loan Party  fails to perform or
     observe any term,  covenant or agreement contained in this Agreement or any
     other  Loan  Document  (other  than  those  specifically   referred  to  in
     subsections  (a),  (b),  (c),  (d) and (e) of this  Section  6.01) and such
     failure  continues  for 30 days  after  either  (i) it is  acknowledged  in
     writing by the  Borrower  or (ii)  written  notice  thereof is given to the
     Borrower by the Agent or any Lender; or

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                                       79

          (g) Debt.  The Borrower or any of its  Subsidiaries  (i) fails to pay,
     when  due and  payable  (whether  at the  scheduled  maturity  or upon  any
     required prepayment,  acceleration,  demand or otherwise), any principal of
     or premium or interest  on any Debt  (except  the Notes)  outstanding  in a
     principal amount of at least  $10,000,000,  and such failure  continues for
     longer than the period of grace, if any,  specified for such failure in the
     indenture or agreement  governing  such Debt,  or (ii) commits or permits a
     breach or default under any  financial  test or covenant  which,  under the
     terms of the  indenture or agreement  governing any Debt (except the Notes)
     outstanding  in a principal  amount of at least  $20,000,000,  requires the
     maintenance  of a  specified  net  worth or  working  capital  or any other
     quantifiable measure of financial condition or financial  performance,  and
     such breach or default  continues  for longer than the period of grace,  if
     any, specified for such failure in such indenture or agreement; or any such
     Debt of at  least  $20,000,000  is  declared  to be due and  payable  or is
     required to be prepaid prior to the stated maturity thereof; or

          (h)  Leases.  (i) Except as  otherwise  permitted  pursuant to Section
     5.02(h),  the  Borrower  or any of its  Subsidiaries  (A) fails to make any
     payment  within the period  required  under any  Material  Lease,  and such
     failure  continues for longer than the period of grace,  if any,  specified
     for such failure in such Material Lease, or (B) fails to perform or observe
     any other term, covenant or agreement that (1) is contained in any Material
     Lease and (2) requires the payment of money or can be performed or observed
     by the payment of money,  and such  failure  continues  for longer than the
     period of grace, if any, specified for such failure in such Material Lease;
     or (ii) any Material  Lease is terminated as a result of any failure by the
     Borrower  or any of its  Subsidiaries  to  perform  or  observe  any  term,
     covenant or agreement contained therein; or

          (i) Bankruptcy.  The Borrower or any Material  Subsidiary is generally
     not paying its debts as they become due or admits in writing its  inability
     to pay its debts generally or makes a general assignment for the benefit of
     creditors;  or any proceeding is instituted by or against any Loan Party or
     any Subsidiary of a Loan Party seeking an order for relief under the United
     States Bankruptcy Code or seeking liquidation,  winding up, reorganization,
     arrangement,  adjustment,  protection,  relief, or composition of it or its
     debts or the appointment of a receiver, trustee, custodian or other similar
     official for it or for any  substantial  part of its property under any law
     relating to bankruptcy, insolvency, liquidation or reorganization or relief
     of debtors and either (i) any such relief in any such  proceeding is sought
     or  consented  to by it or an order for any such relief is entered  against
     it, or (ii) any such proceeding  instituted against it remains  undismissed
     and  unstayed  for a period of 60 days;  or any Loan Party or any  Material
     Subsidiary  takes any corporate  action to authorize any of the actions set
     forth above in this Section 6.01(i); or

          (j)  Judgments.  Any  judgment  or order for the  payment  of money is
     rendered against any of the Loan Parties or any of their Subsidiaries in an
     amount in

<PAGE>


                                       80

     excess of  $10,000,000  for any  single  judgment  or order or in excess of
     $50,000,000  for all such  judgments  or orders and either (i)  enforcement
     proceedings  are  commenced by any creditor upon such judgment or order and
     not stayed, or (ii) there is any period of 60 consecutive days during which
     a stay of  enforcement  of such  judgment or order,  by reason of a pending
     appeal or otherwise, is not in effect; or

          (k) Guaranty. Any provision of the Guaranty after delivery thereof for
     any reason  ceases to be valid and binding on each Loan Party that is party
     thereto,  or any Loan  Party  shall  repudiate  or  purport  to revoke  the
     Guaranty; or

          (l) Collateral  Documents.  The Collateral  Documents,  after delivery
     thereof  pursuant to Section  3.01,  for any reason (other than pursuant to
     the terms  thereof)  cease to create a valid and perfected  first  priority
     security interest in any material portion of the Collateral purported to be
     covered thereby; or

          (m) ERISA.  (i) The Borrower or any ERISA  Affiliate  fails to satisfy
     its contribution requirements under Section 412(c)(11) of the Code, whether
     or not it has sought a waiver under Section  412(d) of the Code; or (ii) in
     the case of an ERISA Event  involving the withdrawal from a Pension Plan of
     a  "substantial  employer"  (as  defined in Section  4001(a)(2)  or Section
     4062(e) of ERISA), the withdrawing  employer's  proportionate share of that
     Pension Plan's Unfunded  Pension  Liabilities is more than  $2,000,000;  or
     (iii) in the case of an ERISA  Event  involving  the  complete  or  partial
     withdrawal  from a Multiemployer  Plan, the  withdrawing  employer incurs a
     withdrawal liability in an aggregate amount exceeding $2,000,000; or (iv) a
     Plan that is  intended to be  qualified  under  Section  401(a) of the Code
     loses its  qualification,  and with respect to such loss of  qualification,
     the  Borrower  or any ERISA  Affiliate  can  reasonably  be  expected to be
     required  to pay (for  additional  taxes,  payments to or on behalf of Plan
     participants,  or otherwise) an aggregate amount exceeding  $2,000,000;  or
     (v) any  combination  of events  listed in clauses (ii) through (iv) occurs
     that involves a net increase in aggregate Unfunded Pension  Liabilities and
     unfunded liabilities in excess of $5,000,000;

then, and in any such event, the Agent (A) shall at the request, or may with the
consent,  of the  Requisite  Lenders,  by notice to the  Borrower,  declare  the
obligation of each Lender to make Advances and the  obligation of the LC Bank to
issue Letters of Credit to be  terminated,  whereupon  the same shall  forthwith
terminate and the Facility Amount and LC  Subcommitment  shall be  automatically
and permanently  reduced to zero, and (B) shall at the request,  or may with the
consent,  of the  Requisite  Lenders,  by notice to the  Borrower,  declare  the
Advances and all fixed and  contingent  obligations of the Borrower to reimburse
the LC Bank for any  payment  that has been or may be made  under any  Letter of
Credit,  together with all interest  thereon and all other amounts payable under
this Agreement,  to be immediately  due and payable,  and thereupon the Advances
and all such fixed and contingent reimbursement obligations,  interest and other

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                                       81

amounts shall become and be immediately  due and payable,  without  presentment,
demand, protest or further notice of any kind, all of which are hereby expressly
waived by the Borrower; provided, however, that if an order for relief under the
United States  Bankruptcy  Code is entered at the request or upon the consent of
the Borrower or  involuntarily  against the Borrower (x) the  obligation of each
Lender to make  Advances and the  obligation  of the LC Bank to issue Letters of
Credit  shall  automatically  be  terminated  and  the  Facility  Amount  and LC
Subcommitment  shall be automatically  and permanently  reduced to zero, and (y)
the Advances and all such fixed and contingent  obligations,  interest and other
amounts shall automatically  become and be immediately due and payable,  without
presentment,  demand, protest or any notice of any kind, all of which are hereby
expressly waived by the Borrower.

     SECTION  6.02.  Rights  Not  Exclusive.  The  rights  provided  for in this
Agreement and the other Loan  Documents are  cumulative and are not exclusive of
any other rights, powers or privileges or remedies provided by law or in equity,
or under any other instrument, document or agreement.


                                   ARTICLE VII

                                    THE AGENT

     SECTION 7.01.  Authorization  and Action.  Each Lender hereby  appoints and
authorizes  the Agent to take such action as agent on its behalf and to exercise
such powers  under this  Agreement  as are  delegated  to the Agent by the terms
hereof,  together with such powers as are reasonably  incidental  thereto. As to
any matters not expressly provided for by this Agreement (including  enforcement
or  collection  of the Notes),  the Agent shall not be required to exercise  any
discretion  or take any action,  but shall be required to act or to refrain from
acting (and shall be fully  protected  in so acting or  refraining  from acting)
upon the instructions of the Requisite  Lenders,  and such instructions shall be
binding upon all Lenders and all holders of Notes;  provided,  however, that the
Agent  shall not be  required  to take any  action  which  exposes  the Agent to
personal liability or which is contrary to this Agreement or applicable law. The
Agent shall not be liable to any Lender if, in accordance with the terms of this
Agreement,  it takes or omits to take any action pursuant to the instructions of
the Requisite Lenders.  The Agent agrees to give to each Lender prompt notice of
each notice given to it by the Borrower pursuant to the terms of this Agreement.
The Agent agrees to perform and discharge the duties and powers  delegated to it
under this Agreement and the other Loan  Documents in accordance  with the terms
hereof and thereof.

     SECTION 7.02. Agent Not Liable. Neither the Agent nor any of its directors,
officers, agents or employees shall be liable for any action taken or omitted to
be taken by it or any of them under or in connection with this Agreement, except
for its or their own gross  negligence or willful  misconduct.  Without limiting
the generality of the  foregoing,  the Agent

<PAGE>


                                       82

(i) may  treat  the  payee of any Note as the  holder  thereof  until  the Agent
receives  written  notice of the  assignment or transfer  thereof signed by such
payee and  including  the  agreement of the assignee or  transferee  to be bound
hereby as it would have been if it had been an original Lender party hereto,  in
form satisfactory to the Agent;  (ii) may consult with legal counsel  (including
counsel for the  Borrower),  independent  public  accountants  and other experts
selected  by it and shall not be liable  for any  action  taken or omitted to be
taken  in good  faith  by it in  accordance  with the  advice  of such  counsel,
accountants or experts;  (iii) makes no warranty or representation to any Lender
and shall not be  responsible  to any Lender for any  statements,  warranties or
representations  (whether  written or oral) made in or in  connection  with this
Agreement;  (iv)  shall not have any duty to  ascertain  or to inquire as to the
performance  or observance of any of the terms,  covenants or conditions of this
Agreement on the part of the Borrower or to inspect the property  (including the
books and records) of the Borrower;  (v) shall not be  responsible to any Lender
for  the  due  execution,  legality,  validity,   enforceability,   genuineness,
sufficiency  or value of this  Agreement or any other Loan Document or any other
instrument  or  document  furnished  pursuant  to any Loan  Document  or for the
creation, validity,  enforceability,  sufficiency, value, perfection or priority
of any Lien purported to be granted to the Agent, whether pursuant to any of the
Collateral Documents or otherwise; and (vi) shall incur no liability under or in
respect of this  Agreement by acting upon any notice,  consent,  certificate  or
other  instrument or writing  (which may be by  telecopier,  telegram,  cable or
telex)  believed  by it in good  faith to be  genuine  and signed or sent by the
proper party or parties.

     SECTION 7.03. Rights as Lender. With respect to its commitment and Pro Rata
Share hereunder,  the Advances and Notes held by it and all other rights, claims
and  interests  accorded it as Lender,  Citibank  shall have the same rights and
powers  under this  Agreement  as any other  Lender and may exercise the same as
though it were not the Agent;  and the term "Lender" or "Lenders"  shall include
Citibank in its  individual  capacity.  Citibank and its  Affiliates  may accept
deposits from, lend money to, act as trustee under  indentures of, and generally
engage in any kind of business with, the Borrower,  any of its  Subsidiaries and
any Person who may do business  with or own  securities  of the  Borrower or any
such  Subsidiary,  all as if Citibank were not the Agent and without any duty to
account  therefor to the Lenders.  Any Lender and its respective  Affiliates may
accept  deposits  from,  lend money to, act as trustee under  indentures of, and
generally  engage  in any  kind  of  business  with,  the  Borrower,  any of its
Subsidiaries  and any Person who may do business  with or own  securities of the
Borrower  or any  such  Subsidiary,  all as if such  Lender  were  not a  Lender
hereunder and without any duty to account therefor to the other Lenders.

     SECTION 7.04. Lender Credit Decision. Each Lender acknowledges that it has,
independently  and without reliance upon the Agent or any other Lender and based
on the  financial  statements  referred  to in  Section  4.01(h)  and such other
documents  and  information  as it has deemed  appropriate,  made its own credit
analysis  and  decision  to  enter  into  this   Agreement.   Each  Lender  also
acknowledges that it will,  independently and without reliance upon the Agent or
any  other  Lender  and  based on such  documents  and  information  as it deems

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                                       83

appropriate at the time,  continue to make its own credit decisions in taking or
not taking action under this Agreement.

     SECTION 7.05. Indemnification. The Lenders agree to indemnify the Agent (to
the extent not reimbursed by the Borrower)  ratably  according to their Pro Rata
Shares from and against any and all liabilities,  obligations,  losses, damages,
penalties,  actions,  judgments,  suits, costs, expenses or disbursements of any
kind or nature  whatsoever  which may be imposed  on,  incurred  by, or asserted
against the Agent in any way relating to or arising out of this Agreement or the
other  Loan  Documents  or any action  taken or omitted by the Agent  under this
Agreement or the other Loan  Documents;  provided that no Lender shall be liable
for any portion of such liabilities,  obligations,  losses, damages,  penalties,
actions,  judgments,  suits, costs, expenses or disbursements resulting from the
Agent's gross negligence or willful misconduct.  Without limiting the foregoing,
each Lender agrees to reimburse  the Agent  promptly upon demand for its ratable
share of any reasonable  out-of-pocket  expenses (including  reasonable fees and
expenses of counsel)  incurred by the Agent in connection with the  preparation,
execution, delivery, modification, amendment, protection or enforcement (whether
through negotiations,  by legal proceedings,  in bankruptcy or otherwise) of, or
legal advice in respect of rights or  responsibilities  under, this Agreement or
the other Loan  Documents,  to the extent that the Agent is not  reimbursed  for
such expenses by the Borrower.

     SECTION 7.06.  Successor  Agent. The Agent may resign at any time by giving
written notice thereof to the Lenders and the Borrower and may be removed at any
time with or without cause by the Requisite  Lenders.  Upon any such resignation
or removal,  the Requisite Lenders shall,  subject to the written consent of the
Borrower,  which consent shall not be unreasonably withheld or delayed, have the
right to appoint a successor  Agent.  If no  successor  Agent shall have been so
appointed by the Requisite  Lenders,  and shall have accepted such  appointment,
within 30 days after the retiring Agent's giving of notice of resignation or the
Requisite  Lenders' removal of the retiring Agent,  then the retiring Agent may,
on behalf of the Lenders, appoint a successor Agent, which shall be a commercial
bank  organized  under the laws of the United  States of America or of any State
and having total assets of at least $20,000,000,000.  Upon the acceptance of any
appointment as Agent hereunder by a successor Agent,  such successor Agent shall
thereupon succeed to and become vested with all the rights,  powers,  privileges
and duties of the retiring  Agent,  and the retiring  Agent shall be  discharged
from its duties and obligations under this Agreement. After any retiring Agent's
resignation  or removal  hereunder as Agent,  the provisions of this Article VII
shall inure to its benefit as to any actions  taken or omitted to be taken by it
while it was Agent under this Agreement.

     SECTION  7.07.  Release  of  Collateral.  The Agent is  hereby  irrevocably
authorized  to release any Lien granted to or held by the Agent upon (i) any and
all Collateral  when the Facility Amount has been  permanently  reduced to zero,
all Letters of Credit  issued  hereunder  have expired or been  discharged,  all
outstanding Advances and LC Exposure have been repaid, and all other Obligations
that are then due and  payable  and of which the Agent then

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                                       84

has written notice  demanding  payment prior to release of Collateral  have been
paid, (ii) any Collateral  constituting  property sold or to be sold or disposed
of as part of or in  connection  with any  disposition  permitted  under Section
5.03(b), or (iii) any Collateral  consisting of an instrument evidencing Debt or
other debt instrument,  if the indebtedness  evidenced  thereby has been paid in
full.  Upon request by the Agent or the Borrower at any time,  each Lender shall
confirm in writing the Agent's  authority to release  Collateral,  or particular
types or items of  Collateral,  as set forth in this  Section  7.07.  Subject to
Section  8.01(g),  the Agent shall not be  obligated  to release any  Collateral
unless it receives such written confirmation from the Requisite Lenders.

     SECTION 7.08.  Release of Guarantor  upon Sale of Stock.  If (i) either (A)
all of the outstanding  shares of capital stock and other equity,  ownership and
profit  interests in any  Guarantor are sold to a Person not an Affiliate of the
Borrower in a transaction which is permitted under Section 5.03(b)(iv),  Section
5.03(b)(v) or Section  5.03(b)(vi) and which is not a Retained  Interest Sale or
(B) the Guarantor Liability Limit of any Guarantor is reduced to zero as part of
a Retained Interest Sale and by reason of a voluntary  reduction of the Facility
Amount  that is elected by the  Borrower at the time and in the manner set forth
in the definition of "Guarantor Liability Limit," and if (ii) the conditions set
forth in Section 5.03(b)(iv),  Section 5.03(b)(v) or Section 5.03(b)(vi), as the
case may be, are met in respect of such  transaction,  then upon  request by the
Agent or the Borrower each Lender shall confirm in writing that the liability of
such Guarantor under the Guaranty is released and discharged effective when such
transaction  is  consummated  and such  requirements  are met,  as set  forth in
Section 2.13 of the Guaranty.  Such  confirmation from the Requisite Lenders (1)
shall  establish  conclusively  that the liability of such  Guarantor  under the
Guaranty is released and discharged as set forth in Section 2.13 of the Guaranty
and (2) may be relied on,  without  further  inquiry,  by the  purchaser in such
transaction and each of its transferees.


                                  ARTICLE VIII

                                  MISCELLANEOUS

     SECTION 8.01.  Amendments.  No amendment or waiver of any provision of this
Agreement or the Notes, nor consent to any departure by the Borrower  therefrom,
shall be effective  unless it is in writing and signed by the Requisite  Lenders
(and any such  waiver  or  consent  shall in any case be  effective  only in the
specific  instance  and  for the  specific  purpose  for  which  given),  but no
amendment,  waiver or consent shall,  unless in writing and signed by the Lender
to be bound or affected thereby, do any of the following:

          (a) change the obligation of such Lender to extend credit hereunder or
     subject such Lender to any additional obligations;

<PAGE>


                                       85

          (b) reduce the  principal  of or  interest on the Notes or any fees or
     other  amounts  payable to such  Lender  hereunder  or under any other Loan
     Document;

          (c) postpone any date fixed for any payment  (including  any mandatory
     prepayment) of principal of or interest on any Advances or LC Exposure held
     by such Lender or any fees or other  amounts  payable to such Lender  under
     any Loan Document;

          (d)  waive,   reduce  or  postpone  any  Facility  Reduction  required
     hereunder;

          (e) amend the  definition  of "Facility  Amount,"  "Pro Rata Share" or
     "Requisite Lenders";

          (f)  waive any  Event of  Default  that is  continuing  under  Section
     6.01(a) or 6.01(b) in respect of a payment due to such Lender;

          (g) release any  substantial  portion of the Collateral  other than in
     accordance with the terms of this Agreement;

          (h) release or limit the liability of any Guarantor under the Guaranty
     other than in accordance with the terms of the Guaranty;

          (i) amend Section 2.13, Section 2.17 or Section 6.01(a); or

          (j) amend this Section 8.01;

and (x) no amendment,  waiver or consent shall,  unless in writing and signed by
the Agent in addition to the Lenders required above to take such action,  affect
the rights or duties of the Agent under this  Agreement or any Loan Document and
(y) no amendment,  waiver or consent shall,  unless in writing and signed by the
LC Bank in addition to the Lenders  required  above to take such action,  affect
the rights or duties of the LC Bank under this Agreement.

     SECTION 8.02. Notices.  All notices and other  communications  provided for
hereunder shall be in writing (including telecopier, telegraphic, telex or cable
communication)  and  mailed,   telecopied,   telegraphed,   telexed,  cabled  or
delivered,  if to the Borrower,  at Integrated Health Services,  Inc., 10065 Red
Run Boulevard,  Owings Mills,  Maryland  21117,  Attention:  General Counsel and
Attention:  Eleanor  Harding,  Senior Vice  President,  with a copy to: Hunton &
Williams,  43rd Floor,  MetLife  Building,  200 Park Avenue,  New York, New York
10166, Attention: John R. Fallon, Jr.; if to any Lender, at its Domestic Lending
Office specified opposite its name on Schedule I hereto; and if to the Agent, at
Citibank,  N.A., 399 Park Avenue, New York, New York 10043, Attention:  Margaret
A. Brown,  Vice President,  with a copy to: Shearman & Sterling,  555 California
Street,  20th Floor,  San  Francisco,  California  94104,

<PAGE>


                                       86

Attention:  Steven E.  Sherman;  or, as to each party,  at such other address as
shall be designated by such party in a written notice to the other parties.  All
such notices and  communications  shall, when mailed,  telecopied,  telegraphed,
telexed  or cabled,  be  effective  when  deposited  in the  mails,  telecopied,
delivered to the telegraph  company,  confirmed by telex answerback or delivered
to the cable company,  respectively,  except that notices and  communications to
the Agent pursuant to Article II or VII shall not be effective until received by
the Agent.

     SECTION  8.03. No Waiver;  Remedies.  No failure on the part of any Lender,
the LC Bank or the  Agent to  exercise,  and no delay in  exercising,  any right
under any Loan Document shall operate as a waiver thereof;  nor shall any single
or partial  exercise of any such right  preclude  any other or further  exercise
thereof or the exercise of any other right.  The  remedies  herein  provided are
cumulative and not exclusive of any remedies provided by law.

     SECTION 8.04. Costs and Expenses.  The Borrower agrees to pay on demand all
reasonable  costs and  expenses  incurred  by the Agent in  connection  with the
preparation, negotiation, execution, delivery, modification and amendment of the
Loan Documents and the other documents to be delivered under the Loan Documents,
including  the  reasonable  fees and  out-of-pocket  expenses of counsel for the
Agent with  respect  thereto and with  respect to  advising  the Agent as to its
rights and  responsibilities  under the Loan  Documents.  The  Borrower  further
agrees to pay on demand all reasonable costs and expenses,  including reasonable
fees and expenses of attorneys  (including allocable costs of in-house counsel),
accountants, advisors and other experts, incurred by the Agent or the Lenders in
respect of any Event of Default or while any Event of Default is  continuing  or
in connection with the protection,  resolution or enforcement  (whether  through
negotiations,   by  legal  proceedings,  in  bankruptcy  or  otherwise)  of  the
Obligations or the Collateral or any right, remedy,  power, interest or claim of
the Agent or any Lender under any Loan Document.

     SECTION  8.05.  Right  of  Set-off.   Whenever  any  Event  of  Default  is
continuing,  each Lender may at any time or from time to time,  with the consent
of the  Requisite  Lenders but without any prior  notice to the  Borrower or any
other Person,  set off and apply any and all deposits (general or special,  time
or  demand,  provisional  or final) at any time held and other  debt at any time
owing by such  Lender  to or for the  credit  or the  account  of the  Borrower,
whether or not then due, and whether or not then fully secured,  against any and
all  Advances,  LC Exposure  and other  Obligations  then owing to such  Lender,
whether or not then due.  After any such set-off and  application  is made,  the
Lender that made it shall promptly notify the Borrower thereof,  but the failure
to do so shall not affect the validity of the set-off and  application and shall
not expose such Lender to any liability. The Lenders' right of setoff under this
Section 8.05 is cumulative  with and additional to all other rights and remedies
(including other rights of set-off) of the Lenders.

     SECTION 8.06.  Indemnity.  (a) General  Indemnity.  The Borrower shall pay,
defend,  indemnify, and hold each Lender, the Agent, their respective Affiliates
and each of their

<PAGE>


                                       87

respective officers, directors, employees, counsel, agents and attorneys-in-fact
(each,  an  "INDEMNIFIED   PERSON")  harmless  from  and  against  any  and  all
liabilities, obligations, losses, damages, penalties, actions, judgments, suits,
costs,  charges,  expenses  or  disbursements  (including  reasonable  fees  and
expenses  of  counsel  and  allocated  costs of  internal  counsel  incurred  in
defending any such action or incurred in enforcing this Section  8.06(a)) of any
kind or nature whatsoever with respect to the execution,  delivery,  enforcement
and   performance  of  this  Agreement  and  any  other  Loan  Document  or  the
transactions  contemplated  herein,  and  with  respect  to  any  investigation,
litigation  or  proceeding  related to this  Agreement  or the  Advances  or the
Letters  of  Credit  or the  use of the  proceeds  thereof,  whether  or not any
Indemnified  Person is a party  thereto (all the  foregoing,  collectively,  the
"INDEMNIFIED  LIABILITIES"),  except that the Borrower  shall have no obligation
hereunder  to any  Indemnified  Person with respect to  Indemnified  Liabilities
arising from the gross  negligence  or willful  misconduct  of such  Indemnified
Person.

     (b) Environmental Indemnity. The Borrower shall pay, defend, indemnify, and
hold harmless each Indemnified  Person from and against any and all liabilities,
obligations,  losses,  damages,  penalties,  actions,  judgments,  suits, costs,
charges,  expenses or disbursements  (including  reasonable fees and expenses of
counsel and the allocated cost of internal counsel), which may be incurred by or
asserted against any Indemnified Person in connection with or arising out of any
pending or threatened  investigation  or  Environmental  Claim arising out of or
related to any acts or  omissions  or any property of the Borrower or any of its
Subsidiaries.  In no event shall any site visit, observation,  or testing by the
Agent or any Lender be a representation  that Hazardous Materials are or are not
present in, on, or under the site, or that there has been or shall be compliance
with any Environmental Law. Neither the Borrower nor any other party is entitled
to rely on any site visit,  observation,  or testing by the Agent or any Lender.
Neither the Agent nor any Lender  owes any duty of care to protect the  Borrower
or any other Person  against,  or to inform the Borrower or any other Person of,
any adverse condition affecting any site or property.

     SECTION 8.07.  Assignments and  Participations.  (a) Permitted  Assignment.
Each Lender may assign to one or more banks or other  entities  all or a portion
of its rights and obligations under this Agreement, but (i) each such assignment
shall be of a constant,  and not a varying,  percentage  of all of the assigning
Lender's rights and obligations under this Agreement, unless otherwise consented
to by the Agent;  (ii) the amount of the commitment and outstanding  Advances of
the assigning Lender being assigned pursuant to each such assignment (determined
as of the date of the Assignment and Acceptance with respect to such assignment)
shall  not  be  less  than  $5,000,000  or the  total  amount  of the  remaining
commitment and outstanding Advances of such Lender, except that an assignment to
an  existing  Lender may be in an amount less than  $5,000,000,  (iii) each such
assignment shall be to an Eligible  Assignee,  and (iv) the parties to each such
assignment  shall  execute  and  deliver to the Agent,  for its  acceptance  and
recording in the Register, an Assignment and Acceptance,  together with any Note
or Notes subject to such assignment and a processing and recordation fee payable
to the Agent of $2,500. Upon such

<PAGE>


                                       88

execution, delivery, acceptance and recording, from and after the effective date
specified in each Assignment and Acceptance,  (A) the assignee  thereunder shall
be a party hereto and, to the extent that rights and obligations  hereunder have
been assigned to it pursuant to such Assignment and Acceptance,  have the rights
and  obligations of a Lender  hereunder and (B) the Lender  assignor  thereunder
shall, to the extent that rights and obligations hereunder have been assigned by
it pursuant to such  Assignment  and  Acceptance,  relinquish  its rights and be
released  from its  obligations  under this  Agreement  (and,  in the case of an
Assignment and Acceptance  covering all or the remaining portion of an assigning
Lender's rights and obligations under this Agreement, such Lender shall cease to
be a party hereto).

     (b) Effect of  Assignment.  By executing and  delivering an Assignment  and
Acceptance,  the Lender assignor  thereunder and the assignee thereunder confirm
to and agree with each other and the other parties hereto that (i) other than as
provided in such  Assignment  and  Acceptance,  such  assigning  Lender makes no
representation  or warranty  and assumes no  responsibility  with respect to any
statements,  warranties or  representations  made in or in connection  with this
Agreement or the execution,  legality,  validity,  enforceability,  genuineness,
sufficiency  or value of this  Agreement  or any other  instrument  or  document
furnished   pursuant   hereto  or  as  to  the   Collateral   or  the  validity,
enforceability,  perfection  or priority of any Lien upon the  Collateral;  (ii)
such  assigning  Lender  makes no  representation  or  warranty  and  assumes no
responsibility  with respect to the  financial  condition of the Borrower or the
performance or observance by the Borrower of any of its  obligations  under this
Agreement or any other instrument or document furnished  pursuant hereto;  (iii)
such assignee  confirms that it has received a copy of this Agreement,  together
with copies of the financial  statements referred to in Section 4.01(h) and such
other  documents and  information  as it has deemed  appropriate to make its own
credit analysis and decision to enter into such Assignment and Acceptance;  (iv)
such assignee  will,  independently  and without  reliance upon the Agent,  such
assigning Lender or any other Lender and based on such documents and information
as it shall  deem  appropriate  at the  time,  continue  to make its own  credit
decisions in taking or not taking action under this Agreement; (v) such assignee
confirms  that it is an  Eligible  Assignee;  (vi) such  assignee  appoints  and
authorizes  the Agent to take such action as agent on its behalf and to exercise
such powers  under this  Agreement  as are  delegated  to the Agent by the terms
hereof,  together with such powers as are reasonably  incidental thereto;  (vii)
such assignee  agrees that it will perform in accordance with their terms all of
the  obligations  which  by the  terms  of this  Agreement  are  required  to be
performed by it as a Lender;  and (viii) such assignee  confirms and agrees that
it shall have no greater indemnification rights pursuant to Section 2.16(c) than
its Lender assignor.

     (c) Maintenance of Agreements. The Agent, acting for this purpose (but only
for this purpose) as the agent of the Borrower (and in such capacity neither the
Agent nor any of its directors,  officers,  agents or employees  shall be liable
for any  action  taken or  omitted  to be taken by it or any of them under or in
connection  with  this  Section  8.07(c),  except  for its or  their  own  gross
negligence or willful misconduct),  shall maintain at its address referred to in
Section 8.02 a copy of each Assignment and Acceptance  delivered to and accepted
by it and a  register  for

<PAGE>


                                        89

the  recordation  of the names and addresses of the Lenders and the  commitments
and Pro Rata  Shares of, and  principal  amount of the  Advances  owing to, each
Lender from time to time (the "REGISTER").  The entries in the Register shall be
conclusive  and  binding  for  all  purposes,  absent  manifest  error,  and the
Borrower,  the Agent and the  Lenders  shall  treat  each  Person  whose name is
recorded  in the  Register  as a  Lender  hereunder  for  all  purposes  of this
Agreement. The Register shall be available for inspection by the Borrower or any
Lender  at any  reasonable  time and from  time to time  upon  reasonable  prior
notice.

     (d) Procedure. Upon its receipt of an Assignment and Acceptance executed by
an assigning Lender and an assignee Lender  representing  that it is an Eligible
Assignee,  together with any Note or Notes subject to such assignment, the Agent
shall,  if  such  Assignment  and  Acceptance  has  been  completed  and  is  in
substantially  the form of Exhibit E-2 hereto,  (i) accept such  Assignment  and
Acceptance,  (ii) record the information  contained  therein in the Register and
(iii) give prompt  notice  thereof to the  Borrower.  Within five  Business Days
after its  receipt of such  notice,  the  Borrower,  at its own  expense,  shall
execute and deliver to the Agent in exchange for the surrendered Note or Notes a
new Note or Notes to the order of such Eligible  Assignee in an aggregate amount
equal to the interest in the  surrendered  Note or Notes assigned to it pursuant
to such Assignment and Acceptance  and, if the assigning  Lender has retained an
interest in the  surrendered  Note or Notes, a new Note or Notes to the order of
the assigning  Lender in an aggregate  amount equal to the interest so retained.
Such new Note or Notes shall be in an  aggregate  principal  amount equal to the
aggregate principal amount of such surrendered Note or Notes, shall be dated the
effective  date of such  Assignment  and  Acceptance  and shall  otherwise be in
substantially the form of Exhibit A.

     (e)  Participations.  Each  Lender may sell  participations  to one or more
banks or other entities in all or a portion of its rights and obligations  under
this  Agreement,   but  (i)  such  Lender's  obligations  under  this  Agreement
(including its  commitment to the Borrower  hereunder)  shall remain  unchanged,
(ii) such Lender shall remain solely responsible to the other parties hereto for
the performance of such  obligations,  (iii) such Lender shall remain the holder
of any such  Note or Notes  for all  purposes  of this  Agreement,  and (iv) the
Borrower,  the Agent and the other  Lenders  shall  continue  to deal solely and
directly  with  such  Lender  in  connection   with  such  Lender's  rights  and
obligations under this Agreement.

     (f)  Additional  Information.  Any  Lender  may,  in  connection  with  any
assignment or participation or proposed assignment or participation  pursuant to
this Section 8.07,  disclose to the assignee or participant or proposed assignee
or  participant,  any  information  relating to the  Borrower  furnished to such
Lender by or on behalf of the Borrower,  but only if the assignee or participant
or proposed assignee or participant is obligated to preserve the confidentiality
of any  confidential  information  relating to the Borrower  received by it from
such Lender.

<PAGE>


                                       90

     (g)  Permitted  Assignments.  Any  Lender  may assign any of its rights and
obligations  under this Agreement to any of its Affiliates  without notice to or
consent of the Borrower or the Agent,  and such Lender or any of its  Affiliates
may assign any of its rights (including,  without limitation,  rights to payment
of  principal  and/or  interest  under the Notes)  under this  Agreement  to any
Federal Reserve Bank without notice to or consent of the Borrower or the Agent.

     SECTION 8.08. Binding Effect. This Agreement shall become effective when it
has been executed by the parties  hereto and the conditions set forth in Section
3.01 have been satisfied and  thereafter  shall be binding upon and inure to the
benefit  of the  Borrower,  the  Agent  and each  Lender  and  their  respective
successors  and assigns,  except that the  Borrower  shall not have the right to
assign its rights  hereunder or any interest  herein  without the prior  written
consent  of each of the  Lenders  and the  Agent.  When  (and  only  when)  this
Agreement becomes effective,  the commitments of the financial institutions that
are party to the Existing  Facility to extend credit under the Existing Facility
shall  be  terminated,  but  all  claims  against  the  Borrower  or  any of its
Subsidiaries  under  or in  respect  of the  Existing  Facility,  and all  Liens
securing  any such claim,  shall  remain in full force and effect until paid and
released as set forth in the payout and release agreement  delivered pursuant to
Section 3.01(g).

     SECTION 8.09. Governing Law; Consent to Jurisdiction; Venue. This Agreement
and the other Loan  Documents  shall be governed by, and construed in accordance
with,  the laws of the State of New York.  Any legal action or  proceeding  with
respect  to any Loan  Document  may be brought in the courts of the State of New
York or of the  United  States for the  Southern  District  of New York,  and by
execution and delivery of this  Agreement,  each of the Borrower,  the Agent and
the  Lenders  consents,  for  itself  and in  respect  of its  property,  to the
jurisdiction  of those courts.  Each of the Borrower,  the Agent and the Lenders
irrevocably waives any objection, including any objection to the laying of venue
or based on the grounds of forum non  conveniens,  which it may now or hereafter
have to the bringing of any action or proceeding in such jurisdiction in respect
of any Loan  Document.  The  Borrower,  the Agent  and the  Lenders  each  waive
personal service of any summons,  complaint or other process,  which may be made
by any other means permitted by New York law.

     SECTION 8.10. Waiver of Jury Trial. THE BORROWER, THE LENDERS AND THE AGENT
WAIVE THEIR RESPECTIVE RIGHTS TO A TRIAL BY JURY OF ANY CLAIM OR CAUSE OF ACTION
BASED UPON OR ARISING  OUT OF OR  RELATED  TO THIS  AGREEMENT  OR ANY OTHER LOAN
DOCUMENT  OR THE  TRANSACTIONS  CONTEMPLATED  HEREBY OR THEREBY  IN ANY  ACTION,
PROCEEDING OR OTHER LITIGATION OF ANY TYPE BROUGHT BY ANY OF THE PARTIES AGAINST
ANY OTHER PARTY OR PARTIES, WHETHER BASED ON CONTRACT, TORT, STATUTORY LIABILITY
OR OTHERWISE.  THE BORROWER, THE LENDERS AND THE AGENT AGREE THAT ANY SUCH CLAIM
OR CAUSE OF ACTION SHALL BE TRIED BY THE COURT WITHOUT A JURY. THIS WAIVER

<PAGE>


                                       91

SHALL APPLY TO EACH FUTURE AMENDMENT, RENEWAL, SUPPLEMENT OR MODIFICATION OF ANY
LOAN DOCUMENT AND TO EACH FUTURE LOAN DOCUMENT.

     SECTION  8.11.  Limitation  of  Liability.  No  claim  may be  made  by the
Borrower,  any  Subsidiary of the Borrower,  any Lender,  the Agent or any other
Person  against  the Agent or any other  Lender  or the  Affiliates,  directors,
officers,  employees,  attorneys  or  agents  of any of them  for  any  special,
indirect or  consequential  damages or, to the fullest extent  permitted by law,
for any  punitive  damages in  respect of any claim or cause of action  (whether
based on contract,  tort,  statutory  liability,  or any other ground) based on,
arising out of or related to any Loan Document or the transactions  contemplated
hereby or any act, omission or event occurring in connection therewith,  and the
Borrower (for itself and on behalf of each of its  Subsidiaries),  the Agent and
each Lender hereby waive,  release and agree never to sue upon any claim for any
such damages,  whether such claim now exists or hereafter  arises and whether or
not it is now known or suspected to exist in its favor.

     SECTION 8.12.  Entire  Agreement.  This Agreement,  together with the other
Loan  Documents,  embodies  the entire  Agreement  and  understanding  among the
Borrower,  the Lenders and the Agent and supersedes all prior or contemporaneous
agreements and  understandings of such persons,  verbal or written,  relating to
the subject  matter  hereof and thereof  except for the Fee Letter and any prior
arrangements  made  with  respect  to the  payment  by the  Borrower  of (or any
indemnification  for) any fees,  costs or expenses payable to or incurred (or to
be incurred) by or on behalf of the Agent or any Lender.

     SECTION 8.13. Survival. The Borrower's liability for any and all additional
interest,  fees, taxes,  compensation,  costs, losses,  expense  reimbursements,
indemnification  and other similar  Obligations  arising under any Loan Document
shall survive the expiration or termination of the commitments of the Lenders to
extend credit  hereunder and the repayment and retirement of all Advances and LC
Exposure at any time outstanding hereunder.

     SECTION 8.14. Execution in Counterparts.  This Agreement may be executed in
any  number  of  counterparts  and  by  different  parties  hereto  in  separate
counterparts,  each of which when so executed  shall be deemed to be an original
and all of which taken together shall constitute one and the same agreement.


              [THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK]



<PAGE>


                                      S-1

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

                                      INTEGRATED HEALTH SERVICES, INC.


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      CITIBANK, N.A.,
                                           as Administrative Agent and Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      BANK OF AMERICA N.T.&S.A.
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      THE BANK OF NOVA SCOTIA,
                                           as LC Bank, a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>


                                      S-2

                                      CORESTATES BANK, N.A.,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      CREDIT LYONNAIS
                                          NEW YORK BRANCH,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      DEUTSCHE BANK AG,
                                           NEW YORK BRANCH AND/OR
                                           CAYMAN ISLANDS BRANCH
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      FIRST UNION NATIONAL BANK OF
                                           NORTH CAROLINA,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>


                                      S-3

                                      NATIONSBANK, N.A.,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


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


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      TORONTO DOMINION (TEXAS), INC.,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      VAN KAMPEN AMERICAN CAPITAL
                                           PRIME RATE INCOME TRUST,
                                           as a Lender and Co-Agent


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>


                                      S-4

                                      CREDITANSTALT CORPORATE
                                           FINANCE, INC.,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      FLEET NATIONAL BANK,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      GENERAL ELECTRIC CAPITAL
                                           CORPORATION,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      HIBERNIA NATIONAL BANK,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>


                                      S-5

                                      AMSOUTH BANK,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      THE BANK OF TOKYO-MITSUBISHI
                                           TRUST COMPANY,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                       THE SANWA BANK, LIMITED,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      SIGNET BANK,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>


                                      S-6

                                      THE SUMITOMO BANK, LIMITED,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:


                                      FIRST AMERICAN NATIONAL BANK,
                                           as a Lender


                                      By: /s/ 
                                         ------------------------------------
                                           Name:
                                           Title:

<PAGE>

                        INTEGRATED HEALTH SERVICES, INC.
                             10065 Red Run Boulevard
                          Owings Mills, Maryland 21117


                                September 6, 1996


To the Administrative Agent and
  the Lenders parties to the Revolving
  Credit Agreement referred to below


                  Amendment No. 1 to Revolving Credit Agreement
              Consent of Administrative Agent and Requisite Lenders
              -----------------------------------------------------


Ladies and Gentlemen:

     Reference is made to the revolving  credit  agreement,  dated as of May 15,
1996 (the "Credit Agreement"),  among Integrated Health Services,  Inc. ("IHS"),
Citibank N.A., as administrative  agent thereunder (the "Agent"),  and the other
financial  institutions party thereto, as lenders thereunder.  Capitalized terms
used and not otherwise  defined  herein are used herein as defined in the Credit
Agreement.

     First  American and IHS have amended the First  American  Merger  Agreement
pursuant to an amendment,  dated as of September 9, 1996 (the "Amendment"),  and
the plan of  reorganization  (the "Plan of  Reorganization")  in the  bankruptcy
proceeding of First  American in order to  incorporate  settlements  among First
American,  the  Health  Care  Financing  Administration  and the  Department  of
Justice.  The  Amendment,  among other  things,  increases  the  purchase  price
potentially  payable by IHS in connection  with the First American Merger by $35
million,  so that the aggregate purchase price could be as high as $312 million.
Copies  of the  Amendment  and the  amended  Plan of  Reorganization  have  been
provided to you under separate cover.

     Pursuant to Section  5.03(c)(xii)(A) of the Credit Agreement,  in order for
IHS to  consummate  the First  American  Merger  pursuant to the First  American
Merger  Agreement,  as  amended  by the  Amendment,  and  the  amended  Plan  of
Reorganization,  (i) the terms and  conditions  of the Amendment and the amended
Plan of Reorganization must be satisfactory to the Agent in its sole discretion,
and (ii) the  terms of the  Amendment  and the  amended  Plan of  Reorganization
relating to the increase in the aggregate purchase price potentially  payable by
IHS in connection  therewith must be  satisfactory  to the Requisite  Lenders in
their sole  discretion.  IHS hereby  requests  that you consent to the terms and
conditions of the Amendment  and the amended Plan of  Reorganization  and to the
consummation of the First American Merger



<PAGE>


                                       2

pursuant to the First American  Merger  Agreement,  as amended by the Amendment,
and the amended Plan of Reorganization.

     IHS also  hereby  requests  that you agree (i) to amend the  definition  of
"Debt" in the  Credit  Agreement  by adding  to the end of such  definition  the
proviso ";  provided,  however,  that the  contingent  payments which may become
payable in accordance  with the First American Merger  Agreement,  including any
payments made to the Health Care Financing  Administration  or the Department of
Justice as required under the First American Merger Agreement, in a total amount
not in excess of $162  million,  shall not  consitute  Debt for purposes of this
Agreement";  and (ii) to amend Section  5.03(c)(xii) of the Credit  Agreement by
deleting  in  the  fourth  line  of  such   section  the  words  "be  final  and
nonappealable"  and inserting in their place the words "have been  entered,  and
its effectiveness shall not have been stayed or enjoined in any manner,".

     Please  evidence your  acknowledgement  of and agreement and consent to the
foregoing  by  executing  and  returning  not later  than close of  business  on
September 11, 1996 the three  counterparts  of this  Amendment No. 1 and consent
enclosed herewith to Citicorp Securities,  Inc., 399 Park Avenue, 9th Floor, New
York, New York 10043, Attention: Rosemary Bell. This Amendment No. 1 and consent
shall  become  effective  as of  the  date  first  above  written  when  and  if
counterparts of this Amendment No. 1 and consent shall have been executed by the
Requisite  Lenders and the consent  attached  hereto shall have been executed by
the Guarantors. This Amendment No. 1 and consent is subject to the provisions of
Section 8.01 of the Credit Agreement.

     This  Amendment  No.  1 and  consent  may  be  executed  in any  number  of
counterparts   and  by  any  combination  of  the  parties  hereto  in  separate
counterparts,  each of which  counterparts shall be an original and all of which
taken together shall constitute one and the same Amendment No. 1 and consent.

                                            Very truly yours,

                                            INTEGRATED HEALTH
                                               SERVICES, INC.


                                            By: /s/ 
                                               --------------------------------
                                               Name:
                                               Title:




<PAGE>


                                       3

ACKNOWLEDGED, AGREED AND CONSENTED TO as of the date first above written:

CITIBANK, N.A.,
   as Administrative Agent and as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    

BANK OF AMERICA NATIONAL TRUST
   AND SAVINGS ASSOCIATION,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


THE BANK OF NOVA SCOTIA,
   as LC Bank, a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


CORESTATES BANK, N.A.,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>


                                       4

CREDIT LYONNAIS,
   NEW YORK BRANCH,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


DEUTSCHE BANK AG,
   NEW YORK BRANCH AND/OR
   CAYMAN ISLANDS BRANCH,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


FIRST UNION NATIONAL BANK
   OF NORTH CAROLINA,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


NATIONSBANK, N.A.,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>


                                        5

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


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


TORONTO DOMINION (TEXAS), INC.,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


VAN KAMPEN AMERICAN CAPITAL
   PRIME RATE INCOME TRUST,
   as a Lender and Co-Agent


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


CREDITANSTALT CORPORATE
   FINANCE, INC.,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>


                                        6

FLEET NATIONAL BANK,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


GENERAL ELECTRIC
   CAPITAL CORPORATION,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


HIBERNIA NATIONAL BANK,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


AMSOUTH BANK OF ALABAMA,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>


                                        7

THE BANK OF TOKYO-MITSUBISHI
   TRUST COMPANY,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


THE SANWA BANK, LIMITED,
  NEW YORK BRANCH
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


SIGNET BANK,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    


THE SUMITOMO BANK, LIMITED,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>


                                        8

FIRST AMERICAN NATIONAL BANK,
   as a Lender


By: /s/                           
   -------------------------------------
   Name:                     
   Title:                    



<PAGE>



                                     CONSENT

     The undersigned,  as Guarantors under the Subsidiary Guaranty,  dated as of
May 15, 1996 (the "Guaranty"),  in favor of the Agent for the Lenders parties to
the Credit  Agreement  referred to in the  foregoing  letter waiver and consent,
hereby  consent to such letter  waiver and consent and hereby  confirm and agree
that  notwithstanding  the effectiveness of such letter waiver and consent,  the
Guaranty  is, and shall  continue  to be, in full force and effect and is hereby
confirmed and ratified in all respects.

     ALABAMA SENIOR LIFE CARE, INC.
     ALPINE MANOR, INC.
     AMCARE HEALTH SERVICES, INC.
     AMCARE, INC.
     ARBOR LIVING CENTERS OF FLORIDA, INC.
     ARBOR LIVING CENTERS OF TEXAS, INC.
     ASIA CARE, INC.
     BETHAMY LIVING CENTER MANAGEMENT COMPANY
     BETHAMY LIVING CENTERS LIMITED PARTNERSHIP
     BRIAR HILL, INC.
     BRIARCLIFF NURSING HOME, INC.
     CAMBRIDGE CARE CENTERS, INC.
     CAMBRIDGE GROUP OF INDIANA, INC.
     CAMBRIDGE GROUP OF PENNSYLVANIA, INC.
     CAMBRIDGE GROUP OF TEXAS, INC.
     CARE CENTERS HOLDING, INC.
     CARRIAGE-By: -THE-LAKE OF IHS, INC.
     CEDARCROFT HEALTH SERVICES, INC.
     CENTRAL PARK LODGES, INC.
     CENTRAL PARK LODGES OF WEST PALM BEACH, INC.
     CENTRAL PARK LODGES (TARPON SPRINGS), INC.
     CLARA BURKE NURSING HOME, INC.
     CLAREMONT INTEGRATED HEALTH, INC.
     COMPREHENSIVE POSTACUTE SERVICES, INC.
     DERRY INTEGRATED HEALTH, INC.
     ELIZABELL CO., INC.
     ELM CREEK OF IHS, INC.
     F.L.C. BENEVA NURSING PAVILION, INC.
     F.L.C. SARASOTA NURSING PAVILION, INC.
     FERRIGAN MOBILE X-RAY, INC.
     FIRELANDS OF IHS, INC.
     FLORIDA LIFE CARE, INC.
     FLORIDA LIFE CARE, INC.
     GAINESVILLE HEALTH CARE CENTER, INC.
     GRAVOIS HEALTH CARE, INC.



<PAGE>


                                        2

     HEALTH CARE SYSTEMS, INC.
     HEALTHCARE PHARMACY SERVICES OF FLORIDA, INC.
     HEALTHCARE PHARMACY SERVICES OF PENNSYLVANIA, INC.
     HEALTHCARE PHARMACY SERVICES OF TEXAS, INC.
     HOME HEALTH INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT I, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT VII-B, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE OF INTEGRATED HEALTH SERVICES, INC.
     IHS ACQUISITION XIII, INC.
     IHS AT LANSING, INC.
     IHS OF DANA, INC.
     INTEGRACARE, INC.
     INTEGRATED-BALLARD, INC.
     INTEGRATED HEALTH GROUP LIMITED PARTNERSHIP
     INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.
     INTEGRATED HEALTH OF WATERFORD COMMONS, INC.
     INTEGRATED HEALTH SERVICES AT ALEXANDRIA, INC.
     INTEGRATED HEALTH SERVICES AT BIG SAIL, INC.
     INTEGRATED HEALTH SERVICES AT BLUE RIDGE MANOR, INC.
     INTEGRATED HEALTH SERVICES AT BRIARCLIFF HAVEN, INC.
     INTEGRATED HEALTH SERVICES AT CADIZ, INC.
     INTEGRATED HEALTH SERVICES AT CENTRAL FLORIDA, INC.
     INTEGRATED HEALTH SERVICES AT CHEYENNE, INC.
     INTEGRATED HEALTH SERVICES AT COLORADO SPRINGS, INC.
     INTEGRATED HEALTH SERVICES AT COLUMBUS, INC.
     INTEGRATED HEALTH SERVICES AT DAYTON, INC.
     INTEGRATED HEALTH SERVICES AT DRIFTWOOD, INC.
     INTEGRATED HEALTH SERVICES AT EASTERN MASSACHUSETTS, INC.
     INTEGRATED HEALTH SERVICES AT GRANDVIEW CARE CENTER, INC.
     INTEGRATED HEALTH SERVICES AT GREAT BEND, INC.
     INTEGRATED HEALTH SERVICES AT HOPEDALE, INC.
     INTEGRATED HEALTH SERVICES AT HOUSTON, INC.
     INTEGRATED HEALTH SERVICES AT INDIAN CREEK, INC.
     INTEGRATED HEALTH SERVICES AT KEN, INC.
     INTEGRATED HEALTH SERVICES AT NEWARK, INC.
     INTEGRATED HEALTH SERVICES AT ORMOND BEACH, INC.
     INTEGRATED HEALTH SERVICES AT PARK REGENCY, INC.
     INTEGRATED HEALTH SERVICES AT PENN, INC.
     INTEGRATED HEALTH SERVICES AT SILVERCREST, INC.
     INTEGRATED HEALTH SERVICES AT SOMERSET VALLEY, INC.
     INTEGRATED HEALTH SERVICES AT SOUTHERN HILLS, INC.
     
     
     
<PAGE>
     
     
                                        3
     
     INTEGRATED HEALTH SERVICES AT STEUBENVILLE
     INTEGRATED HEALTH SERVICES AT SYCARMORE CREEK, INC.
     INTEGRATED HEALTH SERVICES AT THREE RIVERS, INC.
     INTEGRATED HEALTH SERVICES AT TREYBURN, INC.
     INTEGRATED HEALTH SERVICES FINANCIAL HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES NPR, INC.
     INTEGRATED HEALTH SERVICES OF ARCADIA, INC.
     INTEGRATED HEALTH SERVICES OF ATHENS, INC.
     INTEGRATED HEALTH SERVICES OF BRENTWOOD, INC.
     INTEGRATED HEALTH SERVICES OF CALIFORNIA, INC.
     INTEGRATED HEALTH SERVICES OF CLIFF MANOR, INC.
     INTEGRATED HEALTH SERVICES OF COLORADO AT CHERRY CREEK,
     INC.
     INTEGRATED HEALTH SERVICES OF EAGLE CREEK, INC.
     INTEGRATED HEALTH SERVICES OF GREEN BRIAR, INC.
     INTEGRATED HEALTH SERVICES OF HERITAGE MANOR, INC.
     INTEGRATED HEALTH SERVICES OF HICKORY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF INDIAN HILLS, INC.
     INTEGRATED HEALTH SERVICES OF JACKSONVILLE, INC.
     INTEGRATED HEALTH SERVICES OF KURT, INC.
     INTEGRATED HEALTH SERVICES OF LESTER, INC.
     INTEGRATED HEALTH SERVICES OF MELISSA, INC.
     INTEGRATED HEALTH SERVICES OF MISSOURI, INC.
     INTEGRATED HEALTH SERVICES OF ORANGE PARK, INC.
     INTEGRATED HEALTH SERVICES OF RIVERBEND, INC.
     INTEGRATED HEALTH SERVICES OF SCENIC HILLS, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW II, INC.
     INTEGRATED LIVING COMMUNITIES AT DENTON (MARYLAND), INC.
     INTEGRATED LIVING COMMUNITIES OF SARASOTA, INC.
     INTEGRATED LIVING COMMUNITIES RETIREMENT MANAGEMENT, INC.
     INTEGRATED MANAGEMENT-CARRINGTON PONTE, INC.
     INTEGRATED MANAGEMENT-GOVERNOR'S PARK, INC.
     INTEGRATED OF AMARILLO, INC.
     INTEGRATED PHYSICIAN GROUP SERVICES, INC.
     ISABETH CO., INC.
     LPC BETHAMY HEALTH CORPORATION
     MANCHESTER INTEGRATED HEALTH, INC.
     MOBILE RAY OF NEW ORLEANS, INC.
     MOUNTAIN VIEW NURSING CENTER, INC.
     NEW SOUTHWOOD ASSOCIATES, INC.
     PALESTINE NURSING CENTER, INC.
     
     
     
<PAGE>
     
     
                                        4
     
     PALESTINE NURSING CENTER, INC.
     PATIENT CARE PHARMACY, INC.
     PATIENT CARE PHARMACY - COLORADO SPRINGS, INC.
     PHARMACEUTICAL DOSE SERVICE, INC.
     PINELLAS PARK NURSING HOME, INC.
     PROFESSIONAL REVIEW NETWORK, INC.
     REHAB MANAGEMENT SYSTEMS, INC.
     REST HAVEN NURSING CENTERS, INC.
     REST HAVEN NURSING CENTERS (CHESTNUT HILL), INC.
     REST HAVEN NURSING CENTERS (WHITEMARSH), INC.
     RIKAD PROPERTIES, INC.
     SAMARITAN CARE, INC.
     SAMARITAN CARE, INC.
     SAMARITAN MANAGEMENT, INC.
     SENIOR LIFE CARE, INC.
     SENIOR LIFE CARE OF CALIFORNIA, INC.
     SENIOR LIFE CARE OF LOUISIANA, INC.
     SENIOR LIFE CARE OF OKLAHOMA, INC.
     SENIOR LIFE CARE OF TENNESSEE, INC.
     SENIOR LIFE CARE OF TEXAS, INC.
     SLC COMMUNITY CARE, INC.
     SOUTHWOOD HOLDINGS, INC.
     SPRING CREEK OF IHS, INC.
     SYMPHONY ANCILLARY SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 1, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 2, INC.
     SYMPHONY HEALTH CARE CONSULTING, INC.
     SYMPHONY HEALTH SERVICES, INC.
     SYMPHONY HOME CARE SERVICES, INC.
     SYMPHONY HOME CARE SERVICES NO. 1, INC.
     SYMPHONY HOME CARE SERVICES NO. 2, INC.
     SYMPHONY HOME CARE SERVICES NO. 3, INC.
     SYMPHONY HOME CARE SERVICES NO. 4, INC.
     SYMPHONY HOME CARE SERVICES NO. 5, INC.
     SYMPHONY HOME CARE SERVICES NO. 6, INC.
     SYMPHONY HOME CARE SERVICES NO. 7, INC.
     SYMPHONY HOME CARE SERVICES NO. 8, INC.
     SYMPHONY HOME CARE SERVICES NO. 9, INC.
     SYMPHONY HOME CARE SERVICES NO. 10, INC.
     SYMPHONY HOME CARE SERVICES NO. 11, INC.
     SYMPHONY HOME CARE SERVICES NO. 12, INC.
     SYMPHONY HOME CARE SERVICES NO. 13, INC.



<PAGE>


                                        5


     SYMPHONY HOME CARE SERVICES NO. 14, INC.
     SYMPHONY HOME CARE SERVICES NO. 15, INC.
     SYMPHONY HOME CARE SERVICES NO. 16, INC.
     SYMPHONY HOME CARE SERVICES NO. 17, INC.
     SYMPHONY HOME CARE SERVICES NO. 100, INC.
     SYMPHONY HOME CARE SERVICES NO. 101, INC.
     SYMPHONY HOME CARE SERVICES NO. 102, INC.
     SYMPHONY HOME CARE SERVICES NO. 103, INC.
     SYMPHONY HOME CARE SERVICES NO. 104, INC.
     SYMPHONY HOME CARE SERVICES NO. 105, INC.
     SYMPHONY HOME CARE SERVICES NO. 106, INC.
     SYMPHONY HOME CARE SERVICES NO. 107, INC.
     SYMPHONY HOME CARE SERVICES NO. 108, INC.
     SYMPHONY HOME CARE SERVICES NO. 109, INC.
     SYMPHONY HOME CARE SERVICES NO. 110, INC.
     SYMPHONY HOME CARE SERVICES NO. 113, INC.
     SYMPHONY HOME CARE SERVICES NO. 114, INC.
     SYMPHONY HOME CARE SERVICES NO. 115, INC.
     SYMPHONY HOME CARE SERVICES NO. 116, INC.
     SYMPHONY HOME CARE SERVICES NO. 117, INC.
     SYMPHONY HOME CARE SERVICES NO. 118, INC.
     SYMPHONY HOME CARE SERVICES NO. 119, INC.
     SYMPHONY HOME CARE SERVICES NO. 120, INC.
     SYMPHONY HOME CARE SERVICES NO. 121, INC.
     SYMPHONY HOME CARE SERVICES NO. 122, INC.
     SYMPHONY PHARMACY SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES NO. 1, INC.
     SYMPHONY REHABILITATION SERVICES NO. 2, INC.
     SYMPHONY REHABILITATION SERVICES NO. 3, INC.
     SYMPHONY REHABILITATION SERVICES NO. 4, INC.
     SYMPHONY RESPIRATORY SERVICES, INC.
     TEXAS LPC, INC.
     WEST COAST CAMBRIDGE, INC.
     WOODRIDGE CONVALESCENT CENTER, INC.


     By: /s/ 
        ---------------------------------
        Name:
        Title:
             of Each Guarantor or of the
             General Partner of such Guarantor


<PAGE>

                        INTEGRATED HEALTH SERVICES, INC.
                             10065 Red Run Boulevard
                          Owings Mills, Maryland 21117


                                November 8, 1996


To the Administrative Agent and
  the Lenders parties to the Revolving
  Credit Agreement referred to below


                  Amendment No.2 to Revolving Credit Agreement
                  --------------------------------------------


Ladies and Gentlemen:

     Reference is made to the Revolving  Credit  Agreement,  dated as of May 15,
1996,  as amended by Amendment  No. 1 dated  September  6, 1996 (such  Revolving
Credit Agreement as so amended being the "Credit  Agreement"),  among Integrated
Health Services, Inc. ("IHS"), Citibank N.A., as administrative agent thereunder
(the "Agent"),  and the other financial  institutions party thereto,  as lenders
thereunder.  Capitalized  terms used and not otherwise  defined  herein are used
herein as defined in the Credit Agreement.

     IHS has proposed to acquire Coram Healthcare  Corporation ("Coram") pursunt
to an  Agreement  and Plan of Merger  entered  into as of October  19, 1996 (the
"Merger Agreement") and in connection therewith has requested that the Requisite
Lenders  agree to amend certain  covenants  contained in Article V of the Credit
Agreement to permit such  acquisition.  We understand that the Requisite Lenders
are, on the terms and conditions stated below, willing to grant our request, and
the Requisite  Lenders have agreed to amend the Credit  Agreement as hereinafter
set forth.

     Effective  as of the date  hereof and  subject to the  satisfaction  of the
condition  precedents set forth below, the Credit Agreement is hereby amended as
follows:

          (a) Section  5.03(c) is amended by  deleting  the period at the end of
     subsection (xv) thereof and substituting  therefor "; and" and adding a new
     subsection (xvi) following such subsection (xv) to read as follows:

               "(xvi) The merger  pursuant to the  Agreement  and Plan of Merger
               ('Merger  Agreement')  entered  into as of October 19, 1996 among
               Coram  Healthcare  Corporation  ('Coram'),  the  Borrower and IHS
               Acquisition XIX, Inc. (the 'Coram Merger'), provided that (A) any
               amendment or modification of such Merger Agreement after November
               8,1996 which increases the Debt assumed



<PAGE>


                                        2

               thereunder by the Borrower or any of its Subsidiaries or the cash
               consideration  payable by the Borrower or any of its Subsidiaries
               in  connection  therewith  in  excess  of  $10,000,000  shall  be
               satisfactory to the Requisite  Lenders in their sole  discretion,
               (B) at the time of or after giving effect to the Coram Merger, no
               Event of Default or Potential  Default  shall exist or result and
               (C) the  Borrower  shall  comply with the  provisions  of Section
               5.02(e), and neither the Borrower nor any of its Subsidiaries nor
               any of their properties shall be or become bound by or subject to
               any contractual obligation that is or would be violated or put in
               default  by  reason  of  such  compliance  or by  reason  of  the
               enforcement  of the claims and Liens of the Agent and the Lenders
               arising from such compliance."

          (b) Section  5.03(d) is amended by  deleting  the period at the end of
     subsection (v) thereof and  substituting  therefor "; and" and adding a new
     subsection (vi) following such subsection (v) to read as follows:

               "(vi) In connection  with the Coram Merger,  (A) Debt owed by the
               Borrower to Coram Funding, Inc. ('Coram Funding') in an aggregate
               principal  amount not in excess of the amount equal to the sum of
               $172,300,000  plus  interest  at the rate of 11% per  annum  from
               January 1, 1997 to the date of the  cloisng  of the Coram  Merger
               divided by 0.98625 and which shall mature in full no earlier than
               the tenth  anniversary of its issuance,  bear interest at rate no
               greater  than  11%  per  annum,  have  subordination  provisions,
               covenants  and other terms and  conditions  identical to those in
               the 1996 Subordinated  Debt Indenture (except certain  exceptions
               thereto as set forth in the  Agreement  dated as of  October  19,
               1996  between  the  Borrower  and  Coram  Funding)  and  have  no
               scheduled principal payments until maturity, and (B) Debt owed by
               Coram to MedPartners,  Inc. in an aggregate  principal amount not
               in excess of  $52,687,000  (plus an amount  equal to the  accrued
               interest  from  September 30, 1996 through the date of closing of
               the Coram  Merger  on the 7%  Convertible  Subordinated  Notes of
               Coram  to  Caremark   Inc.  due  October  1,  2005  and  the  12%
               Non-Convertible Subordinated Notes of Coram to Caremark, Inc. due
               October  1,  2005) and which  shall  mature no  earlier  than the
               second anniversary of its issuance and bear interest at a rate no
               greater  that the  lesser  of (1) 8% per  annum  or (2)  one-half
               percent below the interest rate in effect from time to time under
               this Agreement."

     This  Amendment  shall become  effective when and only when the Agent shall
have  received  (A)  counterparts  of  this  Amendment  executed  by IHS and the
Requisite  Lenders,  or as to any of such Lenders,  advice  satisfactory  to the
Agent that such Lender has executed this Amendment, (B) an amendment fee for the
ratable  account of each  Lender in an  aggregate  amount  equal to .0005 of the
Facility Amount and the supplemental fee as set forth in a letter dated November
8, 1996 from the



<PAGE>


                                        3

Agent to IHS (the "Agent's Letter") and (C) counterparts of the Consent appended
hereto (the "Consent"),  executed by each Guarantor. In addition, this Amendment
shall be of no force or effect if (i) the Agent  does not  receive  on or before
the date of the  closing  of the  acquisition  of Coram  pursuant  to the Merger
Agreement  an  additional  fee for the  ratable  account  of each  Lender  in an
aggregate amount equal to .001375 of the Facility Amount and (ii) the Agent does
not receive  the  additional  fee as set forth in the Agent's  Letter by the due
date therefor.

          IHS represents and warrants as follows:

          (a) IHS is duly organized, validly existing and in good standing under
     the laws of Delaware.  Each Guarantor is a corporation or partnership  duly
     organized and validly  existing under the laws of the jurisdiction in which
     it is organized.

          (b) Each of IHS and each  Guarantor has the  corporate or  partnership
     power to execute,  deliver and perform this  Amendment and the Consent,  as
     the case  may be,  and to take  all  action  necessary  to  consummate  the
     transactions   contemplated   hereunder.   The   execution,   delivery  and
     performance  by IHS and each  Guarantor of this  Amendment and the Consent,
     respectively,  have been duly authorized by all necessary action and do not
     contravene (i) its certificate or articles of incorporation (or, in case of
     a  partnership,  governing  agreements)  or (ii) any law or any  indenture,
     lease or written agreement binding on or affecting it.

          (c) No  authorization or approval or other action by, and no notice to
     or  filing  with,  any  Governmental  Authority  is  required  for  the due
     execution,  delivery  and  performance  by  IHS or any  Guarantor  of  this
     Amendment or the Consent, respectively.

          (d) This  Amendment  and the  Consent  constitutes  legal,  valid  and
     binding  obligations of IHS and each Guarantor,  respectively,  enforceable
     against IHS and each  Guarantor,  respectively,  in  accordance  with their
     respective  terms subject to laws  generally  affecting the  enforcement of
     creditors' rights.

     Upon the effectiveness of this Amendment, on and after the date hereof each
reference in the Credit Agreement to "this Agreement",  "hereunder", "hereof" of
words of like import  referring to the Credit  Agreement,  and each reference in
the other Loan Documents to "the Credit Agreement",  "thereunder",  "thereof" or
words of like  import  referring  to the Credit  Agreement,  shall mean and be a
reference to the Credit  Agreement  as amended  hereby.  Except as  specifically
amended above, the Credit Agreement, and all other Loan Documents, are and shall
continue to be in full force and effect and are hereby in all respects  ratified
and confirmed. The execution, delivery and effectiveness of this Amendment shall
not,  except as  expressly  provided  herein,  operate as a waiver of any right,
power or remedy of any Lender or the Agent under any of the Loan Documents,  not
constitute  a  waiver  of any  provision  of any of  the  Loan  Documents.  This
Amendment  shall be governed by, and construed in accordance  with,  the laws of
the State of New York.




<PAGE>


                                        4


     Please evidence your  acknowledgement  of and agreement to the foregoing by
executing  and  returning  not later than close of business on November 13, 1996
the three  counterparts of this Amendment No. 2 and consent enclosed herewith to
Citicorp Securities, Inc., 399 Park Avenue, 9th Floor, New York, New York 10043,
Attention:  Rosemary  Bell.  This  Amendment No. 2 and consent is subject to the
provisions of Section 8.01 of the Credit Agreement.

     This  Amendment  No.  2 and  consent  may  be  executed  in any  number  of
counterparts   and  by  any  combination  of  the  parties  hereto  in  separate
counterparts,  each of which  counterparts shall be an original and all of which
taken together shall constitute one and the same Amendment No. 2 and consent.

                                               Very truly yours,

                                               INTEGRATED HEALTH
                                                  SERVICES, INC.


                                               By: /s/ 
                                                  ------------------------------
                                                  Name:
                                                  Title:

ACKNOWLEDGED, AGREED
  AND CONSENTED TO as of
  the date first above written:

CITIBANK, N.A.,
   as Administrative Agent and as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


BANK OF AMERICA NATIONAL TRUST
   AND SAVINGS ASSOCIATION,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


<PAGE>


                                        5


THE BANK OF NOVA SCOTIA,
   as LC Bank, a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


CORESTATES BANK, N.A.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


CREDIT LYONNAIS,
   NEW YORK BRANCH,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


DEUTSCHE BANK AG,
   NEW YORK BRANCH AND/OR
   CAYMAN ISLANDS BRANCH,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        6


FIRST UNION NATIONAL BANK
   OF NORTH CAROLINA,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


NATIONSBANK, N.A.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


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


By: /s/ 
   -------------------------------------
   Name:
   Title:


TORONTO DOMINION (TEXAS), INC.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        7


VAN KAMPEN AMERICAN CAPITAL
   PRIME RATE INCOME TRUST,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


CREDITANSTALT CORPORATE
   FINANCE, INC.,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


By: /s/ 
   -------------------------------------
   Name:
   Title:


FLEET NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


GENERAL ELECTRIC
   CAPITAL CORPORATION,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


<PAGE>


                                        8


HIBERNIA NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


AMSOUTH BANK OF ALABAMA,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE BANK OF TOKYO-MITSUBISHI
   TRUST COMPANY,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE SANWA BANK, LIMITED,
  NEW YORK BRANCH
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        9


SIGNET BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE SUMITOMO BANK, LIMITED,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


FIRST AMERICAN NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:






<PAGE>


                                       10

ALLIED IRISH BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


PROVIDENT BANK OF MARYLAND,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


BANK OF AMERICA ILLINOIS
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:




<PAGE>



                                     CONSENT

     The undersigned,  as Guarantors under the Subsidiary Guaranty,  dated as of
May 15, 1996 (the "Guaranty"),  in favor of the Agent for the Lenders parties to
the Credit Agreement referred to in the foregoing Amendment No. 2 hereby consent
to such  Amendment No. 2 and hereby confirm and agree that  notwithstanding  the
effectiveness  of such  Amendment No. 2, the Guaranty is, and shall  continue to
be, in full  force  and  effect  and is hereby  confirmed  and  ratified  in all
respects.

     ABC GP, INC.
     ABC HOME HEALTH AND HOSPICE OF ALBANY, INC.
     ABC HOME HEALTH AND HOSPICE OF ATHENS, INC.
     ABC HOME HEALTH AND HOSPICE OF BRUNSWICK, INC.
     ABC HOME HEALTH AND HOSPICE OF DUBLIN, INC.
     ABC HOME HEALTH AND HOSPICE OF MACON, INC.
     ABC HOME HEALTH AND HOSPICE OF SAVANNAH, INC.
     ABC HOME HEALTH AND HOSPICE OF TIFTON, INC.
     ABC HOME HEALTH AND HOSPICE OF VIDALIA, INC.
     ABC HOME HEALTH AND HOSPICE OF WAYCROSS, INC.
     ABC HOME NURSING, INC.
     ABC NEWCO, INC.
     ABC PHARMACEUTICALS, INC.
     ALABAMA SENIOR LIFE CARE, INC.
     ALPINE MANOR, INC.
     AMCARE HEALTH SERVICES, INC.
     AMCARE, INC.
     ARBOR LIVING CENTERS OF FLORIDA, INC.
     ARBOR LIVING CENTERS OF TEXAS, INC.
     ASIA CARE, INC.
     BETHAMY LIVING CENTER MANAGEMENT COMPANY
     BETHAMY LIVING CENTERS LIMITED PARTNERSHIP
     BRIAR HILL, INC.
     BRIARCLIFF NURSING HOME, INC.
     CAMBRIDGE CARE CENTERS, INC.
     CAMBRIDGE GROUP OF INDIANA, INC.
     CAMBRIDGE GROUP OF PENNSYLVANIA, INC.
     CAMBRIDGE GROUP OF TEXAS, INC.
     CARE CENTERS HOLDING, INC.
     CARRIAGE-By-THE-LAKE OF IHS, INC.
     CEDARCROFT HEALTH SERVICES, INC.
     CENTRAL PARK LODGES, INC.
     CENTRAL PARK LODGES OF WEST PALM BEACH, INC.
     CENTRAL PARK LODGES (TARPON SPRINGS), INC.
     CLARA BURKE NURSING HOME, INC.



<PAGE>



     CLAREMONT INTEGRATED HEALTH, INC.
     COMPREHENSIVE POSTACUTE SERVICES, INC.
     DERRY INTEGRATED HEALTH, INC.
     ELIZABELL CO., INC.
     ELM CREEK OF IHS, INC.
     F.L.C. BENEVA NURSING PAVILION, INC.
     F.L.C. SARASOTA NURSING PAVILION, INC.
     FERRIGAN MOBILE X-RAY, INC.
     FIRELANDS OF IHS, INC.
     FIRST AMERICAN HOME CARE OF ALABAMA, INC.
     FIRST AMERICAN HOME CARE OF ARKANSAS, INC.
     FIRST AMERICAN HOME CARE OF CALIFORNIA, INC.
     FIRST AMERICAN HOME CARE OF COLORADO, INC.
     FIRST AMERICAN HOME CARE OF FLORIDA, INC.
     FIRST AMERICAN HOME CARE OF FT. LAUDERDALE, INC.
     FIRST AMERICAN HOME CARE OF GEORGIA, INC.
     FIRST AMERICAN HOME CARE OF ILLINOIS, INC.
     FIRST AMERICAN HOME CARE OF INDIANA, INC.
     FIRST AMERICAN HOME CARE OF LOUISIANA, INC.
     FIRST AMERICAN HOME CARE OF MICHIGAN, INC.
     FIRST AMERICAN HOME CARE OF MISSISSIPPI, INC.
     FIRST AMERICAN HOME CARE OF MISSOURI, INC.
     FIRST AMERICAN HOME CARE OF NAPLES, INC.
     FIRST AMERICAN HOME CARE OF NEBRASKA, INC.
     FIRST AMERICAN HOME CARE OF NEW MEXICO, INC.
     FIRST AMERICAN HOME CARE OF NORTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF PENNSYLVANIA, INC.
     FIRST AMERICAN HOME CARE OF OHIO, INC.
     FIRST AMERICAN HOME CARE OF OKLAHOMA, INC.
     FIRST AMERICAN HOME CARE OF SOUTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF TENNESSEE, INC.
     FIRST AMERICAN HOME CARE OF TEXAS, INC.
     FIRST AMERICAN HOME CARE OF VALDOSTA, INC.
     FIRST AMERICAN HOME CARE OF VIRGINIA, INC.
     FIRST AMERICAN HOME CARE OF WEST VIRGINIA, INC.
     FIRST AMERICAN INTERNATIONAL, INC.
     FLORIDA LIFE CARE, INC.
     GAINESVILLE HEALTH CARE CENTER, INC.
     GRAVOIS HEALTH CARE, INC.
     HEALTH CARE SYSTEMS, INC.
     HEALTHCARE PHARMACY SERVICES OF FLORIDA, INC.
     HEALTHCARE PHARMACY SERVICES OF PENNSYLVANIA, INC.
     HEALTHCARE PHARMACY SERVICES OF TEXAS, INC.
     HOME HEALTH INTEGRATED HEALTH SERVICES OF FLORIDA, INC.



<PAGE>



     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT I, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT VII-B, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE OF INTEGRATED HEALTH SERVICES, INC.
     IHS ACQUISITION XIII, INC.
     IHS ACQUISITION XVIII, INC.
     IHS AT LANSING, INC.
     IHS CHICAGO POST-ACUTE NETWORK, INC.
     IHS OF DANA, INC.
     INTEGRACARE, INC.
     INTEGRATED-BALLARD, INC.
     INTEGRATED HEALTH GROUP LIMITED PARTNERSHIP
     INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.
     INTEGRATED HEALTH OF WATERFORD COMMONS, INC.
     INTEGRATED HEALTH SERVICES AT ALEXANDRIA, INC.
     INTEGRATED HEALTH SERVICES AT BIG SAIL, INC.
     INTEGRATED HEALTH SERVICES AT BLUE RIDGE MANOR, INC.
     INTEGRATED HEALTH SERVICES AT BRIARCLIFF HAVEN, INC.
     INTEGRATED HEALTH SERVICES AT CADIZ, INC.
     INTEGRATED HEALTH SERVICES AT CENTRAL FLORIDA, INC.
     INTEGRATED HEALTH SERVICES AT CHEYENNE, INC.
     INTEGRATED HEALTH SERVICES AT CINCINNATI, INC.
     INTEGRATED HEALTH SERVICES AT COLORADO SPRINGS, INC.
     INTEGRATED HEALTH SERVICES AT COLUMBUS, INC.
     INTEGRATED HEALTH SERVICES AT DAYTON, INC.
     INTEGRATED HEALTH SERVICES AT DRIFTWOOD, INC.
     INTEGRATED HEALTH SERVICES AT EASTERN MASSACHUSETTS, INC.
     INTEGRATED HEALTH SERVICES AT GRANDVIEW CARE CENTER, INC.
     INTEGRATED HEALTH SERVICES AT GREAT BEND, INC.
     INTEGRATED HEALTH SERVICES AT HOPEDALE, INC.
     INTEGRATED HEALTH SERVICES AT HOUSTON, INC.
     INTEGRATED HEALTH SERVICES AT INDIAN CREEK, INC.
     INTEGRATED HEALTH SERVICES AT KENT, INC.
     INTEGRATED HEALTH SERVICES AT KING DAVID CENTER, INC.
     INTEGRATED HEALTH SERVICES AT NEWARK, INC.
     INTEGRATED HEALTH SERVICES AT ORMOND BEACH, INC.
     INTEGRATED HEALTH SERVICES AT PARK REGENCY, INC.
     INTEGRATED HEALTH SERVICES AT PENN, INC.
     INTEGRATED HEALTH SERVICES AT SILVERCREST, INC.
     INTEGRATED HEALTH SERVICES AT SOMERSET VALLEY, INC.
     INTEGRATED HEALTH SERVICES AT SOUTHERN HILLS, INC.
     INTEGRATED HEALTH SERVICES AT STEUBENVILLE
     INTEGRATED HEALTH SERVICES AT SYCARMORE CREEK, INC.
     INTEGRATED HEALTH SERVICES AT THREE RIVERS, INC.



<PAGE>



     INTEGRATED HEALTH SERVICES AT TREYBURN, INC.
     INTEGRATED HEALTH SERVICES FINANCIAL HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES NPR, INC.
     INTEGRATED HEALTH SERVICES OF ARCADIA, INC.
     INTEGRATED HEALTH SERVICES OF ATHENS, INC.
     INTEGRATED HEALTH SERVICES OF BRENTWOOD, INC.
     INTEGRATED HEALTH SERVICES OF BRUNSWICK, INC.
     INTEGRATED HEALTH SERVICES OF CALIFORNIA, INC.
     INTEGRATED HEALTH SERVICES OF CLIFF MANOR, INC.
     INTEGRATED HEALTH SERVICES OF COLORADO AT CHERRY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF EAGLE CREEK, INC.
     INTEGRATED HEALTH SERVICES OF GREEN BRIAR, INC.
     INTEGRATED HEALTH SERVICES OF HERITAGE MANOR, INC.
     INTEGRATED HEALTH SERVICES OF HICKORY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF INDIAN HILLS, INC.
     INTEGRATED HEALTH SERVICES OF JACKSONVILLE, INC.
     INTEGRATED HEALTH SERVICES OF KURT, INC.
     INTEGRATED HEALTH SERVICES OF LESTER, INC.
     INTEGRATED HEALTH SERVICES OF MELISSA, INC.
     INTEGRATED HEALTH SERVICES OF MISSOURI, INC.
     INTEGRATED HEALTH SERVICES OF ORANGE PARK, INC.
     INTEGRATED HEALTH SERVICES OF RIVERBEND, INC.
     INTEGRATED HEALTH SERVICES OF SCENIC HILLS, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW II, INC.
     INTEGRATED HEALTH SERVICES OF SUNSET, INC.
     INTEGRATED MANAGEMENT-GOVERNOR'S PARK, INC.
     INTEGRATED OF AMARILLO, INC.
     INTEGRATED PHYSICIAN GROUP SERVICES, INC.
     ISABETH CO., INC.
     J.R. REHAB ASSOCIATES, INC.
     LPC BETHAMY HEALTH CORPORATION
     MANCHESTER INTEGRATED HEALTH, INC.
     MOBILE RAY OF NEW ORLEANS, INC.
     MOUNTAIN VIEW NURSING CENTER, INC.
     NEW SOUTHWOOD ASSOCIATES, INC.
     PALESTINE NURSING CENTER, INC.
     PATIENT CARE PHARMACY, INC.
     PATIENT CARE PHARMACY - COLORADO SPRINGS, INC.
     PHARMACEUTICAL DOSE SERVICE, INC.
     PINELLAS PARK NURSING HOME, INC.
     PROFESSIONAL REVIEW NETWORK, INC.
     REHAB MANAGEMENT SYSTEMS, INC.
     
     
     
<PAGE>
     
     
     
     REST HAVEN NURSING CENTERS, INC.
     REST HAVEN NURSING CENTERS (CHESTNUT HILL), INC.
     REST HAVEN NURSING CENTERS (WHITEMARSH), INC.
     RIKAD PROPERTIES, INC.
     SAMARITAN CARE, INC. (Illinois Domestic)
     SAMARITAN CARE, INC. (Michigan Domestic)
     SAMARITAN MANAGEMENT, INC.
     SLC COMMUNITY CARE, INC.
     SOUTHWOOD HOLDINGS, INC.
     SPRING CREEK OF IHS, INC.
     SYMPHONY ANCILLARY SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 1, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 2, INC.
     SYMPHONY HEALTH CARE CONSULTING, INC.
     SYMPHONY HEALTH SERVICES, INC.
     SYMPHONY HOME CARE SERVICES, INC.
     SYMPHONY HOME CARE SERVICES NO. 1, INC.
     SYMPHONY HOME CARE SERVICES NO. 2, INC.
     SYMPHONY HOME CARE SERVICES NO. 3, INC.
     SYMPHONY HOME CARE SERVICES NO. 4, INC.
     SYMPHONY HOME CARE SERVICES NO. 5, INC.
     SYMPHONY HOME CARE SERVICES NO. 6, INC.
     SYMPHONY HOME CARE SERVICES NO. 7, INC.
     SYMPHONY HOME CARE SERVICES NO. 8, INC.
     SYMPHONY HOME CARE SERVICES NO. 9, INC.
     SYMPHONY HOME CARE SERVICES NO. 10, INC.
     SYMPHONY HOME CARE SERVICES NO. 11, INC.
     SYMPHONY HOME CARE SERVICES NO. 12, INC.
     SYMPHONY HOME CARE SERVICES NO. 13, INC.
     SYMPHONY HOME CARE SERVICES NO. 14, INC.
     SYMPHONY HOME CARE SERVICES NO. 15, INC.
     SYMPHONY HOME CARE SERVICES NO. 16, INC.
     SYMPHONY HOME CARE SERVICES NO. 17, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- CALIFORNIA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- LOUISIANA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- OKLAHOMA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- TENNESSEE, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- TEXAS. INC.
     SYMPHONY HOME CARE SERVICES NO. 19, INC.
     SYMPHONY HOME CARE SERVICES NO. 100, INC.
     SYMPHONY HOME CARE SERVICES NO. 101, INC.
     SYMPHONY HOME CARE SERVICES NO. 102, INC.
     SYMPHONY HOME CARE SERVICES NO. 103, INC.
     
     
     
<PAGE>
     
     
     SYMPHONY HOME CARE SERVICES NO. 104, INC.
     SYMPHONY HOME CARE SERVICES NO. 105, INC.
     SYMPHONY HOME CARE SERVICES NO. 106, INC.
     SYMPHONY HOME CARE SERVICES NO. 107, INC.
     SYMPHONY HOME CARE SERVICES NO. 108, INC.
     SYMPHONY HOME CARE SERVICES NO. 109, INC.
     SYMPHONY HOME CARE SERVICES NO. 110, INC.
     SYMPHONY HOME CARE SERVICES NO. 113, INC.
     SYMPHONY HOME CARE SERVICES NO. 114, INC.
     SYMPHONY HOME CARE SERVICES NO. 115, INC.
     SYMPHONY HOME CARE SERVICES NO. 116, INC.
     SYMPHONY HOME CARE SERVICES NO. 117, INC.
     SYMPHONY HOME CARE SERVICES NO. 118, INC.
     SYMPHONY HOME CARE SERVICES NO. 119, INC.
     SYMPHONY HOME CARE SERVICES NO. 120, INC.
     SYMPHONY HOME CARE SERVICES NO. 121, INC.
     SYMPHONY HOME CARE SERVICES NO. 122, INC.
     SYMPHONY PHARMACY SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES NO. 1, INC.
     SYMPHONY REHABILITATION SERVICES NO. 2, INC.
     SYMPHONY REHABILITATION SERVICES NO. 3, INC.
     SYMPHONY REHABILITATION SERVICES NO. 4, INC.
     SYMPHONY RESPIRATORY SERVICES, INC.
     TEXAS LPC, INC.
     WEST COAST CAMBRIDGE, INC.
     WOODRIDGE CONVALESCENT CENTER, INC.
     
     
     By: /s/ 
        ---------------------------------
        Name:
        Title:
             of Each Guarantor or of the
             General Partner of such Guarantor

<PAGE>

                        INTEGRATED HEALTH SERVICES, INC.
                             10065 Red Run Boulevard
                          Owings Mills, Maryland 21117


                                 March 24, 1997


To the Administrative Agent and
  the Lenders parties to the Revolving
  Credit Agreement referred to below


                  Amendment No.3 to Revolving Credit Agreement
                  --------------------------------------------


Ladies and Gentlemen:

     Reference is made to the Revolving  Credit  Agreement,  dated as of May 15,
1996, as amended by Amendment No. 1 dated  September 6, 1996 and Amendment No. 2
dated November 8, 1996 (such Revolving  Credit Agreement as so amended being the
"Credit Agreement"),  among Integrated Health Services,  Inc. ("IHS"),  Citibank
N.A., as administrative agent thereunder (the "Agent"),  and the other financial
institutions party thereto,  as lenders  thereunder.  Capitalized terms used and
not otherwise defined herein are used herein as defined in the Credit Agreement.

     IHS has  proposed to (i) issue  senior  subordinated  notes in an aggregate
principal  amount  of up to  $450,000,000  and (ii)  purchase  the  indebtedness
outstanding under the 1994 Subordinated Debt Indenture and the 1995 Subordinated
Debt  Indenture.  In connection  with the foregoing,  IHS has requested that the
Lenders  agree to amend certain  covenants  contained in Article V of the Credit
Agreement to permit such transactions.  We understand that the Requisite Lenders
are, on the terms and conditions stated below, willing to grant our request, and
the Requisite  Lenders have agreed to amend the Credit  Agreement as hereinafter
set forth.

     Effective  as of the date  hereof and  subject to the  satisfaction  of the
condition  precedents set forth below, the Credit Agreement is hereby amended as
follows:

          (a) The definition of "1996  Subordinated  Debt  Indenture" in Section
     1.01 is amended in full to read as follows:

               "'1996 SUBORDINATED DEBT INDENTURE' means the Indenture, dated as
          of May 15, 1996,  between the  Borrower,  as Issuer,  and Signet Trust
          Company, as Trustee."

          (b) In Section 1.01,  the following  definition of "1997  Subordinated
     Debt Indenture" is added in the appropriate alphabetical order:




<PAGE>


                                        2

               "'1997  SUBORDINATED  DEBT  INDENTURE'  means the Indenture to be
          entered into after April 7, 1997 between the Borrower,  as Issuer, and
          the  trustee   thereunder  in  connection   with  a  proposed   senior
          subordinated note offering."

          (c) The definition of  "Subordinated  Debt Indentures" in Section 1.01
     is amended in full to read as follows:

          "'SUBORDINATED   DEBT   INDENTURES'   means   the   1992   Convertible
          Subordinated  Debt Indenture,  the 1993 Convertible  Subordinated Debt
          Indenture, the 1994 Subordinated Debt Indenture, the 1995 Subordinated
          Debt  Indenture,  the 1996  Subordinated  Debt Indenture and, upon the
          effectiveness thereof, the 1997 Subordinated Debt Indenture"

          (d) Section  5.03(d) is amended by  deleting  the period at the end of
     subsection (v) thereof and  substituting  therefor "; and" and adding a new
     subsection (vi) following such subsection (v) to read as follows:

          "(vi)  Subordinated  Debt incurred  under the 1997  Subordinated  Debt
          Indenture in an aggregate principal amount of up to $450,000,000, with
          an interest rate not in excess of 10.25%,  and any extension,  renewal
          or refinancing of such Debt so long as either (A) the principal amount
          of such Debt is not  increased  or (B) any  increase in the  principal
          amount of such Debt is  permitted  pursuant to another  clause of this
          Section  5.03(d);  provided that the terms and conditions of such 1997
          Subordinated Debt Indenture shall be (1) substantially  similar to the
          terms and conditions contained in the 1996 Subordinated Debt Indenture
          and (2) satisfactory to the Agent in its sole discretion."

          (e) Section 5.03(h)(G) is amended in full to read as follows:

               "(G) so long as no Event of  Default  exists or would  result and
          unless  otherwise   prohibited  under  this  Agreement  and  the  1993
          Convertible  Subordinated  Debt  Indenture,  the  Borrower  may pay on
          January 1, 2001 any  principal  amount then due and payable  under the
          1993 Convertible Subordinated Debt Indenture; and"

          (f)  Section  5.03(h)  is  amended  by  adding  a new  subsection  (H)
     following subsection (G) to read as follows:

               "(H)   purchase  by  tender  or  otherwise  any  or  all  of  the
               indebtedness   outstanding   under  the  1994  Subordinated  Debt
               Indenture and the 1995  Subordinated Debt Indenture for an amount
               not in excess of 116% of the principal amount purchased, provided
               that the aggregate  amount of such purchases  cannot be in excess
               of the aggregate net proceeds of the  Subordinated  Debt referred
               to in Section 5.03(d)(vi)."



<PAGE>


                                        3


     This  Amendment  shall become  effective on the date when and only when the
Agent shall have received (A) counterparts of this Amendment executed by IHS and
the Requisite Lenders, or as to any of such Lenders,  advice satisfactory to the
Agent that such Lender has executed this Amendment and (B)  counterparts  of the
Consent appended hereto (the "Consent"), executed by each Guarantor.

          IHS represents and warrants as follows:

          (a) IHS is duly  organized  and  validly  existing  under  the laws of
     Delaware. Each Guarantor is a corporation or partnership duly organized and
     validly  existing  under  the  laws  of the  jurisdiction  in  which  it is
     organized.

          (b) Each of IHS and each  Guarantor has the  corporate or  partnership
     power to execute,  deliver and perform this  Amendment and the Consent,  as
     the case  may be,  and to take  all  action  necessary  to  consummate  the
     transactions   contemplated   hereunder.   The   execution,   delivery  and
     performance  by IHS and each  Guarantor of this  Amendment and the Consent,
     respectively,  have been duly authorized by all necessary action and do not
     contravene (i) its certificate or articles of incorporation (or, in case of
     a  partnership,  governing  agreements)  or (ii) any law or any  indenture,
     lease or written agreement binding on or affecting it.

          (c) No  authorization or approval or other action by, and no notice to
     or  filing  with,  any  Governmental  Authority  is  required  for  the due
     execution,  delivery  and  performance  by  IHS or any  Guarantor  of  this
     Amendment or the Consent, respectively.

          (d) This  Amendment  and the  Consent  constitutes  legal,  valid  and
     binding  obligations of IHS and each Guarantor,  respectively,  enforceable
     against IHS and each  Guarantor,  respectively,  in  accordance  with their
     respective  terms subject to laws  generally  affecting the  enforcement of
     creditors' rights.

          (e) The Credit Agreement is a "Credit Agreement" within the meaning of
     the 1997  Subordinated  Debt  Indenture,  upon its  effectiveness,  and the
     obligations  under the  Credit  Agreement  when  incurred  will be  "Senior
     Indebtedness" within the meaning of the 1997 Subordinated Debt Indenture.

     Upon the effectiveness of this Amendment, on and after the date hereof each
reference in the Credit Agreement to "this Agreement",  "hereunder", "hereof" of
words of like import  referring to the Credit  Agreement,  and each reference in
the other Loan Documents to "the Credit Agreement",  "thereunder",  "thereof" or
words of like  import  referring  to the Credit  Agreement,  shall mean and be a
reference to the Credit  Agreement  as amended  hereby.  Except as  specifically
amended above, the Credit Agreement, and all other Loan Documents, are and shall
continue to be in full force and effect and are hereby in all respects  ratified
and confirmed. The execution, delivery and effectiveness of this Amendment shall
not,  except as  expressly  provided  herein,  operate as a waiver of any right,
power or remedy of any Lender or the Agent under any of the Loan Documents,



<PAGE>


                                        4

not  constitute  a waiver of any  provision of any of the Loan  Documents.  This
Amendment  shall be governed by, and construed in accordance  with,  the laws of
the State of New York.

     Please evidence your  acknowledgement  of and agreement to the foregoing by
executing  and  returning  not later than the close of business on April 4, 1997
three  counterparts  of this Amendment No. 3 to Citicorp  Securities,  Inc., 399
Park Avenue, 9th Floor, New York, New York 10043, Attention: Rosemary Bell. This
Amendment  No. 3 is subject  to the  provisions  of  Section  8.01 of the Credit
Agreement.

     This Amendment No. 3 may be executed in any number of  counterparts  and by
any  combination of the parties hereto in separate  counterparts,  each of which
counterparts  shall  be an  original  and  all of  which  taken  together  shall
constitute one and the same Amendment No. 3.

                                                Very truly yours,

                                                INTEGRATED HEALTH
                                                   SERVICES, INC.


                                                By: /s/ 
                                                   -----------------------------
                                                   Name:
                                                   Title:



ACKNOWLEDGED, AGREED
  AND CONSENTED TO as of
  the date first above written:

CITIBANK, N.A.,
   as Administrative Agent and as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


BANK OF AMERICA NATIONAL TRUST
   AND SAVINGS ASSOCIATION,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        5


THE BANK OF NOVA SCOTIA,
   as LC Bank, a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


CORESTATES BANK, N.A.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


CREDIT LYONNAIS,
   NEW YORK BRANCH,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


DEUTSCHE BANK AG,
   NEW YORK BRANCH AND/OR
   CAYMAN ISLANDS BRANCH,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        6


FIRST UNION NATIONAL BANK
   OF NORTH CAROLINA,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


NATIONSBANK, N.A.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


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


By: /s/ 
   -------------------------------------
   Name:
   Title:


TORONTO DOMINION (TEXAS), INC.,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:


VAN KAMPEN AMERICAN CAPITAL
   PRIME RATE INCOME TRUST,
   as a Lender and Co-Agent


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        7


CREDITANSTALT CORPORATE
   FINANCE, INC.,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


By: /s/ 
   -------------------------------------
   Name:
   Title:


FLEET NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


GENERAL ELECTRIC
   CAPITAL CORPORATION,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


HIBERNIA NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        8



AMSOUTH BANK OF ALABAMA,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE BANK OF TOKYO-MITSUBISHI
   TRUST COMPANY,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE SANWA BANK, LIMITED,
  NEW YORK BRANCH
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


SIGNET BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


THE SUMITOMO BANK, LIMITED,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:



<PAGE>


                                        9


FIRST AMERICAN NATIONAL BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


ALLIED IRISH BANK,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


PROVIDENT BANK OF MARYLAND,
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:


BANK OF AMERICA ILLINOIS
   as a Lender


By: /s/ 
   -------------------------------------
   Name:
   Title:




<PAGE>



                                     CONSENT

     The undersigned,  as Guarantors under the Subsidiary Guaranty,  dated as of
May 15,  1996 or  under  Agreements  to be  Bound  by such  Subsidiary  Guaranty
(collectively, the "Guaranty"), in favor of the Agent for the Lenders parties to
the Credit Agreement referred to in the foregoing Amendment No. 3 hereby consent
to such  Amendment No. 3 and hereby confirm and agree that  notwithstanding  the
effectiveness  of such  Amendment No. 3, the Guaranty is, and shall  continue to
be, in full  force  and  effect  and is hereby  confirmed  and  ratified  in all
respects.

     ABC GP, INC.
     ABC HOME HEALTH AND HOSPICE OF ALBANY, INC.
     ABC HOME HEALTH AND HOSPICE OF ATHENS, INC.
     ABC HOME HEALTH AND HOSPICE OF BRUNSWICK, INC.
     ABC HOME HEALTH AND HOSPICE OF DUBLIN, INC.
     ABC HOME HEALTH AND HOSPICE OF MACON, INC.
     ABC HOME HEALTH AND HOSPICE OF SAVANNAH, INC.
     ABC HOME HEALTH AND HOSPICE OF TIFTON, INC.
     ABC HOME HEALTH AND HOSPICE OF VIDALIA, INC.
     ABC HOME HEALTH AND HOSPICE OF WAYCROSS, INC.
     ABC HOME NURSING, INC.
     ABC NEWCO, INC.
     ABC PHARMACEUTICALS, INC.
     ALABAMA SENIOR LIFE CARE, INC.
     ALPINE MANOR, INC.
     ARBOR LIVING CENTERS OF FLORIDA, INC.
     ARBOR LIVING CENTERS OF TEXAS, INC.
     ASIA CARE, INC.
     BETHAMY LIVING CENTER MANAGEMENT COMPANY
     BETHAMY LIVING CENTERS LIMITED PARTNERSHIP
     BRIAR HILL, INC.
     BRIARCLIFF NURSING HOME, INC.
     CAMBRIDGE CARE CENTERS, INC.
     CAMBRIDGE GROUP OF INDIANA, INC.
     CAMBRIDGE GROUP OF PENNSYLVANIA, INC.
     CAMBRIDGE GROUP OF TEXAS, INC.
     CARE CENTERS HOLDING, INC.
     CARRIAGE-By-THE-LAKE OF IHS, INC.
     CEDARCROFT HEALTH SERVICES, INC.
     CENTRAL PARK LODGES, INC.
     CENTRAL PARK LODGES OF WEST PALM BEACH, INC.
     CENTRAL PARK LODGES (TARPON SPRINGS), INC.
     CLARA BURKE NURSING HOME, INC.
     CLAREMONT INTEGRATED HEALTH, INC.
     COMPREHENSIVE POSTACUTE SERVICES, INC.
     DERRY INTEGRATED HEALTH, INC.
     ELIZABELL CO., INC.



<PAGE>


                                        3

     ELM CREEK OF IHS, INC.
     F.L.C. BENEVA NURSING PAVILION, INC.
     F.L.C. SARASOTA NURSING PAVILION, INC.
     FERRIGAN MOBILE X-RAY, INC.
     FIRELANDS OF IHS, INC.
     FIRST AMERICAN HOME CARE OF ALABAMA, INC.
     FIRST AMERICAN HOME CARE OF ARKANSAS, INC.
     FIRST AMERICAN HOME CARE OF CALIFORNIA, INC.
     FIRST AMERICAN HOME CARE OF COLORADO, INC.
     FIRST AMERICAN HOME CARE OF FLORIDA, INC.
     FIRST AMERICAN HOME CARE OF FT. LAUDERDALE, INC.
     FIRST AMERICAN HOME CARE OF GEORGIA, INC.
     FIRST AMERICAN HOME CARE OF ILLINOIS, INC.
     FIRST AMERICAN HOME CARE OF INDIANA, INC.
     FIRST AMERICAN HOME CARE OF LOUISIANA, INC.
     FIRST AMERICAN HOME CARE OF MICHIGAN, INC.
     FIRST AMERICAN HOME CARE OF MISSISSIPPI, INC.
     FIRST AMERICAN HOME CARE OF MISSOURI, INC.
     FIRST AMERICAN HOME CARE OF NAPLES, INC.
     FIRST AMERICAN HOME CARE OF NEBRASKA, INC.
     FIRST AMERICAN HOME CARE OF NEW MEXICO, INC.
     FIRST AMERICAN HOME CARE OF NORTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF OHIO, INC.
     FIRST AMERICAN HOME CARE OF OKLAHOMA, INC.
     FIRST AMERICAN HOME CARE OF PENNSYLVANIA, INC.
     FIRST AMERICAN HOME CARE OF SOUTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF TENNESSEE, INC.
     FIRST AMERICAN HOME CARE OF TEXAS, INC.
     FIRST AMERICAN HOME CARE OF VALDOSTA, INC.
     FIRST AMERICAN HOME CARE OF VIRGINIA, INC.
     FIRST AMERICAN HOME CARE OF WEST VIRGINIA, INC.
     FIRST AMERICAN INTERNATIONAL, INC.
     FLORIDA LIFE CARE, INC.
     GAINESVILLE HEALTH CARE CENTER, INC.
     GRAVOIS HEALTH CARE, INC.
     HEALTH CARE SYSTEMS, INC.
     HOME HEALTH INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT I, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT VII-B, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE OF INTEGRATED HEALTH SERVICES, INC.
     IHS ACQUISITION XIII, INC.
     IHS ACQUISITION XV, INC.
     IHS ACQUISITION XVIII, INC.
     IHS ACQUISITION XIX, INCL



<PAGE>


                                        4


     IHS ACQUISITION XXII, INC.
     IHS AT LANSING, INC.
     IHS CHICAGO POST-ACUTE NETWORK, INC.
     IHS DEVELOPMENT-HIGHLANDS PARK, INC.
     IHS HOME CARE, INC.
     IHS LAND ACQUISITION-HIGHLANDS PARK, INC.
     IHS MANAGEMENT GROUP, INC.
     IHS NETWORK SERVICES, INC.
     IHS OF DANA, INC.
     IN-HOME HEALTH CARE, INC.
     INTEGRACARE, INC.
     INTEGRATED-BALLARD, INC.
     INTEGRATED HEALTH GROUP LIMITED PARTNERSHIP
     INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.
     INTEGRATED HEALTH OF WATERFORD COMMONS, INC.
     INTEGRATED HEALTH SERVICES AT ALEXANDRIA, INC.
     INTEGRATED HEALTH SERVICES AT BIG SAIL, INC.
     INTEGRATED HEALTH SERVICES AT BLUE RIDGE MANOR, INC.
     INTEGRATED HEALTH SERVICES AT BRIARCLIFF HAVEN, INC.
     INTEGRATED HEALTH SERVICES AT CADIZ, INC.
     INTEGRATED HEALTH SERVICES AT CENTRAL FLORIDA, INC.
     INTEGRATED HEALTH SERVICES AT CHEYENNE, INC.
     INTEGRATED HEALTH SERVICES AT COLORADO SPRINGS, INC.
     INTEGRATED HEALTH SERVICES AT COLUMBUS, INC.
     INTEGRATED HEALTH SERVICES AT DAYTON, INC.
     INTEGRATED HEALTH SERVICES AT DRIFTWOOD, INC.
     INTEGRATED HEALTH SERVICES AT EASTERN MASSACHUSETTS, INC.
     INTEGRATED HEALTH SERVICES AT GRANDVIEW CARE CENTER, INC.
     INTEGRATED HEALTH SERVICES AT GREAT BEND, INC.
     INTEGRATED HEALTH SERVICES AT HIGHLANDS PARK, INC.
     INTEGRATED HEALTH SERVICES AT HOPEDALE, INC.
     INTEGRATED HEALTH SERVICES AT HOUSTON, INC.
     INTEGRATED HEALTH SERVICES AT INDIAN CREEK, INC.
     INTEGRATED HEALTH SERVICES AT KENT, INC.
     INTEGRATED HEALTH SERVICES AT KING DAVID CENTER, INC.
     INTEGRATED HEALTH SERVICES AT NEWARK, INC.
     INTEGRATED HEALTH SERVICES AT ORMOND BEACH, INC.
     INTEGRATED HEALTH SERVICES AT PARK REGENCY, INC.
     INTEGRATED HEALTH SERVICES AT PENN, INC.
     INTEGRATED HEALTH SERVICES AT SILVERCREST, INC.
     INTEGRATED HEALTH SERVICES AT SOMERSET VALLEY, INC.
     INTEGRATED HEALTH SERVICES AT SOUTHERN HILLS, INC.
     INTEGRATED HEALTH SERVICES AT STEUBENVILLE
     INTEGRATED HEALTH SERVICES AT SYCARMORE CREEK, INC.
     INTEGRATED HEALTH SERVICES AT THREE RIVERS, INC.



<PAGE>


                                        5

     INTEGRATED HEALTH SERVICES AT TREYBURN, INC.
     INTEGRATED HEALTH SERVICES FINANCIAL HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES NPR, INC.
     INTEGRATED HEALTH SERVICES OF ARCADIA, INC.
     INTEGRATED HEALTH SERVICES OF ATHENS, INC.
     INTEGRATED HEALTH SERVICES OF BRENTWOOD, INC.
     INTEGRATED HEALTH SERVICES OF BRUNSWICK, INC.
     INTEGRATED HEALTH SERVICES OF CALIFORNIA, INC.
     INTEGRATED HEALTH SERVICES OF CLIFF MANOR, INC.
     INTEGRATED HEALTH SERVICES OF COLORADO AT CHERRY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF EAGLE CREEK, INC.
     INTEGRATED HEALTH SERVICES OF GREEN BRIAR, INC.
     INTEGRATED HEALTH SERVICES OF HERITAGE MANOR, INC.
     INTEGRATED HEALTH SERVICES OF HICKORY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF INDIAN HILLS, INC.
     INTEGRATED HEALTH SERVICES OF JACKSONVILLE, INC.
     INTEGRATED HEALTH SERVICES OF KURT, INC.
     INTEGRATED HEALTH SERVICES OF LESTER, INC.
     INTEGRATED HEALTH SERVICES OF MELISSA, INC.
     INTEGRATED HEALTH SERVICES OF MISSOURI, INC.
     INTEGRATED HEALTH SERVICES OF ORANGE PARK, INC.
     INTEGRATED HEALTH SERVICES OF RIVERBEND, INC.
     INTEGRATED HEALTH SERVICES OF SCENIC HILLS, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW II, INC.
     INTEGRATED HEALTH SERVICES OF SUNSET, INC.
     INTEGRATED MANAGED CARE, INC. (formerly Isabeth Co., Inc.)
     INTEGRATED MANAGEMENT-GOVERNOR'S PARK, INC.
     INTEGRATED OF AMARILLO, INC.
     INTEGRATED PHYSICIAN GROUP SERVICES, INC.
     J.R. REHAB ASSOCIATES, INC.
     LIFEWAY, INC.
     LPC BETHAMY HEALTH CORPORATION, L.P.
     MANCHESTER INTEGRATED HEALTH, INC.
     MOBILE RAY OF NEW ORLEANS, INC.
     MOUNTAIN VIEW NURSING CENTER, INC.
     NEW SOUTHWOOD ASSOCIATES, INC.
     PALESTINE NURSING CENTER, INC.
     PINELLAS PARK NURSING HOME, INC.
     PREFERRED HOME HEALTH SERVICES, INC.
     PROFESSIONAL REVIEW NETWORK, INC.
     REHAB MANAGEMENT SYSTEMS, INC.
     REST HAVEN NURSING CENTERS, INC.
     REST HAVEN NURSING CENTERS (CHESTNUT HILL), INC.



<PAGE>


                                        6


     REST HAVEN NURSING CENTERS (WHITEMARSH), INC.
     RIKAD PROPERTIES, INC.
     SAMARITAN CARE, INC. (Illinois Domestic)
     SAMARITAN CARE, INC. (Michigan Domestic)
     SAMARITAN MANAGEMENT, INC.
     SHC OF ARIZONA, L.P.
     SHC SERVICES OF ARIZONA, L.P.
     SIGNATURE HOME CARE GROUP, INC.
     SIGNATURE HOME CARE, INC.
     SIGNATURE HOME CARE OF ARLINGTON, INC.
     SIGNATURE HOME CARE OF FLORIDA, INC.
     SIGNATURE HOME CARE OF GEORGIA, INC.
     SIGNATURE HOME CARE OF KANSAS, INC.
     SIGNATURE HOME CARE OF NEW JERSEY, INC.
     SIGNATURE HOME CARE OF NEW JERSEY GENERAL PARTNERSHIP
     SIGNATURE HOME CARE OF SAN ANTONIO, INC.
     SIGNATURE HOME CARE SERVICES OF FLORIDA, INC.
     SIGNATURE HOME CARE SERVICES OF SAN ANTONIO, INC.
     SIGNATURE MANAGEMENT SERVICES, INC.
     SIGNATURE RECEIVABLES CORP.
     SLC COMMUNITY CARE, INC.
     SOUTHWOOD HOLDINGS, INC.
     SPRING CREEK OF IHS, INC.
     SYMPHONY ANCILLARY SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 1, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 2, INC.
     SYMPHONY HEALTH CARE CONSULTING, INC.
     SYMPHONY HEALTH SERVICES, INC.
     SYMPHONY HOME CARE SERVICES, INC.
     SYMPHONY HOME CARE SERVICES NO. 1, INC.
     SYMPHONY HOME CARE SERVICES NO. 2, INC.
     SYMPHONY HOME CARE SERVICES NO. 3, INC.
     SYMPHONY HOME CARE SERVICES NO. 4, INC.
     SYMPHONY HOME CARE SERVICES NO. 5, INC.
     SYMPHONY HOME CARE SERVICES NO. 6, INC.
     SYMPHONY HOME CARE SERVICES NO. 7, INC.
     SYMPHONY HOME CARE SERVICES NO. 8, INC.
     SYMPHONY HOME CARE SERVICES NO. 9, INC.
     SYMPHONY HOME CARE SERVICES NO. 10, INC.
     SYMPHONY HOME CARE SERVICES NO. 11, INC.
     SYMPHONY HOME CARE SERVICES NO. 12, INC.
     SYMPHONY HOME CARE SERVICES NO. 13, INC.
     SYMPHONY HOME CARE SERVICES NO. 14, INC.
     SYMPHONY HOME CARE SERVICES NO. 15, INC.
     


<PAGE>


                                        7

     SYMPHONY HOME CARE SERVICES NO. 16, INC.
     SYMPHONY HOME CARE SERVICES NO. 17, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- CALIFORNIA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- LOUISIANA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- OKLAHOMA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- TEXAS. INC.
     SYMPHONY HOME CARE SERVICES NO. 19, INC.
     SYMPHONY HOME CARE SERVICES NO. 100, INC.
     SYMPHONY HOME CARE SERVICES NO. 101, INC.
     SYMPHONY HOME CARE SERVICES NO. 102, INC.
     SYMPHONY HOME CARE SERVICES NO. 103, INC.
     SYMPHONY HOME CARE SERVICES NO. 104, INC.
     SYMPHONY HOME CARE SERVICES NO. 105, INC.
     SYMPHONY HOME CARE SERVICES NO. 106, INC.
     SYMPHONY HOME CARE SERVICES NO. 107, INC.
     SYMPHONY HOME CARE SERVICES NO. 108, INC.
     SYMPHONY HOME CARE SERVICES NO. 109, INC.
     SYMPHONY HOME CARE SERVICES NO. 110, INC.
     SYMPHONY HOME CARE SERVICES NO. 113, INC.
     SYMPHONY HOME CARE SERVICES NO. 114, INC.
     SYMPHONY HOME CARE SERVICES NO. 115, INC.
     SYMPHONY HOME CARE SERVICES NO. 116, INC.
     SYMPHONY HOME CARE SERVICES NO. 117, INC.
     SYMPHONY HOME CARE SERVICES NO. 118, INC.
     SYMPHONY HOME CARE SERVICES NO. 119, INC.
     SYMPHONY HOME CARE SERVICES NO. 120, INC.
     SYMPHONY HOME CARE SERVICES NO. 121, INC.
     SYMPHONY HOME CARE SERVICES NO. 122, INC.
     SYMPHONY REHABILITATION SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES NO. 1, INC.
     SYMPHONY REHABILITATION SERVICES NO. 2, INC.
     SYMPHONY REHABILITATION SERVICES NO. 3, INC.
     SYMPHONY REHABILITATION SERVICES NO. 4, INC.
     SYMPHONY RESPIRATORY SERVICES, INC.
     TEXAS LPC, INC.


<PAGE>


                                       8

     THE BESTON CORPORATION
     WEST COAST CAMBRIDGE, INC.
     WOODRIDGE CONVALESCENT CENTER, INC.
     
     
     By: /s/ 
        ---------------------------------
        Name:
        Title:
             of Each Guarantor or of the
             General Partner of such Guarantor





<PAGE>

                        INTEGRATED HEALTH SERVICES, INC.
                             10065 Red Run Boulevard
                          Owings Mills, Maryland 21117


                                  July 3, 1997


To the Administrative Agent and
  the Lenders parties to the Revolving
  Credit Agreement referred to below


                  Amendment No. 4 to Revolving Credit Agreement
                  ---------------------------------------------


Ladies and Gentlemen:

     Reference is made to the Revolving  Credit  Agreement,  dated as of May 15,
1996,  as amended by Amendment  No. 1 dated  September 6, 1996,  Amendment No. 2
dated November 8, 1996 and Amendment No. 3 dated March 24, 1997 (such  Revolving
Credit Agreement as so amended being the "Credit  Agreement"),  among Integrated
Health Services, Inc. ("IHS"), Citibank N.A., as administrative agent thereunder
(the "Agent"),  and the other financial  institutions party thereto,  as lenders
thereunder.  Capitalized  terms used and not otherwise  defined  herein are used
herein as defined in the Credit Agreement.

     IHS has proposed to enter into a lease  financing  facility (the "Synthetic
Lease Facility")  pursuant to which one or more of its  Subsidiaries  will enter
into one or more leases for its headquarters  facility and other properties.  As
part of such lease  financings,  IHS and its  Subsidiaries  (other than Inactive
Subsidiaries) propose to guaranty certain obligations of such Subsidiaries under
such leases and grant a security  interest  in the  Collateral  to secure  those
guaranties,  with such  security  interest  to be pari passu  with the  security
interest of the Lenders.  In addition,  IHS has proposed to sell certain  assets
which  sales  require  the  consent  of the  Requisite  Lenders,  to  amend  the
definition  of "Cash  Flow  from  Operations",  to amend  the  Credit  Agreement
covenant relating to stock repurchases and to acquire Community Care of America,
Inc. In connection  with the  foregoing,  IHS has  requested  that the Requisite
Lenders  agree to amend certain  covenants  contained in Article V of the Credit
Agreement  and to amend the  definition of  "Debt/EBITDAR  Ratio" to permit such
transactions,  to amend Schedule 1.01 (c) to the Credit Agreement and to replace
the  Pledge  and  Security   Agreements   heretofore  executed  by  IHS  or  its
Subsidiaries  with the  Pledge and  Security  Agreements  in the forms  attached
hereto.  We  understand  that  the  Requisite  Lenders  are,  on the  terms  and
conditions  stated  below,  willing  to grant our  requests,  and the  Requisite
Lenders have agreed to amend the Credit Agreement as hereinafter set forth.

     Effective  as of the date  hereof and  subject to the  satisfaction  of the
condition  precedents set forth below, the Credit Agreement is hereby amended as
follows:




<PAGE>


                                        2

          (a) Section 1.01 is amended by adding the following definitions in the
     appropriate alphabetical order:

          "'CCA' means Community Care of America, Inc."

          "'SYNTHETIC LEASE FACILITY' means the lease to be entered into between
          State Street Bank and Trust Company,  as Corporate Owner Trustee,  and
          Integrated Health Services at Highlands Park, Inc., as Lessee, and the
          other  leases  to be  entered  into by  Subsidiaries  of the  Borrower
          pursuant to the  Participation  Agreement to be entered into among the
          Borrower,  Integrated  Health  Services at Highlands  Park,  Inc., IHS
          Development  -  Highlands  Park,  Inc.,  State  Street  Bank and Trust
          Company, as Corporate Owner Trustee, an Individual Owner Trustee,  the
          Certificate  Holder  party  thereto,  the  Note  Holders  thereto  and
          Citibank, N. A., as Agent."

          (b) The  definition of "CASH FLOW FROM  OPERATIONS" in Section 1.01 is
     amended in full to read as follows:

          "'CASH FLOW FROM OPERATIONS'  means,  with respect to any Person,  the
          sum,  determined as of the last day of any Quarter for such Person and
          its  subsidiaries  on a  consolidated  basis for the  12-month  period
          including such Quarter and the  immediately  preceding  three Quarters
          (taken as a single  period),  of (i) net income  after taxes minus any
          extraordinary  gain and any non-recurring  gain on any divestiture and
          plus  any  extraordinary  loss  and  any  non-recurring  loss  on  any
          divestiture,  (ii)  depreciation,  amortization,  and  other  non-cash
          charges  deducted in determining net income,  (iii) Interest  Expense,
          (iv) Lease  Expense and (v) with respect to Cash Flow from  Operations
          of  the  Borrower  and  its  Subsidiaries  only,  Receivables  Program
          Charges,  all determined in accordance with GAAP;  provided,  however,
          that (A) income  attributable  to any other Person or business that is
          not at least 50% owned,  directly or indirectly,  by such Person shall
          be counted,  in determining net income, only to the extent such income
          is received in cash by such Person or a  subsidiary  of such Person in
          such  period and is not  reinvested  in such other  Person or business
          (other than as a loan payable on demand) within six months thereafter,
          except that,  with respect to the Borrower only,  income from minority
          Investments  existing on the Closing  Date and  described  in Schedule
          5.03(c)  shall be  counted  in  accordance  with the  Borrower's  past
          practice,  (B) no  adjustments  shall  be  made  to  reflect  minority
          interests in  subsidiaries  and (C)  non-recurring  cash charges in an
          aggregate  amount not in excess of $30,000,000 in connection  with the
          terminated acquisition



<PAGE>


                                        3

          of Coram shall be included as an addback to net income for purposes of
          this definition."

          (c) The  definition  of "DEBT" in  Section  1.01 is amended in full to
     read as follows:

          "'DEBT' as applied  to any  Person  and in each case  determined  on a
          consolidated   basis  in   conformity   with  GAAP,   means   (without
          duplication)  (i) all indebtedness for borrowed money (whether by loan
          or the issuance of debt securities or otherwise); (ii) all obligations
          issued,  undertaken  or  assumed  as the  deferred  purchase  price of
          property or services or interest thereon,  except accounts and accrued
          expenses currently payable;  (iii) all monetary  obligations under the
          Synthetic  Lease Facility,  (iv) all  reimbursement  obligations  with
          respect to surety bonds,  letters of credit,  bankers' acceptances and
          similar  instruments,  whether  or not  contingent;  (v) all  monetary
          obligations under any Capital Lease; (vi) all obligations  (contingent
          or otherwise)  to purchase,  retire or redeem any capital stock or any
          other equity interest of such Person;  (vii) all monetary  obligations
          measured by, or  determined  on the basis of, the value of any capital
          stock of such Person; and (viii) all obligations,  whether or not such
          obligations  constitute  Debt as defined in clauses (i) through  (vii)
          above,  secured by (or for which the holder of the  obligation  has an
          existing  right,  contingent or otherwise,  to be secured by) any Lien
          upon any  property of such Person or any  Subsidiary  of such  Person,
          except  any such  obligation  secured by a Lien that is imposed by law
          and not voluntarily granted;  provided,  however,  that the contingent
          payments  which  may  become  payable  in  connection  with the  First
          American  Merger,  including  any  payments  made to the  Health  Care
          Financing  Administration  or the  Department  of Justice as  required
          under the First  American  Merger  Agreement  in a total amount not in
          excess of $162 million, shall not constitute Debt for purposes of this
          Agreement."

          (d)  Subparagraph  (3) in the  definition of  "DEBT/EBITDAR  RATIO" in
     Section 1.01 is amended in full to read as follows:

          "(3)  adding to EBITDAR of the  Borrower  and such  Subsidiaries,  the
          EBITDAR  and  Non-Recurring  Charges  determined  solely  for any such
          acquired  company or Health  Care  Facility,  for the  portion of such
          period that  preceded the  acquisition;  provided,  however,  that for
          Quarters ending during the 12-month period  immediately  following the
          closing of the First  American  Merger,  EBITDAR of First American for
          the period from the closing to the date of determination,



<PAGE>


                                        4

          annualized  for the  12-month  period  then  ended  shall  be added to
          EBITDAR of the Borrower and such Subsidiaries; provided, further, that
          for Quarters ending during the 12-month period  immediately  following
          the closing of the  acquisition of CCA,  EBITDAR of CCA for the period
          from the  closing  to the date of  determination,  annualized  for the
          12-month  period then ended shall be added to EBITDAR of the  Borrower
          and such Subsidiaries."

          (e) Section  5.03(a) is amended by  deleting  the period at the end of
     subsection (xii) thereof and substituting therefor "; and" and adding a new
     subsection (xiii) following such subsection (xii) to read as follows:

          "(xiii) any Liens upon (a) stock of  Subsidiaries  and certain related
          assets  granted by the  Borrower  or one or more  Subsidiaries  of the
          Borrower and (b) real property  interests and certain  related  assets
          granted by one or more  Subsidiaries of the Borrower,  in each case in
          connection with the Synthetic Lease Facility."

          (f) Section  5.03(c)(viii) is amended by adding to the end thereof the
     following provision:

          "provided,  further, that the acquisition of CCA will not be deemed an
          Investment for purposes of this Subsection 5.03(c)(viii);"

          (g) Section  5.03(c) is amended by  deleting  the period at the end of
     subsection  (xv)  thereof  and  substituting  ";  and"  and  adding  a  new
     subsection (xvi) following such subsection (xv) to read as follows:

          "(xvi)  The  acquisition  of  CCA  by  the  Borrower  or  any  of  its
          Subsidiaries  substantially on the terms set forth in the letter dated
          June 24, 1997 from the Borrower to the Lenders, provided, that (A) the
          purchase  price for the shares of CCA does not exceed $4.50 per share,
          (B) at the time of or after  giving  effect  to such  acquisition,  no
          Event of Default or Potential  Default shall exist or result,  and (C)
          the Borrower shall comply with the provisions of Section 5.02(e),  and
          neither  the  Borrower  nor any of its  Subsidiaries  nor any of their
          properties  shall be or become bound by or subject to any  contractual
          obligation that is or would be violated or put in default by reason of
          such  compliance  or by reason of the  enforcement  of the  claims and
          Liens of the Agent and Lenders arising from such compliance; provided,
          further, that the acquisition of CCA shall not be deemed an Investment
          for purposes of Section 5.03(c)(xi)."



<PAGE>


                                        5


          (h) Section  5.03(d) is amended by  deleting  the period at the end of
     subsection (vi) thereof and substituting  therefor "; and" and adding a new
     subsection (vii) following such subsection (vi) to read as follows:

          "(vii)  Debt  in an  aggregate  principal  amount  not  in  excess  of
          $100,000,000  incurred by the Borrower or any of its  Subsidiaries  in
          connection with the Synthetic Lease Facility."

          (i) Section  5.03 (f) is amended by deleting  the period at the end of
     subsection (vi) thereof and substituting  therefor "; and" and adding a new
     subsection (vii) following such subsection (vi) to read as follows:

          "(vii)  Accommodation  Obligations  incurred by the Borrower or any of
          its Subsidiaries in connection with the Synthetic Lease Facility."

          (j) Section 5.03(h)(B) is amended in full to read as follows:

          "(B) The Borrower from time to time may purchase outstanding shares of
          the Borrower's common stock or purchase  options,  or enter into other
          transactions,  to purchase  such stock,  so long as (1) the  aggregate
          amount expended for all such purchases, options and other transactions
          at any time after the Closing  Date does not exceed  $50,000,000  (the
          "Purchase  Limit")  and  (2)  any  such  purchase,   option  or  other
          transaction  is made in  compliance  with all  applicable  laws and no
          Potential  Default or Event of Default exists at the time of, or would
          result from, any such purchase,  option or other transaction (and, for
          this purpose,  the amounts counted toward the Purchase Limit shall not
          be reduced by or on account of any subsequent resale of the Borrower's
          Common Stock);"




<PAGE>

                                        6

          (k)  Schedule  1.01(c)  is amended  by adding to the end  thereof  the
     following assets:

                Health Care Facilities Assets Designated for Sale
                -------------------------------------------------

Facility Name                          Location                         # Units
- -------------                          --------                         -------
Avenel (Owned)                         Plantation, FL                   120
Auburndale (Owned)                     Auburndale, FL                   120
Sarasota Pavillion (Owned)             Sarasota, FL                     180
Central Florida at Orlando
   (Owned)                             Orlando, FL                      120
Central Florida at Vero Beach (
  (Owned)                              Vero Beach, FL                   110
Chestnut Hill (Owned)                  Philadelphia, PA                 200
Claremont (Owned)                      Claremont, NH                     62
Clearwater (Owned)                     Clearwater, FL                   150
Derry (Owned)                          Derry, NH                        112
Jacksonville (Owned)                   Jacksonville, FL                 120
Pinellas Park (Owned)                  Pinellas Park, FL                120
William & Mary (Owned)                 St. Petersburg, FL                96
Tarpon Springs (Owned)                 Tarpon Springs, FL               120
Venice North (Owned)                   Venice, FL                       178

     In  connection  with the  Synthetic  Lease  Facility,  the  Lenders  hereby
instruct  the Agent,  coincidentally  with the  closing of the  Synthetic  Lease
Facility, to enter into the Intercreditor  Agreement and the Pledge and Security
Agreements  to be  delivered  as provided in this  Amendment.  Upon the delivery
thereof,  the Pledge and  Security  Agreements,  in the forms  attached  hereto,
thereafter  shall be deemed Pledge and Security  Agreements  for all purposes of
the  Loan  Documents  and  each  Lender  shall  be  bound  by the  terms of such
Intercreditor Agreement.

     This  Amendment  shall become  effective on the date when and only when the
Agent shall have received (A) counterparts of this Amendment executed by IHS and
the Requisite Lenders, or as to any of such Lenders,  advice satisfactory to the
Agent that such Lender has executed  this  Amendment,  (B)  counterparts  of the
Consent  appended  hereto (the  "Consent"),  executed by each  Guarantor and (C)
evidence  that all  amounts  due and payable  under  Section  8.04 of the Credit
Agreement  have been paid in full,  provided,  that the closing of the Synthetic
Lease  Facility  shall not occur until and unless the Agent shall have  received
(1)  counterparts  of  the   Intercreditor   and  Collateral  Agency  Agreement,
substantially in the form of Exhibit A hereto,  executed by the parties thereto,
(2) a pledge and security agreement, duly executed and delivered,  substantially
in the form of Exhibit B-1 in the case of IHS and  substantially  in the form of
Exhibit B-2 in the case of each  Subsidiary  that has prior hereto  executed and
delivered a Pledge and Security Agreement, together with (a) the certificates or
other  instruments  pledged under each  respective  existing Pledge and Security
Agreement, accompanied by undated stock powers or transfer documents executed in
blank,  and (b)  evidence  satisfactory  to the Lenders  that all other  actions
necessary or, in the opinion of the



<PAGE>


                                        7

Lenders, desirable to perfect and protect the security interests created by such
pledge and security agreements have been taken,  including delivery to the Agent
of all instruments constituting Collateral, duly endorsed, and delivery of UCC-1
financing statements or amendments thereto duly executed by each Grantor under a
pledge and security  agreement and in form  sufficient for filing in all offices
in which the Agent or any Lender may consider  filing to be appropriate  and (3)
an opinion of LeBoeuf,  Lamb Greene & MacRae,  LLP, counsel to the Borrower,  in
form and substance satisfactory to the Agent.

          IHS represents and warrants as follows:

          (a) IHS is duly  organized  and  validly  existing  under  the laws of
     Delaware. Each Guarantor is a corporation or partnership duly organized and
     validly  existing  under  the  laws  of the  jurisdiction  in  which  it is
     organized.

          (b) Each of IHS and each  Guarantor has the  corporate or  partnership
     power to execute,  deliver and perform this  Amendment and the Consent,  as
     the case  may be,  and to take  all  action  necessary  to  consummate  the
     transactions   contemplated   hereunder.   The   execution,   delivery  and
     performance  by IHS and each  Guarantor of this  Amendment and the Consent,
     respectively,  have been duly authorized by all necessary action and do not
     contravene (i) its certificate or articles of incorporation (or, in case of
     a  partnership,  governing  agreements)  or (ii) any law or any  indenture,
     lease or written agreement binding on or affecting it.

          (c) No  authorization or approval or other action by, and no notice to
     or  filing  with,  any  Governmental  Authority  is  required  for  the due
     execution,  delivery  and  performance  by  IHS or any  Guarantor  of  this
     Amendment or the Consent, respectively.

          (d) This  Amendment  and the  Consent  constitutes  legal,  valid  and
     binding  obligations of IHS and each Guarantor,  respectively,  enforceable
     against IHS and each  Guarantor,  respectively,  in  accordance  with their
     respective  terms subject to laws  generally  affecting the  enforcement of
     creditors' rights.

          (e) The Guarantors  executing the Consent are all of the  Subsidiaries
     (other than Inactive Subsidiaries) of IHS.

     Upon the effectiveness of this Amendment, on and after the date hereof each
reference in the Credit Agreement to "this Agreement",  "hereunder", "hereof" or
words of like import  referring to the Credit  Agreement,  and each reference in
the other Loan Documents to "the Credit Agreement",  "thereunder",  "thereof" or
words of like  import  referring  to the Credit  Agreement,  shall mean and be a
reference to the Credit  Agreement  as amended  hereby.  Except as  specifically
amended above, the Credit Agreement, and all other Loan Documents, are and shall
continue to be in full force and effect and are hereby in all respects  ratified
and confirmed. The execution, delivery and effectiveness of this Amendment shall
not,  except as  expressly  provided  herein,  operate as a waiver of any right,
power or remedy of any Lender or the Agent under any of the Loan Documents,  not
constitute a waiver of any provision of any of the Loan Documents. This



<PAGE>


                                        8

Amendment  shall be governed by, and construed in accordance  with,  the laws of
the State of New York.

     Please evidence your  acknowledgement  of and agreement to the foregoing by
executing  and  returning  not later than the close of  business on July 8, 1997
three  counterparts  of this Amendment No. 4 to Citicorp  Securities,  Inc., 399
Park Avenue, 9th Floor, New York, New York 10043, Attention: Rosemary Bell. This
Amendment  No. 4 is subject  to the  provisions  of  Section  8.01 of the Credit
Agreement.

     This Amendment No. 4 may be executed in any number of  counterparts  and by
any  combination of the parties hereto in separate  counterparts,  each of which
counterparts  shall  be an  original  and  all of  which  taken  together  shall
constitute one and the same Amendment No. 4.

                                                Very truly yours,

                                                INTEGRATED HEALTH
                                                   SERVICES, INC.


                                                By: /s/ 
                                                   -----------------------------
                                                   Name:
                                                   Title:

ACKNOWLEDGED, AGREED
  AND CONSENTED TO as of
  the date first above written:

CITIBANK, N.A.,
   as Administrative Agent and as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


BANK OF AMERICA NATIONAL TRUST
   AND SAVINGS ASSOCIATION,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  

<PAGE>


                                        9



THE BANK OF NOVA SCOTIA,
   as LC Bank, a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


CORESTATES BANK, N.A.,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


CREDIT LYONNAIS,
   NEW YORK BRANCH,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


DEUTSCHE BANK AG,
   NEW YORK BRANCH AND/OR
   CAYMAN ISLANDS BRANCH,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  



<PAGE>


                                       10



FIRST UNION NATIONAL BANK
   OF NORTH CAROLINA,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


NATIONSBANK, N.A.,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


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


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


TORONTO DOMINION (TEXAS), INC.,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


VAN KAMPEN AMERICAN CAPITAL
   PRIME RATE INCOME TRUST,
   as a Lender and Co-Agent


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  



<PAGE>


                                       11



CREDITANSTALT CORPORATE
   FINANCE, INC.,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


FLEET NATIONAL BANK,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


GENERAL ELECTRIC
   CAPITAL CORPORATION,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


HIBERNIA NATIONAL BANK,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  



<PAGE>


                                       12


AMSOUTH BANK OF ALABAMA,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


THE BANK OF TOKYO-MITSUBISHI
   TRUST COMPANY,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


THE SANWA BANK, LIMITED,
  NEW YORK BRANCH
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


SIGNET BANK,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


THE SUMITOMO BANK, LIMITED,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  



<PAGE>


                                       13


FIRST AMERICAN NATIONAL BANK,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


ALLIED IRISH BANK,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


PROVIDENT BANK OF MARYLAND,
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


BANK OF AMERICA ILLINOIS
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  


CRESTAR BANK
   as a Lender


By: /s/                         
   -------------------------------------
   Name:                   
   Title:                  




<PAGE>



                                     CONSENT

     The undersigned,  as Guarantors under the Subsidiary Guaranty,  dated as of
May 15,  1996 or  under  Agreements  to be  Bound  by such  Subsidiary  Guaranty
(collectively, the "Guaranty"), in favor of the Agent for the Lenders parties to
the Credit Agreement referred to in the foregoing Amendment No. 4 hereby consent
to such  Amendment No. 4 and hereby confirm and agree that  notwithstanding  the
effectiveness  of such  Amendment No. 4, the Guaranty is, and shall  continue to
be, in full  force  and  effect  and is hereby  confirmed  and  ratified  in all
respects.

     ABC GP, INC.
     ABC HOME HEALTH AND HOSPICE OF ALBANY, INC.
     ABC HOME HEALTH AND HOSPICE OF ATHENS, INC.
     ABC HOME HEALTH AND HOSPICE OF BRUNSWICK, INC.
     ABC HOME HEALTH AND HOSPICE OF DUBLIN, INC.
     ABC HOME HEALTH AND HOSPICE OF MACON, INC.
     ABC HOME HEALTH AND HOSPICE OF SAVANNAH, INC.
     ABC HOME HEALTH AND HOSPICE OF TIFTON, INC.
     ABC HOME HEALTH AND HOSPICE OF VIDALIA, INC.
     ABC HOME HEALTH AND HOSPICE OF WAYCROSS, INC.
     ABC HOME NURSING, INC.
     ABC NEWCO, INC.
     ABC PHARMACEUTICALS, INC.
     ALABAMA SENIOR LIFE CARE, INC.
     ALPINE MANOR, INC.
     ARBOR LIVING CENTERS OF FLORIDA, INC.
     ARBOR LIVING CENTERS OF TEXAS, INC.
     ASIA CARE, INC.
     BETHAMY LIVING CENTER MANAGEMENT COMPANY
     BETHAMY LIVING CENTERS LIMITED PARTNERSHIP
     BRIAR HILL, INC.
     BRIARCLIFF NURSING HOME, INC.
     CAMBRIDGE CARE CENTERS, INC.
     CAMBRIDGE GROUP OF INDIANA, INC.
     CAMBRIDGE GROUP OF PENNSYLVANIA, INC.
     CAMBRIDGE GROUP OF TEXAS, INC.
     CARE CENTERS HOLDING, INC.
     CARRIAGE-BY-THE-LAKE OF IHS, INC.
     CEDARCROFT HEALTH SERVICES, INC.
     CENTRAL PARK LODGES, INC.
     CENTRAL PARK LODGES OF WEST PALM BEACH, INC.
     CENTRAL PARK LODGES (TARPON SPRINGS), INC.
     CLARA BURKE NURSING HOME, INC.
     CLAREMONT INTEGRATED HEALTH, INC.
     COMPREHENSIVE POSTACUTE SERVICES, INC.
     DERRY INTEGRATED HEALTH, INC.
     ELIZABELL CO., INC.




<PAGE>


                                        2

     ELM CREEK OF IHS, INC.
     F.L.C. BENEVA NURSING PAVILION, INC.
     F.L.C. SARASOTA NURSING PAVILION, INC.
     FERRIGAN MOBILE X-RAY, INC.
     FIRELANDS OF IHS, INC.
     FIRST AMERICAN HOME CARE OF ALABAMA, INC.
     FIRST AMERICAN HOME CARE OF ARKANSAS, INC.
     FIRST AMERICAN HOME CARE OF CALIFORNIA, INC.
     FIRST AMERICAN HOME CARE OF COLORADO, INC.
     FIRST AMERICAN HOME CARE OF FLORIDA, INC.
     FIRST AMERICAN HOME CARE OF FT. LAUDERDALE, INC.
     FIRST AMERICAN HOME CARE OF GEORGIA, INC.
     FIRST AMERICAN HOME CARE OF ILLINOIS, INC.
     FIRST AMERICAN HOME CARE OF INDIANA, INC.
     FIRST AMERICAN HOME CARE OF LOUISIANA, INC.
     FIRST AMERICAN HOME CARE OF MICHIGAN, INC.
     FIRST AMERICAN HOME CARE OF MISSISSIPPI, INC.
     FIRST AMERICAN HOME CARE OF MISSOURI, INC.
     FIRST AMERICAN HOME CARE OF NAPLES, INC.
     FIRST AMERICAN HOME CARE OF NEBRASKA, INC.
     FIRST AMERICAN HOME CARE OF NEW MEXICO, INC.
     FIRST AMERICAN HOME CARE OF NORTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF OHIO, INC.
     FIRST AMERICAN HOME CARE OF OKLAHOMA, INC.
     FIRST AMERICAN HOME CARE OF PENNSYLVANIA, INC.
     FIRST AMERICAN HOME CARE OF SOUTH CAROLINA, INC.
     FIRST AMERICAN HOME CARE OF TENNESSEE, INC.
     FIRST AMERICAN HOME CARE OF TEXAS, INC.
     FIRST AMERICAN HOME CARE OF VALDOSTA, INC.
     FIRST AMERICAN HOME CARE OF VIRGINIA, INC.
     FIRST AMERICAN HOME CARE OF WEST VIRGINIA, INC.
     FIRST AMERICAN INTERNATIONAL, INC.
     FLORIDA LIFE CARE, INC.
     GAINESVILLE HEALTH CARE CENTER, INC.
     GRAVOIS HEALTH CARE, INC.
     HEALTH CARE SYSTEMS, INC.
     HOME HEALTH INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT I, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF DISTRICT VII-B, INC.
     HOSPICE INTEGRATED HEALTH SERVICES OF FLORIDA, INC.
     HOSPICE OF INTEGRATED HEALTH SERVICES, INC.
     IHS ACQUISITION XIII, INC.
     IHS ACQUISITION XV, INC.
     IHS ACQUISITION XVIII, INC.





<PAGE>


                                        3

     IHS ACQUISITION XIX, INC.
     IHS ACQUISITION XXII, INC.
     IHS AT LANSING, INC.
     IHS CHICAGO POST-ACUTE NETWORK, INC.
     IHS DEVELOPMENT-HIGHLANDS PARK, INC.
     IHS HOME CARE, INC.
     IHS LAND ACQUISITION-HIGHLANDS PARK, INC.
     IHS MANAGEMENT GROUP, INC.
     IHS NETWORK SERVICES, INC.
     IHS OF DANA, INC.
     IN-HOME HEALTH CARE, INC.
     INTEGRACARE, INC.
     INTEGRATED-BALLARD, INC.
     INTEGRATED HEALTH GROUP LIMITED PARTNERSHIP
     INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.
     INTEGRATED HEALTH OF WATERFORD COMMONS, INC.
     INTEGRATED HEALTH SERVICES AT ALEXANDRIA, INC.
     INTEGRATED HEALTH SERVICES AT BIG SAIL, INC.
     INTEGRATED HEALTH SERVICES AT BLUE RIDGE MANOR, INC.
     INTEGRATED HEALTH SERVICES AT BRIARCLIFF HAVEN, INC.
     INTEGRATED HEALTH SERVICES AT CADIZ, INC.
     INTEGRATED HEALTH SERVICES AT CENTRAL FLORIDA, INC.
     INTEGRATED HEALTH SERVICES AT CHEYENNE, INC.
     INTEGRATED HEALTH SERVICES AT COLORADO SPRINGS, INC.
     INTEGRATED HEALTH SERVICES AT COLUMBUS, INC.
     INTEGRATED HEALTH SERVICES AT DAYTON, INC.
     INTEGRATED HEALTH SERVICES AT DRIFTWOOD, INC.
     INTEGRATED HEALTH SERVICES AT EASTERN MASSACHUSETTS, INC.
     INTEGRATED HEALTH SERVICES AT GRANDVIEW CARE CENTER, INC.
     INTEGRATED HEALTH SERVICES AT GREAT BEND, INC.
     INTEGRATED HEALTH SERVICES AT HIGHLANDS PARK, INC.
     INTEGRATED HEALTH SERVICES AT HOPEDALE, INC.
     INTEGRATED HEALTH SERVICES AT HOUSTON, INC.
     INTEGRATED HEALTH SERVICES AT INDIAN CREEK, INC.
     INTEGRATED HEALTH SERVICES AT KENT, INC.
     INTEGRATED HEALTH SERVICES AT KING DAVID CENTER, INC.
     INTEGRATED HEALTH SERVICES AT NEWARK, INC.
     INTEGRATED HEALTH SERVICES AT ORMOND BEACH, INC.
     INTEGRATED HEALTH SERVICES AT PARK REGENCY, INC.
     INTEGRATED HEALTH SERVICES AT PENN, INC.
     INTEGRATED HEALTH SERVICES AT SILVERCREST, INC.
     INTEGRATED HEALTH SERVICES AT SOMERSET VALLEY, INC.
     INTEGRATED HEALTH SERVICES AT SOUTHERN HILLS, INC.
     INTEGRATED HEALTH SERVICES AT STEUBENVILLE
     INTEGRATED HEALTH SERVICES AT SYCAMORE CREEK, INC.



<PAGE>


                                        4

     INTEGRATED HEALTH SERVICES AT THREE RIVERS, INC.
     INTEGRATED HEALTH SERVICES AT TREYBURN, INC.
     INTEGRATED HEALTH SERVICES FINANCIAL HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES HOLDINGS, INC.
     INTEGRATED HEALTH SERVICES NPR, INC.
     INTEGRATED HEALTH SERVICES OF ARCADIA, INC.
     INTEGRATED HEALTH SERVICES OF ATHENS, INC.
     INTEGRATED HEALTH SERVICES OF BRENTWOOD, INC.
     INTEGRATED HEALTH SERVICES OF BRUNSWICK, INC.
     INTEGRATED HEALTH SERVICES OF CALIFORNIA, INC.
     INTEGRATED HEALTH SERVICES OF CLIFF MANOR, INC.
     INTEGRATED HEALTH SERVICES OF COLORADO AT CHERRY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF EAGLE CREEK, INC.
     INTEGRATED HEALTH SERVICES OF GREEN BRIAR, INC.
     INTEGRATED HEALTH SERVICES OF HERITAGE MANOR, INC.
     INTEGRATED HEALTH SERVICES OF HICKORY CREEK, INC.
     INTEGRATED HEALTH SERVICES OF INDIAN HILLS, INC.
     INTEGRATED HEALTH SERVICES OF JACKSONVILLE, INC.
     INTEGRATED HEALTH SERVICES OF KURT, INC.
     INTEGRATED HEALTH SERVICES OF LESTER, INC.
     INTEGRATED HEALTH SERVICES OF MELISSA, INC.
     INTEGRATED HEALTH SERVICES OF MISSOURI, INC.
     INTEGRATED HEALTH SERVICES OF ORANGE PARK, INC.
     INTEGRATED HEALTH SERVICES OF RIVERBEND, INC.
     INTEGRATED HEALTH SERVICES OF SCENIC HILLS, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW, INC.
     INTEGRATED HEALTH SERVICES OF SKYVIEW II, INC.
     INTEGRATED HEALTH SERVICES OF SUNSET, INC.
     INTEGRATED MANAGED CARE, INC. (formerly Isabeth Co., Inc.)
     INTEGRATED MANAGEMENT-GOVERNOR'S PARK, INC.
     INTEGRATED OF AMARILLO, INC.
     INTEGRATED PHYSICIAN GROUP SERVICES, INC.
     J.R. REHAB ASSOCIATES, INC.
     LIFEWAY, INC.
     LPC BETHAMY HEALTH CORPORATION, L.P.
     MANCHESTER INTEGRATED HEALTH, INC.
     MOBILE RAY OF NEW ORLEANS, INC.
     MOUNTAIN VIEW NURSING CENTER, INC.
     NEW SOUTHWOOD ASSOCIATES, INC.
     PALESTINE NURSING CENTER, INC.
     PINELLAS PARK NURSING HOME, INC.
     PREFERRED HOME HEALTH SERVICES, INC.
     PROFESSIONAL REVIEW NETWORK, INC.
     REHAB MANAGEMENT SYSTEMS, INC.
     REST HAVEN NURSING CENTER, INC.



<PAGE>


                                        5

     REST HAVEN NURSING CENTER (CHESTNUT HILL), INC.
     REST HAVEN NURSING CENTER (WHITEMARSH), INC.
     RIKAD PROPERTIES, INC.
     SAMARITAN CARE, INC. (Illinois Domestic)
     SAMARITAN CARE, INC. (Michigan Domestic)
     SAMARITAN MANAGEMENT, INC.
     SHC OF ARIZONA, L.C.
     SHC SERVICES OF ARIZONA, L.C.
     SIGNATURE HOME CARE GROUP, INC.
     SIGNATURE HOME CARE, INC.
     SIGNATURE HOME CARE OF ARLINGTON, INC.
     SIGNATURE HOME CARE OF FLORIDA, INC.
     SIGNATURE HOME CARE OF GEORGIA, INC.
     SIGNATURE HOME CARE OF KANSAS, INC.
     SIGNATURE HOME CARE OF NEW JERSEY, INC.
     SIGNATURE HOME CARE OF NEW JERSEY GENERAL PARTNERSHIP
     SIGNATURE HOME CARE OF SAN ANTONIO, INC.
     SIGNATURE HOME CARE SERVICES OF FLORIDA, INC.
     SIGNATURE HOME CARE SERVICES OF SAN ANTONIO, INC.
     SIGNATURE MANAGEMENT SERVICES, INC.
     SIGNATURE RECEIVABLES CORP.
     SLC COMMUNITY CARE, INC.
     SOUTHWOOD HOLDINGS, INC.
     SPRING CREEK OF IHS, INC.
     SYMPHONY ANCILLARY SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 1, INC.
     SYMPHONY DIAGNOSTIC SERVICES NO. 2, INC.
     SYMPHONY HEALTH CARE CONSULTING, INC.
     SYMPHONY HEALTH SERVICES, INC.
     SYMPHONY HOME CARE SERVICES, INC.
     SYMPHONY HOME CARE SERVICES NO. 1, INC.
     SYMPHONY HOME CARE SERVICES NO. 2, INC.
     SYMPHONY HOME CARE SERVICES NO. 3, INC.
     SYMPHONY HOME CARE SERVICES NO. 4, INC.
     SYMPHONY HOME CARE SERVICES NO. 5, INC.
     SYMPHONY HOME CARE SERVICES NO. 6, INC.
     SYMPHONY HOME CARE SERVICES NO. 7, INC.
     SYMPHONY HOME CARE SERVICES NO. 8, INC.
     SYMPHONY HOME CARE SERVICES NO. 9, INC.
     SYMPHONY HOME CARE SERVICES NO. 10, INC.
     SYMPHONY HOME CARE SERVICES NO. 11, INC.
     SYMPHONY HOME CARE SERVICES NO. 12, INC.
     SYMPHONY HOME CARE SERVICES NO. 13, INC.
     SYMPHONY HOME CARE SERVICES NO. 14, INC.



<PAGE>


                                        6

     SYMPHONY HOME CARE SERVICES NO. 15, INC.
     SYMPHONY HOME CARE SERVICES NO. 16, INC.
     SYMPHONY HOME CARE SERVICES NO. 17, INC.
     SYMPHONY HOME CARE SERVICES NO. 18, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- CALIFORNIA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- LOUISIANA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- OKLAHOMA, INC.
     SYMPHONY HOME CARE SERVICES NO. 18- TEXAS. INC.
     SYMPHONY HOME CARE SERVICES NO. 19, INC.
     SYMPHONY HOME CARE SERVICES NO. 100, INC.
     SYMPHONY HOME CARE SERVICES NO. 101, INC.
     SYMPHONY HOME CARE SERVICES NO. 102, INC.
     SYMPHONY HOME CARE SERVICES NO. 103, INC.
     SYMPHONY HOME CARE SERVICES NO. 104, INC.
     SYMPHONY HOME CARE SERVICES NO. 105, INC.
     SYMPHONY HOME CARE SERVICES NO. 106, INC.
     SYMPHONY HOME CARE SERVICES NO. 107, INC.
     SYMPHONY HOME CARE SERVICES NO. 108, INC.
     SYMPHONY HOME CARE SERVICES NO. 109, INC.
     SYMPHONY HOME CARE SERVICES NO. 110, INC.
     SYMPHONY HOME CARE SERVICES NO. 113, INC.
     SYMPHONY HOME CARE SERVICES NO. 114, INC.
     SYMPHONY HOME CARE SERVICES NO. 115, INC.
     SYMPHONY HOME CARE SERVICES NO. 116, INC.
     SYMPHONY HOME CARE SERVICES NO. 117, INC.
     SYMPHONY HOME CARE SERVICES NO. 118, INC.
     SYMPHONY HOME CARE SERVICES NO. 119, INC.
     SYMPHONY HOME CARE SERVICES NO. 120, INC.
     SYMPHONY HOME CARE SERVICES NO. 121, INC.
     SYMPHONY HOME CARE SERVICES NO. 122, INC.
     SYMPHONY REHABILITATION SERVICES, INC.
     SYMPHONY REHABILITATION SERVICES NO. 1, INC.
     SYMPHONY REHABILITATION SERVICES NO. 2, INC.
     SYMPHONY REHABILITATION SERVICES NO. 3, INC.
     SYMPHONY REHABILITATION SERVICES NO. 4, INC.
     SYMPHONY RESPIRATORY SERVICES, INC.
     TEXAS LPC, INC.
     


<PAGE>


                                        7

     THE BESTON CORPORATION
     WEST COAST CAMBRIDGE, INC.
     WOODRIDGE CONVALESCENT CENTER, INC.


     By: /s/ 
        -------------------------------------
        Name:
        Title:
             of Each Guarantor or of the
             General Partner of such Guarantor





                                  $450,000,000

                        INTEGRATED HEALTH SERVICES, INC.

                    9 1/2% Senior Subordinated Notes due 2007

                               PURCHASE AGREEMENT
                                                                    May 22, 1997
SMITH BARNEY INC.
388 Greenwich Street
New York, New York 10013

DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION
277 Park Avenue
New York, New York 10022

MORGAN STANLEY & CO. INCORPORATED
1585 Broadway
New York, New York 10036

SALOMON BROTHERS INC
7 World Trade Center
New York, New York 10048

Dear Sirs:

     Integrated Health Services,  Inc., a Delaware  corporation (the "Company"),
proposes,  upon the terms and conditions set forth herein,  to issue and sell to
you,  as  the  initial  purchasers  (the  "Initial  Purchasers"),   $450,000,000
aggregate principal amount of its 9 1/2% Senior Subordinated Notes due 2007 (the
"Notes").  The Notes will be issued  pursuant to the provisions of an Indenture,
to be dated as of May 30, 1997 (the "Indenture"),  between the Company and First
Union National Bank of Virginia, as Trustee (the "Trustee").

     The  Company  wishes to confirm as follows its  agreement  with the Initial
Purchasers in connection with the purchase and resale of the Notes.

     1. Preliminary Offering Memorandum and Offering Memorandum.  The Notes will
be offered and sold to the Initial  Purchasers  without  registration  under the
Securities  Act of 1933,  as amended  (the  "Act"),  in reliance on an exemption
pursuant to Section 4(2) under the Act.  The Company has prepared a  preliminary
offering memorandum, dated May 15, 1997 (the "Preliminary Offering Memorandum"),
and an  offering  memorandum,  dated May 22, 1997 (the  "Offering  Memorandum"),
setting forth  information  regarding the Company and the Notes.  Any references
herein to the Preliminary  Offering Memorandum and the Offering Memorandum shall
be deemed to include all  amendments and  supplements  thereto and any documents
filed under the Securities  Exchange Act of 1934, as amended,  and the rules and
regulations  of  the  Securities  and  Exchange  Commission  (the  "Commission")
thereunder  (collectively,   the  "Exchange  Act")  which  are  incorporated  by
reference therein.  As used herein, the term "Incorporated  Documents" means the
documents  which at the time are  incorporated  by reference in the  Preliminary
Offering  Memorandum,  the Offering  Memorandum  or any  amendment or supplement
thereto.  The Company  hereby  confirms  that it has  authorized  the use of the
Preliminary  Offering  Memorandum and the Offering Memorandum in connection with
the offering and resale of the Notes by the Initial Purchasers.



<PAGE>



     The Company  understands that the Initial Purchasers propose to make offers
and  sales  (the  "Exempt  Resales")  of the  Notes  purchased  by  the  Initial
Purchasers  hereunder  only on the  terms  and in the  manner  set  forth in the
Offering Memorandum and Section 2 hereof, as soon as the Initial Purchasers deem
advisable  after this  Agreement has been executed and delivered to persons whom
the Initial Purchasers  reasonably believe to be qualified  institutional buyers
("Qualified  Institutional  Buyers")  as defined in Rule 144A under the Act,  as
such rule may be amended from time to time ("Rule 144A"), in transactions  under
Rule 144A (such persons being referred to herein as the "Eligible Purchasers").

     It is understood and acknowledged that upon original issuance thereof,  and
until  such  time  as the  same  is no  longer  required  under  the  applicable
requirements  of the Act,  the Notes  (and all  securities  issued  in  exchange
therefor or in substitution thereof) shall bear the following legend:

   THIS SECURITY HAS NOT BEEN  REGISTERED  UNDER THE  SECURITIES ACT OF 1933, AS
   AMENDED (THE "SECURITIES  ACT"), OR ANY STATE  SECURITIES LAWS.  NEITHER THIS
   SECURITY NOR ANY INTEREST OR  PARTICIPATION  HEREIN MAY BE  REOFFERED,  SOLD,
   ASSIGNED,  TRANSFERRED,  PLEDGED,  ENCUMBERED OR OTHERWISE DISPOSED OF IN THE
   ABSENCE OF SUCH  REGISTRATION  OR UNLESS SUCH  TRANSACTION IS EXEMPT FROM, OR
   NOT SUBJECT TO, REGISTRATION UNDER SUCH LAWS.

   THE HOLDER OF THIS  SECURITY BY ITS  ACCEPTANCE  HEREOF  AGREES NOT TO OFFER,
   SELL OR  OTHERWISE  TRANSFER  SUCH  SECURITY,  PRIOR TO THE DATE (THE "RESALE
   RESTRICTION  TERMINATION  DATE")  WHICH IS TWO  YEARS  AFTER THE LATER OF THE
   ORIGINAL  ISSUE  DATE  HEREOF  AND THE LAST DATE ON WHICH THE  COMPANY OR ANY
   AFFILIATED  PERSON  OF THE  COMPANY  WAS THE OWNER OF THIS  SECURITY  (OR ANY
   PREDECESSOR  OF SUCH SECURITY)  UNLESS SUCH OFFER,  SALE OR OTHER TRANSFER IS
   (A) TO THE COMPANY,  (B) PURSUANT TO A REGISTRATION  STATEMENT WHICH HAS BEEN
   DECLARED  EFFECTIVE  UNDER  THE  SECURITIES  ACT,  (C)  FOR  SO  LONG  AS THE
   SECURITIES  ARE  ELIGIBLE FOR RESALE  PURSUANT TO RULE 144A,  TO A PERSON THE
   HOLDER REASONABLY BELIEVES IS A "QUALIFIED INSTITUTIONAL BUYER" AS DEFINED IN
   RULE 144A UNDER THE  SECURITIES ACT THAT PURCHASES FOR ITS OWN ACCOUNT OR FOR
   THE ACCOUNT OF A QUALIFIED  INSTITUTIONAL  BUYER TO WHOM NOTICE IS GIVEN THAT
   THE TRANSFER IS BEING MADE IN RELIANCE ON RULE 144A, (D) TO AN  INSTITUTIONAL
   "ACCREDITED  INVESTOR"  WITHIN THE MEANING OF  SUBPARAGRAPH  (a)(1),  (a)(2),
   (a)(3) OR (a)(7) OF RULE 501 UNDER THE  SECURITIES  ACT THAT IS ACQUIRING THE
   SECURITY  FOR ITS OWN  ACCOUNT,  OR FOR THE ACCOUNT OF SUCH AN  INSTITUTIONAL
   "ACCREDITED INVESTOR," FOR INVESTMENT PURPOSES AND NOT WITH A VIEW TO, OR FOR
   OFFER OR SALE IN  CONNECTION  WITH,  ANY  DISTRIBUTION  IN  VIOLATION  OF THE
   SECURITIES  ACT, OR (E)  PURSUANT  TO ANOTHER  AVAILABLE  EXEMPTION  FROM THE
   REGISTRATION REQUIREMENTS OF THE SECURITIES ACT, AND IN EACH OF THE FOREGOING
   CASES SUCH OFFER, SALE OR OTHER TRANSFER IS IN COMPLIANCE WITH ANY APPLICABLE
   STATE SECURITIES LAWS, SUBJECT TO THE COMPANY'S AND THE TRUSTEE'S RIGHT PRIOR
   TO ANY SUCH OFFER, SALE OR TRANSFER PURSUANT TO CLAUSES (D) OR (E) TO REQUIRE
   THE DELIVERY OF AN OPINION OF COUNSEL, CERTIFICATION AND/OR OTHER INFORMATION
   SATISFACTORY  TO  EACH  OF  THEM,  AND IN  EACH  OF THE  FOREGOING  CASES,  A
   CERTIFICATE  OF TRANSFER IN THE FORM PROVIDED FOR IN THE INDENTURE (A COPY OF
   WHICH MAY BE OBTAINED  FROM THE  TRUSTEE) IS COMPLETED  AND  DELIVERED BY THE
   TRANSFEROR  TO THE  TRUSTEE.  THIS LEGEND WILL BE REMOVED UPON THE REQUEST OF
   THE THEN HOLDER OF THIS  SECURITY  AFTER THE RESALE  RESTRICTION  TERMINATION
   DATE.  ANY  TRANSFEREE OF THIS SECURITY  SHALL BE DEEMED TO HAVE  REPRESENTED
   EITHER  (A) THAT IT IS NOT  USING  THE  ASSETS OF AN  EMPLOYEE  BENEFIT  PLAN
   SUBJECT TO THE  EMPLOYEE  RETIREMENT  INCOME  SECURITY  ACT  ("ERISA") OR THE
   INTERNAL  REVENUE CODE (THE "CODE") TO PURCHASE THIS SECURITY OR (B) THAT ITS
   PURCHASE  AND  CONTINUED  HOLDING OF THE  SECURITY  WILL BE COVERED BY A U.S.
   DEPARTMENT OF LABOR CLASS  EXEMPTION WITH RESPECT TO PROHIBITED  TRANSACTIONS
   UNDER SECTION 406(a) OF ERISA.


                                      -2-
<PAGE>



     It is also understood and acknowledged that holders  (including  subsequent
transferees)  of the Notes  will have the  registration  rights set forth in the
registration rights agreement (the "Registration Rights Agreement"), to be dated
the date hereof, in substantially the form of Exhibit A hereto.  Pursuant to the
Registration  Rights  Agreement,  the  Company  will  agree (i) to file with the
Commission,  under the circumstances set forth therein, a registration statement
on the appropriate form under the Act relating to a proposed exchange offer (the
"Registered Exchange Offer") to the holders of the Notes to issue and deliver to
such  holders,  in  exchange  for the  Notes,  a like  principal  amount of debt
securities of the Company  identical in all material  respects to the Notes (the
"New  Notes")  and  (ii)  to use its  reasonable  best  efforts  to  cause  such
registration  statement  to be  declared  effective.  If (a) the  Company is not
permitted  to effect  the  Registered  Exchange  Offer  because  the  Registered
Exchange   Offer  would   violate   any   applicable   law  or  the   applicable
interpretations  of the Commission's staff or because of any change in currently
prevailing  interpretations  of the  Commission's  staff  or (b) the  Registered
Exchange  Offer has not been  consummated  for any other reason  within 240 days
after the Closing Date (as defined herein),  then the Company shall file and use
its  reasonable  best efforts to cause to be declared  effective a  registration
statement on an appropriate form under the Act relating to the offer and sale of
the  Notes by the  holders  thereof  from  time to time in  accordance  with the
methods of distribution  set forth in such  registration  statement and Rule 415
under the Act. The registration  statement to be filed under the Act pursuant to
the   Registration   Rights   Agreement  is  hereinafter   referred  to  as  the
"Registration  Statement."  This Agreement,  the Indenture and the  Registration
Rights  Agreement are  hereinafter  referred to  collectively  as the "Operative
Documents".

     Capitalized  terms  used  herein  without  definition  have the  respective
meanings specified therefor in the Indenture or the Offering Memorandum.

     2. Agreements to Sell,  Purchase and Resell. (a) The Company hereby agrees,
subject to all the terms and conditions  set forth herein,  to issue and sell to
each Initial  Purchaser and, upon the basis of the  representations,  warranties
and agreements of the Company herein  contained and subject to all the terms and
conditions set forth herein,  each Initial Purchaser  agrees,  severally and not
jointly,  to purchase  from the Company,  at a purchase  price of 97.375% of the
principal  amount thereof,  the principal amount of Notes set forth opposite the
name of such Initial Purchaser in Schedule I hereto.

     (b) The Initial  Purchasers  have  advised the Company that they propose to
offer  the  Notes  for sale  upon the  terms  and  conditions  set forth in this
Agreement  and  in  the  Offering  Memorandum.  Each  Initial  Purchaser  hereby
represents  and  warrants  to, and agrees  with,  the Company  that such Initial
Purchaser  (i) is  purchasing  the Notes  pursuant to a private sale exempt from
registration  under the Act, (ii) will not solicit offers for, or offer or sell,
the Notes by means of any form of general solicitation or general advertising or
in any manner  involving a public offering within the meaning of Section 4(2) of
the Act, and (iii) will solicit  offers for the Notes only from, and will offer,
sell or deliver the Notes as part of its initial offering,  only to persons whom
the Initial Purchasers reasonably believe to be Qualified  Institutional Buyers,
or if any such person is buying for one or more institutional accounts for which
such  person is acting  as  fiduciary  or  agent,  only  when  such  person  has
represented  to the  Initial  Purchasers  that each such  account is a Qualified
Institutional Buyer, to whom notice has been given that such sale or delivery is
being made in reliance on Rule 144A and in each case, in transactions under Rule
144A. The Initial  Purchasers  have advised the Company that they will offer the
Notes to Eligible Purchasers at a price initially equal to 100% of the principal
amount thereof,  plus accrued interest, if any, from the date of issuance of the
Notes.  Such  price  may  be  changed  by the  Initial  Purchasers  at any  time
thereafter without notice.

     The Initial Purchasers understand that the Company and, for purposes of the
opinions  to be  delivered  to  the  Initial  Purchasers  pursuant  to  Sections
7(c)(xiii)  and 7(e)  hereof,  counsel to the Company and counsel to the Initial
Purchasers,   will  rely  upon  the   accuracy   and  truth  of  the   foregoing
representations and agreements and the Initial Purchasers hereby consent to such
reliance.

     3.  Delivery  of the Notes and  Payment  Therefor.  Delivery to the Initial
Purchasers  of and  payment  for the Notes  shall be made at the office of Smith
Barney Inc., 388 Greenwich  Street,  New York, NY 10013, at 10:00 A.M., New York
City time, on May 30, 1997 (the "Closing Date"). The place of closing for


                                      -3-
<PAGE>



the Notes and the Closing  Date may be varied by  agreement  between the Initial
Purchasers and the Company.

     The Notes will be delivered to the Initial  Purchasers  against  payment of
the purchase  price therefor by wire transfer of federal or other same day funds
to an account or accounts designated by the Company. The Notes will be evidenced
by one or more global securities in definitive form (the "Global Note") and will
be  registered  in the name of Cede & Co. as  nominee  of The  Depository  Trust
Company  ("DTC").  The Notes to be delivered to the Initial  Purchasers shall be
made  available to the Initial  Purchasers in New York City for  inspection  not
later than 9:30 a.m., New York City time, on the business day next preceding the
Closing Date.

     4.  Agreements  of  the  Company.  The  Company  agrees  with  the  Initial
Purchasers as follows:

     (a) The  Company  will  advise the  Initial  Purchasers  promptly  and,  if
requested by them,  will  confirm  such advice in writing,  within the period of
time  referred  to in  paragraph  (e)  below,  of any  change  in the  Company's
condition (financial or other), business,  prospects,  properties,  net worth or
results  of  operations,  or of the  happening  of any  event,  which  makes any
statement  made in the Offering  Memorandum  (as then  amended or  supplemented)
untrue or which  requires  the  making of any  additions  to or  changes  in the
Offering  Memorandum  (as then  amended  or  supplemented)  in order to make the
statements  therein not  misleading,  or of the necessity to amend or supplement
the Offering  Memorandum  (as then amended or  supplemented)  to comply with any
law.

     (b) The Company will furnish to the Initial Purchasers,  without charge, as
of the date of the  Offering  Memorandum,  such number of copies of the Offering
Memorandum  as may  then be  amended  or  supplemented  as they  may  reasonably
request.

     (c)  The  Company  will  not  make  any  amendment  or  supplement  to  the
Preliminary  Offering  Memorandum  or to the  Offering  Memorandum  of which the
Initial Purchasers shall not previously have been advised or to which they shall
reasonably  object after being so advised or file any document which upon filing
becomes an Incorporated Document,  without delivering a copy of such document to
the Initial Purchasers, prior to or concurrently with such filing.

     (d) Prior to the execution and delivery of this Agreement,  the Company has
delivered or will deliver to the Initial  Purchasers,  without  charge,  in such
quantities  as the Initial  Purchasers  shall have  requested  or may  hereafter
reasonably request,  copies of the Preliminary Offering Memorandum.  The Company
consents to the use, in accordance  with the  securities or Blue Sky laws of the
jurisdictions  in which the Notes are offered by the Initial  Purchasers  and by
dealers,  prior  to the date of the  Offering  Memorandum,  of each  Preliminary
Offering Memorandum so furnished by the Company. The Company consents to the use
of the  Offering  Memorandum  (and of any  amendment or  supplement  thereto) in
accordance  with the securities or Blue Sky laws of the  jurisdictions  in which
the Notes are offered by the Initial Purchasers and by all dealers to whom Notes
may be sold, in connection with the offering and sale of the Notes.

     (e) If, at any time prior to completion of the distribution of the Notes by
the Initial Purchasers to Eligible Purchasers, any event shall occur that in the
judgment of the Company or in the opinion of counsel for the Initial  Purchasers
should be set forth in the Offering Memorandum (as then amended or supplemented)
in order to make the statements therein, in the light of the circumstances under
which they were made,  not  misleading,  or if it is necessary to  supplement or
amend the  Offering  Memorandum,  or to file under the Exchange Act any document
which upon filing becomes an Incorporated  Document, to comply with any law, the
Company will forthwith prepare an appropriate supplement or amendment thereto or
such  document,  and will  expeditiously  furnish to the Initial  Purchasers and
dealers a reasonable number of copies thereof. In the event that the Company and
the Initial  Purchasers agree that the Offering  Memorandum should be amended or
supplemented,  or that a document  should be filed under the  Exchange Act which
upon filing becomes an Incorporated  Document,  the Company, if requested by the
Initial Purchasers, will promptly issue a press release announcing or disclosing
the  matters to be covered  by the  proposed  amendment  or  supplement  or such
document.


                                      -4-
<PAGE>



     (f) The Company will cooperate  with the Initial  Purchasers and with their
counsel in connection with the  qualification of the Notes for offering and sale
by the Initial  Purchasers  and by dealers under the securities or Blue Sky laws
of such jurisdictions as the Initial Purchasers may designate and will file such
consents to service of process or other  documents  necessary or  appropriate in
order to effect such qualification;  provided that in no event shall the Company
be obligated to qualify to do business in any  jurisdiction  where it is not now
so qualified or to take any action which would  subject it to service of process
in suits,  other than those arising out of the offering or sale of the Notes, in
any jurisdiction where it is not now so subject.

     (g) So long as any of the Notes are  outstanding,  the Company will furnish
to the Initial Purchasers (i) as soon as available, a copy of each report of the
Company mailed to stockholders or filed with the Commission,  and (ii) from time
to time such other information  concerning the Company as the Initial Purchasers
may request.

     (h) If  this  Agreement  shall  terminate  or  shall  be  terminated  after
execution  and  delivery  pursuant  to any  provisions  hereof  (otherwise  than
pursuant  to  Section  10 hereof or by notice  given by the  Initial  Purchasers
terminating  this  Agreement  pursuant  to Section 9 or Section 11 hereof) or if
this  Agreement  shall be  terminated by the Initial  Purchasers  because of any
failure  or  refusal  on the part of the  Company  to  comply  with the terms or
fulfill any of the conditions of this Agreement, the Company agrees to reimburse
the  Initial  Purchasers  for all  out-of-pocket  expenses  (including  fees and
expenses of its counsel) reasonably incurred by it in connection  herewith,  but
without any further obligation on the part of the Company for loss of profits or
otherwise.

     (i) The Company will apply the net  proceeds  from the sale of the Notes to
be sold by it hereunder  substantially  in accordance  with the  description set
forth in the Offering Memorandum.

     (j)  Except as stated in this  Agreement  and in the  Preliminary  Offering
Memorandum and Offering Memorandum, the Company has not taken, nor will it take,
directly  or  indirectly,  any action  designed to or that might  reasonably  be
expected to cause or result in stabilization or manipulation of the price of the
Notes to facilitate the sale or resale of the Notes.  Except as permitted by the
Act, the Company will not  distribute any offering  material in connection  with
the Exempt Resales.

     (k) The Company will use its best efforts to cause the Notes to be eligible
for trading on The PORTAL Market.

     (l) From and  after  the  Closing  Date,  so long as any of the  Notes  are
outstanding  and are  "Restricted  Securities"  within  the  meaning of the Rule
144(a)(3) under the Act or, if earlier,  until two years after the Closing Date,
and during any period in which the Company is not subject to Section 13 or 15(d)
of the  Exchange  Act,  the  Company  will  furnish  to holders of the Notes and
prospective purchasers of Notes designated by such holders, upon request of such
holders or such prospective purchasers, the information required to be delivered
pursuant to Rule 144A(d)(4) under the Act to permit compliance with Rule 144A in
connection with resale of the Notes.

     (m) The Company agrees not to sell, offer for sale or solicit offers to buy
or  otherwise  negotiate in respect of any security (as defined in the Act) that
would be  integrated  with the sale of the Notes in a manner that would  require
the  registration  under the Act of the sale to the  Initial  Purchasers  or the
Eligible Purchasers of the Notes.

     (n) The Company  agrees to comply with all of the terms and  conditions  of
the   Registration   Rights   Agreement,   and  all   agreements  set  forth  in
representation  letters of the Company to DTC  relating  to the  approval of the
Notes by DTC for "book entry" transfer.

     (o) The Company agrees that prior to any registration of the Notes pursuant
to the  Registration  Rights  Agreement,  or at such  earlier  time as may be so
required, the Indenture shall be qualified


                                       -5-
<PAGE>


under the Trust  Indenture  Act of 1939 (the  "1939  Act") and will  cause to be
entered into any necessary supplemental indentures in connection therewith.


     5.  Representations  and Warranties of the Company.  The Company represents
and warrants to the Initial Purchasers that:

     (a) The  Preliminary  Offering  Memorandum  and  Offering  Memorandum  with
respect to the Notes have been  prepared  by the  Company for use by the Initial
Purchasers in connection with the Exempt Resales.  No order or decree preventing
the use of the Preliminary Offering Memorandum or the Offering Memorandum or any
amendment or supplement  thereto,  or any order asserting that the  transactions
contemplated by this Agreement are subject to the  registration  requirements of
the Act, has been issued and no proceeding  for that purpose has commenced or is
pending or, to the knowledge of the Company, is contemplated.

     (b) The Preliminary  Offering  Memorandum and the Offering Memorandum as of
their respective  dates and the Offering  Memorandum as of the Closing Date, did
not or will not at any time contain an untrue  statement  of a material  fact or
omit to state a material fact required to be stated therein or necessary to make
the  statements  therein not  misleading,  except that this  representation  and
warranty  does not apply to  statements  in or  omissions  from the  Preliminary
Offering  Memorandum  and  Offering  Memorandum  made in  reliance  upon  and in
conformity with information  relating to the Initial Purchasers furnished to the
Company in writing by or on behalf of the Initial  Purchasers  expressly for use
therein.

     (c) The  Incorporated  Documents  heretofore  filed  were filed in a timely
manner and, when they were filed (or, if any amendment  with respect to any such
document was filed,  when such  document  was filed),  conformed in all material
respects to the  requirements  of the Exchange Act and did not contain an untrue
statement  of a material  fact or omit to state a material  fact  required to be
stated therein or necessary to make the statements  therein not misleading;  and
any further  Incorporated  Documents  will,  when so filed, be filed in a timely
manner and conform in all material  respects to the requirements of the Exchange
Act and will not contain an untrue statement of a material fact or omit to state
a  material  fact  required  to be  stated  therein  or  necessary  to make  the
statements therein not misleading.

     (d) The Indenture has been duly and validly  authorized by the Company and,
upon its  execution,  delivery and  performance  by the Company and assuming due
authorization,  execution,  delivery and  performance by the Trustee,  will be a
valid and binding  agreement of the Company,  enforceable in accordance with its
terms, except as enforcement thereof may be limited by bankruptcy, insolvency or
other similar laws affecting  creditors' rights  generally,  and conforms in all
material respects to the description thereof in the Offering Memorandum;  and no
qualification of the Indenture under the 1939 Act is required in connection with
the offer and sale of the Notes  contemplated  hereby or in connection  with the
Exempt Resales.

     (e) The Notes have been duly  authorized  by the Company and, when executed
by the Company and authenticated by the Trustee in accordance with the Indenture
and delivered to the Initial  Purchasers  against payment therefor in accordance
with the terms hereof,  will have been validly  issued and  delivered,  and will
constitute valid and binding obligations of the Company entitled to the benefits
of the  Indenture and  enforceable  in  accordance  with their terms,  except as
enforcement  thereof may be limited by  bankruptcy,  insolvency or other similar
laws affecting the  enforcement of creditors'  rights  generally,  and the Notes
will conform in all material respects to the description thereof in the Offering
Memorandum.

     (f) All the  outstanding  shares of capital  stock of the Company have been
duly authorized and validly  issued,  are fully paid and  nonassessable  and are
free of any  preemptive  or,  except  as set forth in the  Offering  Memorandum,
similar  rights  and were  issued  and sold in  compliance  with all  applicable
Federal and state  securities  laws;  and the  authorized  capital  stock of the
Company conforms to the description thereof in the Offering Memorandum.


                                      -6-
<PAGE>



     (g) The Company is a corporation  duly organized,  validly  existing and in
good standing under the laws of the State of Delaware with full corporate  power
and  authority  to own,  lease and  operate  its  properties  and to conduct its
business as described in the Offering  Memorandum,  and is duly  registered  and
qualified to conduct its business and is in good  standing in each  jurisdiction
or place  where the nature of its  properties  or the  conduct  of its  business
requires  such  registration  or  qualification,  except where the failure so to
register or qualify  does not have a material  adverse  effect on the  condition
(financial or other), business,  prospects,  properties, net worth or results of
operations of the Company and the Subsidiaries (as hereinafter defined) taken as
a whole (a "Material Adverse Effect").

     (h) All the  Company's  subsidiaries  (as  defined in the Act)  included in
Exhibit  21 to the  Company's  Annual  Report  on Form  10-K for the year  ended
December 31, 1996, are referred to herein  individually  as a  "Subsidiary"  and
collectively as the "Subsidiaries."  Each Subsidiary is a corporation or limited
partnership  duly  organized,  validly  existing  and in  good  standing  in the
jurisdiction of its  organization,  with full corporate or partnership power and
authority to own,  lease and operate its  properties and to conduct its business
as described in the Offering Memorandum, and is duly registered and qualified to
conduct its business and is in good standing in each jurisdiction or place where
the nature of its  properties  or the  conduct  of its  business  requires  such
registration  or  qualification,  except  where the  failure so to  register  or
qualify or be in good standing does not have a Material Adverse Effect.  None of
the  subsidiaries  of the Company other than the  Subsidiaries is engaged in any
business activities or operations or has any material assets or liabilities. All
the outstanding  shares of capital stock of each of the Subsidiaries  which is a
corporation  have been duly  authorized and validly  issued,  are fully paid and
nonassessable,  and are  wholly  owned by the  Company  directly  or  indirectly
through  one of the other  Subsidiaries,  free and  clear of any  lien,  adverse
claim,  security interest,  equity or other encumbrance,  except as described in
the Offering  Memorandum  and except for the shares of capital  stock of certain
Subsidiaries pledged to Citibank, N.A., as administrative agent ("Citibank"), in
connection  with the Company's  Revolving  Credit  Agreement dated as of May 15,
1996 with  Citibank and the lenders from time to time party thereto (the "Credit
Agreement")  and/or to Meditrust  Mortgage  Investments,  Inc. and/or any of its
affiliates  (collectively,  "Meditrust").  Each  limited  partnership  agreement
pursuant  to which the  Company  or a  Subsidiary  holds a  general  partnership
interest in a limited  partnership  which is a  Subsidiary  is in full force and
effect and  constitutes  the legal,  valid and binding  agreement of the parties
thereto,  enforceable against such parties in accordance with the terms thereof,
except as enforcement thereof may be limited by bankruptcy,  insolvency or other
similar laws  affecting the  enforcement of creditors'  rights  generally and by
general  equitable  principles;  and  there  has been no  material  breach of or
default under,  and no event which with notice or lapse of time would constitute
a material  breach of or default  under,  such  agreements by the Company or any
Subsidiary  or,  to the  Company's  best  knowledge,  any  other  party  to such
agreements.

     (i)  There  are no legal or  governmental  proceedings  pending  or, to the
knowledge  of  the  Company,  threatened,  against  the  Company  or  any of the
Subsidiaries,  or to which the Company or any of the  Subsidiaries,  or to which
any of their respective  properties,  is subject,  that are not disclosed in the
Offering  Memorandum and which, if adversely  decided,  are reasonably likely to
cause a Material  Adverse Effect or materially  affect the issuance of the Notes
or the consummation of the transactions contemplated by the Operative Documents.
There  are no  material  agreements,  contracts,  indentures,  leases  or  other
instruments  that  are not  described  in the  Offering  Memorandum  or that are
required to be filed as an exhibit to any Incorporated  Document that are not so
filed.  Neither the Company nor any  Subsidiary  is involved in any strike,  job
action or labor  dispute  with any group of  employees,  and,  to the  Company's
knowledge,  no such action or dispute is threatened,  which is reasonably likely
to have a Material Adverse Effect.

     (j) Neither the Company nor any of the  Subsidiaries is (i) in violation of
its certificate or articles of incorporation or by-laws or other  organizational
documents,  or of any law,  ordinance,  administrative  or governmental  rule or
regulation applicable to the Company or any of the Subsidiaries or of any decree
of any court or governmental agency or body having jurisdiction over the Company
or any of the Subsidiaries, except where any such violation or violations in the
aggregate  would not have a  Material  Adverse  Effect or (ii) in default in any
material  respect in the performance of any  obligation,  agreement or condition
contained in any bond, debenture,  note or any other evidence of indebtedness or
in any material agreement, indenture,


                                       -7-
<PAGE>



lease or other  instrument to which the Company or any of the  Subsidiaries is a
party  or by  which  any of them or any of their  respective  properties  may be
bound, except as may be disclosed in the Offering Memorandum.

     (k)  Neither  the  issuance,  offer,  sale or  delivery  of the Notes,  the
execution,  delivery or  performance  of this  Agreement,  the  Indenture or the
Registration Rights Agreement by the Company nor the consummation by the Company
of the  transactions  contemplated  hereby or thereby (i)  requires any consent,
approval,  authorization  or other order of, or registration or filing with, any
court, regulatory body, administrative agency or other governmental body, agency
or official  (except such as may be required in connection with the registration
under  the Act of the  Notes  and/or  the  New  Notes  in  accordance  with  the
Registration Rights Agreement, the qualification of the Indenture under the 1939
Act and except for  compliance  with the  securities or Blue Sky laws of various
jurisdictions)  or  conflicts  or  will  conflict  with or  constitutes  or will
constitute  a breach of, or a default  under,  the  certificate  or  articles of
incorporation or bylaws, or other  organizational  documents,  of the Company or
any of the  Subsidiaries  or (ii) conflicts or will conflict with or constitutes
or will constitute a breach of, or a default under, in any material respect, any
material agreement, indenture, lease or other instrument to which the Company or
any of the  Subsidiaries  is a party  or by  which  any of them or any of  their
respective  properties may be bound, or violates or will violate in any material
respect any statute, law, regulation or filing or judgment, injunction, order or
decree  applicable  to the  Company or any of the  Subsidiaries  or any of their
respective properties, or will result in the creation or imposition of any lien,
charge or  encumbrance  upon any property or assets of the Company or any of the
Subsidiaries  pursuant to the terms of any  agreement or instrument to which any
of them is a party or by which  any of them may be bound or to which  any of the
property or assets of any of them is subject.

     (l) The  accountants,  KPMG Peat Marwick  LLP, who have  certified or shall
certify the financial statements included as part of the Offering Memorandum (or
any  amendment  or  supplement  thereto),   are  independent   certified  public
accountants under Rule 101 of the AICPA's Code of Professional  Conduct, and its
interpretation and rulings.

     (m)  The  historical  financial  statements,   together  with  the  related
schedules and notes forming part of the Offering  Memorandum  (and any amendment
or supplement thereto),  comply as to form with the requirements of the Exchange
Act and present  fairly in all  material  respects  the  consolidated  financial
position,  results of operations  and changes in  stockholders'  equity and cash
flows of the Company and the  Subsidiaries  on the basis  stated in the Offering
Memorandum at the respective  dates or for the respective  periods to which they
apply;  such  statements  and related  schedules and notes have been prepared in
accordance with generally accepted accounting  principles  consistently  applied
throughout  the periods  involved,  except as disclosed  therein;  and the other
financial  and  statistical  information  and  data set  forth  in the  Offering
Memorandum  (and any  amendment or supplement  thereto) is accurately  presented
and, to the extent such information and data is derived from the financial books
and  records  of the  Company,  is  prepared  on a basis  consistent  with  such
financial  statements  and the books and records of the  Company.  The pro forma
financial  statements  and other pro forma  financial  information  included  or
incorporated  by  reference  in the Offering  Memorandum  have been  prepared in
accordance with the Commission's  rules and guidelines with respect to pro forma
financial  information  and have been properly  compiled on the basis  described
therein,  and  the  assumptions  used in the  preparation  thereof  are,  in the
Company's opinion, reasonable.

     (n) The Company has all requisite  power and authority to execute,  deliver
and perform its  obligations  under this Agreement and the  Registration  Rights
Agreement;  the execution and delivery of, and the performance by the Company of
its obligations under, this Agreement and the Registration Rights Agreement have
been duly and validly  authorized  by the Company,  and this  Agreement  and the
Registration  Rights  Agreement  have been duly  executed  and  delivered by the
Company and constitute the valid and legally binding  agreements of the Company,
enforceable  against the Company in accordance  with their terms,  except as the
enforcement hereof and thereof may be limited by bankruptcy, insolvency or other
similar laws  affecting  the  enforcement  of  creditors'  rights  generally and
subject to the  applicability  of general  principles  of equity,  and except as
rights to indemnity and contribution  hereunder and thereunder may be limited by
Federal or state securities laws or principles of public policy.


                                      -8-
<PAGE>



     (o) Except as  disclosed in the Offering  Memorandum  (or any  amendment or
supplement  thereto),  subsequent  to the date as of which such  information  is
given in the  Offering  Memorandum  (or any  amendment or  supplement  thereto),
neither the Company nor any of the  Subsidiaries  has incurred any  liability or
obligation,  direct or contingent,  or entered into any transaction,  not in the
ordinary  course  of  business,   that  is  material  to  the  Company  and  the
Subsidiaries taken as a whole, and there has not been any material change in the
capital stock, or material  increase in the short-term or long-term debt, of the
Company or any of the  Subsidiaries,  or any  material  adverse  change,  or any
development  involving  or which  could  reasonably  be  expected  to  involve a
prospective  material  adverse  change,  in the condition  (financial or other),
business,  properties, net worth or results of operations of the Company and the
Subsidiaries taken as a whole.

     (p) Each of the Company and the  Subsidiaries has good and marketable title
to all property  (real and  personal)  described in the Offering  Memorandum  as
being owned by it, free and clear of all liens,  claims,  security  interests or
other encumbrances except such as are described in the Offering Memorandum or in
an Incorporated  Document or exhibit thereto,  and all the property described in
the Offering Memorandum as being held under lease by each of the Company and the
Subsidiaries is held by it under valid,  subsisting and enforceable leases, with
only such  exceptions as in the aggregate are not  materially  burdensome and do
not  interfere in any  material  respect with the conduct of the business of the
Company and the Subsidiaries taken as a whole.

     (q) Except as permitted by the Act,  the Company has not  distributed  and,
prior  to the  later  to  occur  of  the  Closing  Date  and  completion  of the
distribution  of the  Notes,  will  not  distribute  any  offering  material  in
connection  with the offering  and sale of the Notes other than the  Preliminary
Offering Memorandum and Offering Memorandum.

     (r)  Each  of the  Company  and  the  Subsidiaries  and,  to the  Company's
knowledge,  the owners of the  facilities  and other  businesses  managed by the
Company or any Subsidiary have such permits, licenses, franchises,  certificates
and other approvals or authorizations of governmental or regulatory  authorities
("Permits")  as are  necessary  under  applicable  law to own  their  respective
properties and to conduct their  respective  business in the manner described in
the Offering  Memorandum  (including,  without  limitation,  such Permits as are
required  under such federal,  state and other health care laws,  and under such
HMO or similar  licensure laws and such insurance laws and  regulations,  as are
applicable  thereto),  and with respect to those facilities and other businesses
that participate in Medicare and/or  Medicaid,  to receive  reimbursement  under
Medicare and Medicaid, subject in each case to such qualifications as may be set
forth in the  Offering  Memorandum  and except to the extent that the failure to
have such Permits would not have a Material Adverse Effect; the Company and each
of the Subsidiaries have fulfilled and performed in all material  respects,  all
their respective material  obligations with respect to the Permits, and no event
has  occurred  which  allows,  or after  notice  or lapse of time  would  allow,
revocation or termination thereof or results in any other material impairment of
the  rights  of the  holder  of any such  Permit,  subject  in each case to such
qualification  as may be set forth in the Offering  Memorandum and except to the
extent that any such revocation or termination would not have a Material Adverse
Effect; and, except as described in the Offering Memorandum, none of the Permits
contains any restriction that is materially  burdensome to the Company or any of
the Subsidiaries.

     (s) The business  practices of the Company and each of its  Subsidiaries do
not violate in any  material  respect any  applicable  provisions  of federal or
state law governing  Medicare or any state Medicaid  program,  including without
limitation,  Sections  1320a-7a  and  1320a-7b of Title 42 of the United  States
Code, and no individual with an ownership or control interest,  as defined in 42
U.S.C. ss.1320a-3(a)(3), in the Company or any of its Subsidiaries, or who is an
officer, director, or managing employee, as defined in 42 U.S.C.  ss.1320a-5(b),
of the Company or any of its  Subsidiaries  is a person  described  in 42 U.S.C.
ss.1320a- 7(b)(8)(B),  and the Company's and each of its Subsidiaries'  business
practices do not violate in any material  respect any  applicable  provisions of
federal or state law regarding physician ownership of, or financial relationship
with, or referral to entities  providing  health care related goods or services,
or laws  requiring  disclosure  of financial  interests  held by  physicians  in
entities  to which they may refer  patients  for the  provision  of health  care
related goods or services.


                                      -9-
<PAGE>



     (t)  The  Company  maintains  a  system  of  internal  accounting  controls
sufficient to provide  reasonable  assurances that (i) transactions are executed
in  accordance  with  management's  general  or  specific  authorization;   (ii)
transactions  are  recorded as  necessary  to permit  preparation  of  financial
statements in conformity with generally  accepted  accounting  principles and to
maintain  accountability for assets; (iii) access to assets is permitted only in
accordance with  management's  general or specific  authorization;  and (iv) the
recorded   accountability  for  assets  is  compared  with  existing  assets  at
reasonable  intervals  and  appropriate  action  is taken  with  respect  to any
differences.

     (u) Neither the Company nor any of the  Subsidiaries  nor, to the Company's
knowledge,  any employee or agent of the Company or any  Subsidiary has made any
payment of funds of the Company or any  Subsidiary  or received or retained  any
funds in violation of any law, rule or regulation,  which violation would have a
Material Adverse Effect.

     (v) Except as disclosed in the Offering Memorandum, the Company and each of
the Subsidiaries have filed all tax returns required to be filed,  which returns
are true and correct in all material  respects,  and neither the Company nor any
Subsidiary is in default in the payment of any taxes which were payable pursuant
to said  returns or any  assessments  with  respect  thereto,  except  where the
failure to file such  returns and make such  payments  would not have a Material
Adverse Effect.

     (w)  The  Company  and  the   Subsidiaries  own  or  possess  all  patents,
trademarks,  trademark registration,  service marks, service mark registrations,
trade  names,  copyrights,   licenses,  inventions,  trade  secrets  and  rights
described in the Offering  Memorandum as being owned by any of them or necessary
for the conduct of their respective businesses,  and the Company is not aware of
any claim to the contrary or any  challenge by any other person to the rights of
the Company and the Subsidiaries with respect to the foregoing.

     (x) The  Company  is not and,  upon sale of the Notes to be issued and sold
thereby in accordance  herewith and the  application  of the net proceeds to the
Company of such sale as described in the Offering  Memorandum  under the caption
"Use of Proceeds," will not be an "investment company" within the meaning of the
Investment Company Act of 1940, as amended.

     (y) When the Notes are issued and  delivered  pursuant  to this  Agreement,
such Notes will not be of the same class (within the meaning of Rule  144A(d)(3)
under the Act) as any  security  of the  Company  that is  listed on a  national
securities  exchange  registered  under Section 6 of the Exchange Act or that is
quoted in a United States automated interdealer quotation system.

     (z) Neither the  Company  nor any  affiliate  (as defined in Rule 501(b) of
Regulation D  ("Regulation  D") under the Act) of the Company has  directly,  or
through any agent  (provided  that no  representation  is made as to the Initial
Purchasers or any person acting on their  behalf),  (i) sold,  offered for sale,
solicited offers to buy or otherwise  negotiated in respect of, any security (as
defined in the Act) which is or will be integrated with the offering and sale of
the Notes in a manner that would require the registration of the Notes under the
Act or (ii) engaged in any form of general  solicitation or general  advertising
(within the meaning of  Regulation  D) in  connection  with the  offering of the
Notes.

     (aa) The Company is not  required to deliver the  information  specified in
Rule  144A(d)(4) in connection  with the offering and resale of the Notes by the
Initial Purchasers.

     (bb)  Assuming (i) that the  representations  and  warranties  in Section 2
hereof are true, (ii) the Initial Purchasers comply with the covenants set forth
in Section 2 hereof and (iii) that each  person to whom the  Initial  Purchasers
offer,  sell or  deliver  the  Notes is a  Qualified  Institutional  Buyer,  the
purchase  and  sale  of  the  Notes  pursuant  hereto   (including  the  Initial
Purchasers'  proposed  offering  of the Notes on the terms and in the manner set
forth in the  Offering  Memorandum  and  Section  2 hereof)  is exempt  from the
registration requirements of the Act.

     (cc) The  execution  and delivery of this  Agreement,  the other  Operative
Documents and the sale of the Notes to the Initial  Purchasers or by the Initial
Purchasers to Eligible  Purchasers  will not involve any prohibited  transaction
within  the  meaning of Section  406 of ERISA or Section  4975 of the Code.  The
representation made by the Company in the preceding sentence is made in reliance
upon and subject to the accuracy of, and compliance  with,  the  representations
and covenants made or deemed made by the Eligible Purchasers as set forth in the
Offering Memorandum under the section entitled "Notice to Investors."


                                      -10-
<PAGE>



     6.  Indemnification  and Contribution.  (a) The Company agrees to indemnify
and hold harmless each Initial  Purchaser and each person,  if any, who controls
any Initial  Purchaser within the meaning of Section 15 of the Act or Section 20
of the  Exchange  Act,  from and against any and all  losses,  claims,  damages,
liabilities and expenses (including  reasonable costs of investigation)  arising
out of or based  upon any untrue  statement  or alleged  untrue  statement  of a
material  fact  contained in the  Preliminary  Offering  Memorandum  or Offering
Memorandum or in any amendment or supplement thereto, or arising out of or based
upon any omission or alleged  omission to state therein a material fact required
to be stated therein or necessary to make the statements therein not misleading,
except insofar as such losses,  claims,  damages,  liabilities or expenses arise
out of or are based upon any untrue  statement  or  omission  or alleged  untrue
statement  or  omission  which has been made  therein  or omitted  therefrom  in
reliance upon and in conformity  with the  information  relating to such Initial
Purchaser  furnished  in writing to the Company by or on behalf of such  Initial
Purchaser expressly for use in connection therewith; provided, however, that the
indemnification  contained in this paragraph (a) with respect to the Preliminary
Offering  Memorandum shall not inure to the benefit of any Initial Purchaser (or
to the benefit of any person  controlling  any Initial  Purchaser) on account of
any such loss, claim, damage,  liability or expense arising from the sale of the
Notes by such Initial Purchaser to any person if the untrue statement or alleged
untrue statement or omission or alleged omission of a material fact contained in
the Preliminary Offering Memorandum was corrected in the Offering Memorandum and
such Initial Purchaser sold Notes to that person without sending or giving at or
prior  to  the  written  confirmation  of  such  sale,  a copy  of the  Offering
Memorandum  (as then  amended or  supplemented)  if the Company  has  previously
furnished  sufficient  copies thereof to such Initial  Purchaser.  The foregoing
indemnity  agreement shall be in addition to any liability which the Company may
otherwise have.

     (b) If any action,  suit or proceeding shall be brought against any Initial
Purchaser or any person  controlling  any Initial  Purchaser in respect of which
indemnity  may be sought  against the Company,  such  Initial  Purchaser or such
controlling   person   shall   promptly   notify  the   parties   against   whom
indemnification  is  being  sought  (the  "indemnifying   parties"),   and  such
indemnifying parties shall assume the defense thereof,  including the employment
of counsel and payment of all fees and expenses.  Such Initial  Purchaser or any
such  controlling  person shall have the right to employ separate counsel in any
such action,  suit or proceeding and to participate in the defense thereof,  but
the fees and  expenses of such  counsel  shall be at the expense of such Initial
Purchaser or such controlling  person unless (i) the  indemnifying  parties have
agreed in writing to pay such fees and expenses,  (ii) the indemnifying  parties
have failed to assume the defense and employ counsel, or (iii) the named parties
to any such action, suit or proceeding (including any impleaded parties) include
both such Initial  Purchaser  or such  controlling  person and the  indemnifying
parties and such Initial  Purchaser or such  controlling  person shall have been
advised by its counsel that  representation  of such  indemnified  party and any
indemnifying  party by the same counsel would be inappropriate  under applicable
standards of professional  conduct  (whether or not such  representation  by the
same counsel has been proposed) due to actual or potential  differing  interests
between them (in which case the  indemnifying  party shall not have the right to
assume the defense of such action,  suit or proceeding on behalf of such Initial
Purchaser or such  controlling  person).  It is  understood,  however,  that the
indemnifying  parties  shall,  in connection  with any one such action,  suit or
proceeding or separate but  substantially  similar or related actions,  suits or
proceedings in the same jurisdiction arising out of the same general allegations
or  circumstances,  be liable for the  reasonable  fees and expenses of only one
separate  firm of attorneys  (in addition to any local  counsel) at any time for
all such  Initial  Purchasers  and  controlling  persons  not  having  actual or
potential  differing  interests with the Initial Purchasers or among themselves,
which firm shall be  designated  in writing by Smith Barney  Inc.,  and that all
such  fees  and  expenses  shall  be  reimbursed  as  they  are  incurred.   The
indemnifying  parties shall not be liable for any settlement of any such action,
suit or proceeding  effected without their written consent,  but if settled with
such written  consent,  or if there be a final judgment for the plaintiff in any
such action, suit or proceeding, the indemnifying parties agree to indemnify and
hold harmless any Initial Purchaser, to the extent provided in


                                      -11-
<PAGE>



paragraph (a), and any such controlling person from and against any loss, claim,
damage, liability or expense by reason of such settlement or judgment.

     (c) Each Initial Purchaser agrees,  severally and not jointly, to indemnify
and hold harmless the Company,  and its  directors and officers,  and any person
who controls the Company  within the meaning of Section 15 of the Act or Section
20 of the Exchange Act to the same extent as the  indemnity  from the Company to
each Initial Purchaser set forth in paragraph (a) hereof,  but only with respect
to information  relating to such Initial Purchaser furnished in writing by or on
behalf of such Initial Purchaser  expressly for use in the Preliminary  Offering
Memorandum or Offering Memorandum or any amendment or supplement thereto. If any
action,  suit or  proceeding  shall be brought  against the Company,  any of its
directors or officers,  or any such controlling  person based on the Preliminary
Offering  Memorandum  or Offering  Memorandum,  or any  amendment or  supplement
thereto,  and in respect of which  indemnity may be sought  against such Initial
Purchaser  pursuant to this paragraph (c), such Initial Purchaser shall have the
rights and duties  given to the Company by paragraph  (b) above  (except that if
the Company shall have assumed the defense thereof such Initial  Purchaser shall
not  be  required  to do  so,  but  may  employ  separate  counsel  therein  and
participate  in the defense  thereof,  but the fees and expenses of such counsel
shall be at such Initial Purchaser's  expense),  and the Company,  its directors
and officers,  and any such controlling  person shall have the rights and duties
given to the Initial Purchasers by paragraph (b) above. The foregoing  indemnity
agreement shall be in addition to any liability which the Initial Purchasers may
otherwise have.

     (d) If the indemnification provided for in this Section 6 is unavailable to
an  indemnified  party  under  paragraphs  (a) or (c)  hereof in  respect of any
losses,  claims,  damages,  liabilities or expenses referred to therein, then an
indemnifying  party,  in lieu of  indemnifying  such  indemnified  party,  shall
contribute to the amount paid or payable by such  indemnified  party as a result
of such losses, claims, damages,  liabilities or expenses (i) in such proportion
as is  appropriate to reflect the relative  benefits  received by the Company on
the one hand and the Initial  Purchasers  on the other hand from the offering of
the  Notes,  or (ii) if the  allocation  provided  by  clause  (i)  above is not
permitted by applicable law, in such proportion as is appropriate to reflect not
only the relative benefits referred to in clause (i) above but also the relative
fault of the Company on the one hand and the Initial  Purchasers on the other in
connection  with the  statements  or  omissions  that  resulted in such  losses,
claims,  damages,  liabilities  or  expenses,  as  well  as any  other  relevant
equitable  considerations.  The relative benefits received by the Company on the
one hand and the  Initial  Purchasers  on the other shall be deemed to be in the
same  proportion as the total net proceeds from the offering  (before  deducting
expenses)  received by the Company bear to the total  discounts and  commissions
received  by the Initial  Purchasers,  in each case as set forth in the table on
the cover page of the Offering Memorandum.  The relative fault of the Company on
the one hand and the Initial Purchasers on the other hand shall be determined by
reference to, among other things, whether the untrue or alleged untrue statement
of a material fact or the omission or alleged  omission to state a material fact
relates to information supplied by the Company on the one hand or by the Initial
Purchasers on the other hand and the parties' relative intent, knowledge, access
to information and opportunity to correct or prevent such statement or omission.

     (e) The Company and the Initial  Purchasers agree that it would not be just
and equitable if  contribution  pursuant to this Section 6 were  determined by a
pro rata  allocation  or by any other  method of  allocation  that does not take
account of the equitable  considerations referred to in paragraph (d) above. The
amount  paid or  payable  by an  indemnified  party as a result  of the  losses,
claims,  damages,  liabilities  and expenses  referred to in paragraph (d) above
shall be deemed to include,  subject to the  limitations  set forth  above,  any
legal  or  other  expenses  reasonably  incurred  by such  indemnified  party in
connection with  investigating  any claim or defending any such action,  suit or
proceeding.  Notwithstanding  the  provisions  of this  Section  6,  no  Initial
Purchaser  shall be required to contribute any amount in excess of the amount by
which the total price of the Notes  purchased  and resold by it as  contemplated
hereby  exceeds  the amount of any  damages  which such  Initial  Purchaser  has
otherwise  been  required  to pay by reason of such  untrue  or  alleged  untrue
statement  or  omission  or alleged  omission.  No person  guilty of  fraudulent
misrepresentation  (within  the  meaning of  Section  11(f) of the Act) shall be
entitled to  contribution  from any person who was not guilty of such fraudulent
misrepresentation.


                                      -12-
<PAGE>



     (f) No indemnifying  party shall,  without the prior written consent of the
indemnified  party,  effect any settlement of any pending or threatened  action,
suit or  proceeding in respect of which any  indemnified  party is or could have
been a party and indemnity could have been sought  hereunder by such indemnified
party,  unless  such  settlement  includes  an  unconditional  release  of  such
indemnified  party from all  liability on claims that are the subject  matter of
such action, suit or proceeding.

     (g) Any losses,  claims,  damages,  liabilities  or  expenses  for which an
indemnified  party is entitled to  indemnification  or  contribution  under this
Section 6 shall be paid by the  indemnifying  party to the indemnified  party as
such  losses,  claims,  damages,  liabilities  or  expenses  are  incurred.  The
indemnity  and  contribution  agreements  contained  in this  Section  6 and the
representations  and warranties of the Company set forth in this Agreement shall
remain  operative  and  in  full  force  and  effect,   regardless  of  (i)  any
investigation  made by or on  behalf  of any  Initial  Purchaser  or any  person
controlling any Initial Purchaser, the Company, its directors or officers or any
person  controlling  the  Company,  (ii)  acceptance  of any Notes  and  payment
therefor hereunder,  and (iii) any termination of this Agreement. A successor to
any Initial Purchaser or any person controlling any Initial Purchaser, or to the
Company, its directors or officers or any person controlling the Company,  shall
be entitled to the benefits of the  indemnity,  contribution  and  reimbursement
agreements contained in this Section 6.

     7.  Conditions  of  the  Initial  Purchasers'   Obligations.   The  several
obligations  of the Initial  Purchasers  to  purchase  the Notes  hereunder  are
subject to the following conditions:

     (a) At the time of execution of this  Agreement and on the Closing Date, no
order or decree  preventing the use of the Offering  Memorandum or any amendment
or supplement thereto, or any order asserting that the transactions contemplated
by this Agreement are subject to the registration  requirements of the Act shall
have been issued and no  proceedings  for that purpose shall have been commenced
or shall be pending or, to the  knowledge of the Company,  be  contemplated.  No
stop order  suspending the sale of the Notes in any  jurisdiction  designated by
the  Initial  Purchasers  shall  have been  issued and no  proceedings  for that
purpose  shall have been  commenced or shall be pending or, to the  knowledge of
the Company, shall be contemplated.

     (b)  Subsequent to the effective  date of this  Agreement,  there shall not
have occurred (i) any change, or any development involving a prospective change,
in or affecting the condition (financial or other),  business,  properties,  net
worth,  or  results  of  operations  of  the  Company  or the  Subsidiaries  not
contemplated  by the  Offering  Memorandum,  which in the opinion of the Initial
Purchasers,  would materially adversely affect the market for the Notes, or (ii)
any event or development  relating to or involving the Company or any officer or
director  of the  Company  which  makes  any  statement  made  in  the  Offering
Memorandum untrue or which, in the opinion of the Company and its counsel or the
Initial Purchasers and their counsel,  requires the making of any addition to or
change in the Offering  Memorandum in order to state a material fact required by
any law to be  stated  therein  or  necessary  in order  to make the  statements
therein not misleading,  if amending or supplementing the Offering Memorandum to
reflect  such  event  or  development  would,  in the  opinion  of  the  Initial
Purchasers, materially adversely affect the market for the Notes.

     (c) The Initial  Purchasers  shall have  received  on the  Closing  Date an
opinion of  Fulbright  & Jaworski  L.L.P.,  counsel for the  Company,  dated the
Closing Date and addressed to the Initial Purchasers, to the effect that:

         (i) The Company is a corporation duly incorporated and validly existing
in good  standing  under the laws of the State of Delaware  with full  corporate
power and authority to own,  lease and operate its properties and to conduct its
business  as  described  in  the  Offering  Memorandum  (and  any  amendment  or
supplement thereto);


                                      -13-
<PAGE>



         (ii) Each  Significant  Subsidiary  (as  defined in Section  1.02(w) of
Regulation S-X promulgated under the Act) is a corporation  validly existing and
in good standing under the laws of the  jurisdiction of its  organization,  with
full corporate power and authority to own, lease, and operate its properties and
to conduct  its  business  as  described  in the  Offering  Memorandum  (and any
amendment or  supplement  thereto);  and all the  outstanding  shares of capital
stock of each of the  Significant  Subsidiaries  have been duly  authorized  and
validly issued, are fully paid and  nonassessable,  and to the knowledge of such
counsel, are wholly owned by the Company directly,  or indirectly through one of
the other Subsidiaries,  free and clear of any security interest,  lien, adverse
claim,  equity  or  other  encumbrance,  except  as  described  in the  Offering
Memorandum  and except for the shares of capital  stock of certain  Subsidiaries
pledged to Citibank as agent in connection with the Credit  Agreement  and/or to
Meditrust;

         (iii) The authorized capital stock of the Company is as set forth under
the caption "Capitalization" in the Offering Memorandum;

         (iv) The Company has  corporate  power and authority to enter into this
Agreement and the Registration  Rights Agreement and to issue,  sell and deliver
the Notes to be sold by it to the Initial  Purchasers  as provided  herein,  and
this Agreement and the Registration  Rights Agreement have been duly authorized,
executed  and  delivered  by the  Company  and  are  valid,  legal  and  binding
agreements of the Company,  enforceable  against the Company in accordance  with
their terms,  except (A) as enforcement of rights to indemnity and  contribution
hereunder and thereunder may be limited by Federal or state  securities  laws or
principles  of public  policy  and (B)  subject  to the  qualification  that the
enforceability  of the Company's  obligations  hereunder and  thereunder  may be
limited  by  bankruptcy,  fraudulent  conveyance,  insolvency,   reorganization,
moratorium,  and other laws relating to or affecting creditors' rights generally
and by general equitable principles;

         (v) The  Indenture has been duly and validly  authorized,  executed and
delivered by the Company and, assuming due authorization, execution and delivery
by the Trustee, is a valid and binding agreement of the Company,  enforceable in
accordance with its terms,  subject to the qualification that the enforceability
of the Company's obligations thereunder may be limited by bankruptcy, fraudulent
conveyance, insolvency,  reorganization,  moratorium, and other laws relating to
or affecting  creditors' rights generally and by general  equitable  principles;
and no  qualification  of the  Indenture  under  the  1939  Act is  required  in
connection  with the  offer  and sale of the  Notes  contemplated  hereby  or in
connection with the Exempt Resales;

         (vi) The Notes have been duly and validly authorized by the Company and
when executed by the Company in accordance with the Indenture and,  assuming due
authentication  of the  Notes  by the  Trustee,  upon  delivery  to the  Initial
Purchasers  against payment  therefor in accordance with the terms hereof,  will
have been validly issued and delivered,  and will  constitute  valid and binding
obligations of the Company entitled to the benefits of the Indenture, subject to
the  qualification  that  the   enforceability  of  the  Company's   obligations
thereunder  may be limited by  bankruptcy,  fraudulent  conveyance,  insolvency,
reorganization,  moratorium,  and other laws relating to or affecting creditors'
rights generally and by general equitable principles;

         (vii) Neither the offer,  sale or delivery of the Notes, the execution,
delivery or  performance  by the  Company of this  Agreement,  the  Registration
Rights Agreement or the Indenture, compliance by the Company with the provisions
hereof  or  thereof  nor   consummation  by  the  Company  of  the  transactions
contemplated  hereby  or  thereby  constitutes  or will  constitute  a breach or
violation of, or a default under,  in any material  respect,  the certificate or
articles of  incorporation  or bylaws or other  organizational  documents of the
Company  or any of  the  Significant  Subsidiaries  or any  material  agreement,
indenture,  lease  or  other  instrument  to  which  the  Company  or any of the
Significant  Subsidiaries  is a party  or by  which  any of them or any of their
respective  properties is bound that is an exhibit to any Incorporated  Document
or is known to such counsel, or will result in the creation or imposition of any
lien, charge or encumbrance upon any property or assets of the Company or any of
the Significant  Subsidiaries pursuant to the terms of any material agreement or
instrument  to which any of them is a party or by which any of them may be bound
or to which any of the  property or assets of any of them is subject  that is an
exhibit to any Incorporated Document or is


                                      -14-
<PAGE>



known to such  counsel,  nor will any such action result in any violation in any
material  respect of any  existing  law,  or any  regulation,  ruling  (assuming
compliance  with all applicable  state  securities and Blue Sky laws and, in the
case of the Registration Rights Agreement,  the Act and the Exchange Act and the
1939  Act),  judgment,  injunction,  order  or  decree  known  to such  counsel,
applicable  to the  Company  or the  Significant  Subsidiaries  or any of  their
respective properties;

         (viii)  No  consent,  approval,  authorization  or other  order  of, or
registration or filing with, any court,  regulatory body,  administrative agency
or other  governmental  body, agency, or official is required on the part of the
Company  (except as have been obtained under the Exchange Act, or such as may be
required  under state  securities  or Blue Sky laws  governing  the purchase and
distribution  of the Notes,  or such as may be required to qualify the Indenture
under  the  1939  Act,  and  such as may be  required  in  connection  with  the
performance  by the Company of its  obligations  under the  Registration  Rights
Agreement,  as to which such  counsel need not express an opinion) for the valid
issuance and sale of the Notes to the Initial Purchasers as contemplated by this
Agreement;

         (ix) The Incorporated  Documents  (except for the financial  statements
and the notes thereto and the schedules and other financial and statistical data
included therein, as to which such counsel need not express any opinion), at the
time they were  filed,  appear on their face to have  complied as to form in all
material respects with the requirements of the Exchange Act;

         (x) To the  knowledge  of such  counsel,  (A)  there  are no  legal  or
governmental proceedings pending or threatened against the Company or any of the
Subsidiaries,  or to which the  Company  or any of the  Subsidiaries,  or any of
their property,  are subject, which are not disclosed in the Offering Memorandum
and which,  if  adversely  decided,  are  reasonably  likely to cause a Material
Adverse  Effect  or  materially   affect  the  issuance  of  the  Notes  or  the
consummation of the transactions contemplated by the Operative Documents and (B)
there  are no  material  agreements,  contracts,  indentures,  leases  or  other
instruments, that are not described in the Offering Memorandum (or any amendment
or  supplement  thereto)  or that are  required to be filed as an exhibit to any
Incorporated Document that are not filed as required;

         (xi) The  statements  in the Offering  Memorandum,  insofar as they are
descriptions  of  contracts,  agreements or other legal  documents,  or refer to
statements of law or legal  conclusions,  are accurate in all material  respects
and present fairly the information required to be shown;

         (xii)  When  the  Notes  are  issued  and  delivered  pursuant  to this
Agreement,  such Notes will not be of the same class (within the meaning of Rule
144A(d)(3)  under the Act) as any  security of the  Company  that is listed on a
national  securities  exchange registered under Section 6 of the Exchange Act or
that is quoted in a United States automated interdealer quotation system;

         (xiii) No  registration  of the Notes under the Act is required for the
sale of the Notes to the Initial Purchasers as contemplated in this Agreement or
for the Exempt  Resales  (assuming (A) that any Eligible  Purchaser who buys the
Notes in the  Exempt  Resales  is a  Qualified  Institutional  Buyer and (B) the
accuracy of the Initial Purchasers'  representations and those of the Company in
this Agreement regarding the absence of general  solicitation in connection with
the Exempt Resales);

         (xiv) The Company is not required to deliver the information  specified
in Rule  144A(d)(4) in  connection  with the offering and resale of the Notes by
the Initial Purchasers; and

         (xv)  Although  such  counsel has not  undertaken,  except as otherwise
indicated in their opinion, to determine independently,  and does not assume any
responsibility for, the accuracy,  completeness or fairness of the statements in
the Offering Memorandum, such counsel has participated in the preparation of the
Offering  Memorandum,  including review and discussion of the contents  thereof,
and has reviewed the Incorporated Documents, and, relying as to materiality to a
large  extent upon the  opinions of officers  and other  representatives  of the
Company,  nothing has come to the attention of such counsel that has caused them
to believe  that the Offering  Memorandum,  as of its date and as of the Closing
Date contained an


                                      -15-
<PAGE>



untrue statement of a material fact or omitted to state a material fact required
to be stated  therein or necessary to make the statements  therein,  in light of
the  circumstances  under  which  they were  made,  not  misleading  or that any
amendment or supplement to the Offering  Memorandum,  as of its respective date,
and as of the Closing Date contained any untrue  statement of a material fact or
omitted to state a material fact  required to be stated  therein or necessary in
order to make the statements  therein, in light of the circumstances under which
they were made,  not  misleading  (it being  understood  that such  counsel need
express  no  opinion  with  respect to the  financial  statements  and the notes
thereto and the schedules and other financial and  statistical  data included or
incorporated by reference in the Offering  Memorandum and information  furnished
by or on behalf of the Initial Purchasers).

     The  opinion  of such  counsel  shall be  limited to the laws of the United
States,  the State of New York and the internal  corporation law of the State of
Delaware.

     (d) The Initial  Purchasers  shall have  received  on the  Closing  Date an
opinion of Marshall A. Elkins,  Esq., General Counsel of the Company,  dated the
Closing Date and addressed to the Initial Purchasers to the effect that:

         (i) The  Company  is duly  registered  and  qualified  to  conduct  its
business and is in good standing as a foreign  corporation in each  jurisdiction
or place  where the nature of its  properties  or the  conduct  of its  business
requires  such  registration  or  qualification,  except where the failure so to
register or qualify or to be in good standing  does not have a Material  Adverse
Effect;

         (ii) All the shares of capital stock of the Company  outstanding  prior
to the issuance of the Notes have been duly authorized and validly  issued,  are
fully paid and nonassessable;

         (iii) Each  Subsidiary is duly  registered and qualified to conduct its
business and is in good standing as a foreign corporation or limited partnership
in each  jurisdiction or place where the nature of its properties or the conduct
of its business requires such  registration or  qualification,  except where the
failure so to  register  or qualify  or to be in good  standing  does not have a
Material Adverse Effect; (iv) Neither the Company nor any of the Subsidiaries is
in violation in any material  respect of its respective  certificate or articles
of incorporation or bylaws, or other  organizational  documents,  or to the best
knowledge  of such  counsel  after  reasonable  inquiry,  is in  default  in any
material  respect in the  performance of any material  obligation,  agreement or
condition  contained  in  any  bond,  debenture,   note  or  other  evidence  of
indebtedness or in any material agreement,  indenture, lease or other instrument
to which the  Company or any of the  Subsidiaries  is a party or by which any of
them or any of their respective  properties may be bound, except as disclosed in
the  Offering  Memorandum  and except to the extent that any such  violation  or
default would not have a Material Adverse Effect;

         (v) Such  counsel  has no reason to believe  that the  Company  and its
Subsidiaries  do not have  all  Permits  (including,  without  limitation,  such
Permits as are necessary under such federal and state health care laws and under
such HMO and similar  licensure laws and such insurance laws and  regulations as
are  applicable  to the Company and its  Subsidiaries)  as are necessary to own,
lease and operate its properties and conduct its business,  except to the extent
that the failure to have such Permits would not have a Material  Adverse Effect;
and to the best knowledge of such counsel after reasonable  inquiry there are no
proceedings pending or threatened against the Company or any of its Subsidiaries
that may cause any such Permit  that is material to the conduct of the  business
of the Company or any of its Subsidiaries to be revoked,  withdrawn,  cancelled,
suspended or not renewed;

         (vi)  Such  counsel  has no  reason to  believe  that (a) the  business
practices  of the  Company or any of its  Subsidiaries  violate in any  material
respect any applicable  provisions of federal or state law governing Medicare or
any state Medicaid program, including without limitation,  Sections 1320a-7a and
1320a-7b of Title 42 of the United States Code, or that any  individual  with an
ownership or control interest, as defined in 42 U.S.C. ss.1320a-3(a)(3),  in the
Company or any of its Subsidiaries or who is an officer,  director,  or managing
employee  as defined in 42 U.S.C.  ss.1320a-5(b),  of the  Company or any of its
Subsidiaries is a


                                      -16-
<PAGE>



person described in 42 U.S.C. ss.1320a-7(b)(8)(B),  or that (b) the Company's or
any  Subsidiary's  business  practices  violate  in  any  material  respect  any
applicable  provisions of federal or state law regarding physician ownership of,
or financial  relationship  with, or referral to entities  providing health care
related goods or services,  or laws requiring  disclosure of financial interests
held by  physicians  in  entities  to which  they  may  refer  patients  for the
provision of health care related goods or services; and to the best knowledge of
such  counsel  after  reasonable  inquiry,  neither  the  Company nor any of its
Subsidiaries  is in violation  of any other law,  ordinance,  administrative  or
governmental  rule  or  regulation  applicable  to  the  Company  or  any of its
Subsidiaries or of any decree of any court or governmental agency or body having
jurisdiction over the Company or any of its  Subsidiaries,  except to the extent
that any such violation would not have a Material Adverse Effect; and

         (vii)  Although  such counsel has not  undertaken,  except as otherwise
indicated in such counsel's opinion,  to determine  independently,  and does not
assume any  responsibility  for, the accuracy,  completeness  or fairness of the
statements  in the Offering  Memorandum,  such counsel has  participated  in the
preparation  of the Offering  Memorandum  and the  Incorporated  Documents,  and
nothing has come to the  attention  of such counsel that has caused such counsel
to believe  that the Offering  Memorandum,  as of its date and as of the Closing
Date,  contained  an untrue  statement  of  material  fact or omitted to state a
material fact required to be stated  therein or necessary to make the statements
therein,  in  light  of the  circumstances  under  which  they  were  made,  not
misleading or that any amendment or supplement to the Offering Memorandum, as of
its respective  date, and as of the Closing Date contained any untrue  statement
of a material  fact or omitted to state a material  fact  required  to be stated
therein or necessary in order to make the  statements  therein,  in light of the
circumstances  under which they were made, not  misleading (it being  understood
that such  counsel  need  express  no  opinion  with  respect  to the  financial
statements  and the notes  thereto and the  schedules  and other  financial  and
statistical   data  included  or  incorporated  by  reference  in  the  Offering
Memorandum and information furnished by or on behalf of the Initial Purchasers).

     (e) The Initial  Purchasers  shall have  received  on the  Closing  Date an
opinion of Dewey  Ballantine,  counsel  for the  Initial  Purchasers,  dated the
Closing  Date,  and  addressed  to the Initial  Purchasers,  with respect to the
matters referred to in clauses (iv), (v), (vi), (xiii) and (xv) of the foregoing
paragraph  (c) and such other  related  matters as the  Initial  Purchasers  may
request.

     (f) The Initial  Purchasers  shall have received  letters  addressed to the
Initial  Purchasers,  and dated the date hereof and the  Closing  Date from KPMG
Peat Marwick LLP, independent certified public accountants, substantially in the
forms heretofore approved by the Initial Purchasers.

     (g)(i) There shall not have been any material  change in the capital  stock
of the Company nor any material  increase in the short-term or long-term debt of
the Company (other than in the ordinary  course of business) from that set forth
or  contemplated  in the Offering  Memorandum  (or any  amendment or  supplement
thereto); (ii) there shall not have been, since the respective dates as of which
information is given in the Offering  Memorandum (or any amendment or supplement
thereto),  except as may otherwise be stated in the Offering  Memorandum (or any
amendment or supplement  thereto),  any material adverse change in the condition
(financial or other), business,  prospects,  properties, net worth or results of
operations  of the  Company  and the  Subsidiaries  taken as a whole;  (iii) the
Company and the  Subsidiaries  shall not have any  liabilities  or  obligations,
direct or contingent  (whether or not in the ordinary course of business),  that
are material to the Company and the Subsidiaries,  taken as a whole,  other than
those  reflected  in the Offering  Memorandum  (or any  amendment or  supplement
thereto);  and  (iv)  all the  representations  and  warranties  of the  Company
contained in this Agreement  shall be true and correct in all material  respects
on and as of the date hereof and on and as of the Closing Date as if made on and
as of the  Closing  Date,  and the  Initial  Purchasers  shall  have  received a
certificate,  dated the Closing Date and signed by the chief  executive  officer
and the chief  accounting  officer of the Company (or such other officers as are
acceptable to the Initial  Purchasers),  to the effect set forth in this Section
7(g) and in Section 7(h) hereof.

     (h) The Company  shall not have  failed at or prior to the Closing  Date to
have  performed or complied  with any of its  agreements  herein  contained  and
required to be performed or complied with by it


                                      -17-
<PAGE>



hereunder at or prior to the Closing Date.

     (i) The Initial Purchasers shall have received  certificates dated the date
hereof  and the  Closing  Date  signed by the chief  accounting  officer  of the
Company   substantially  in  the  forms  heretofore   approved  by  the  Initial
Purchasers, respecting the Company's compliance with the financial covenants set
forth in each of the  Company's  indentures,  the Credit  Agreement  and certain
other agreements of the Company.

     (j)  There  shall  not  have  been  any  announcement  by  any  "nationally
recognized  statistical  rating  organization,"  as defined for purposes of Rule
436(g)  under the Act,  that (i) it is  downgrading  its rating  assigned to any
class of securities of the Company, or (ii) it is reviewing its ratings assigned
to any class of securities  of the Company with a view to possible  downgrading,
or with negative implications, or direction not determined.

     (k) The Notes shall have been approved for trading on PORTAL.

     (l) Prior to the date of this  Agreement,  the Company  shall have received
and shall have  furnished  to the  Initial  Purchasers  copies of the  requisite
written consent of the lenders party to the Credit Agreement to the consummation
by the Company of the transactions  contemplated by the Operative  Documents and
the Offering Memorandum.

     (m) The  Company  shall have  furnished  or caused to be  furnished  to the
Initial  Purchasers  such  further  certificates  and  documents  as the Initial
Purchasers shall have requested.

     All such  opinions,  certificates,  letters and other  documents will be in
compliance with the provisions  hereof only if they are reasonably  satisfactory
in form and  substance  to the  Initial  Purchasers  and counsel for the Initial
Purchasers.

     Any  certificate  or  document  signed by any  officer of the  Company  and
delivered to the Initial  Purchasers,  or to counsel for the Initial Purchasers,
shall be deemed a  representation  and  warranty  by the  Company to the Initial
Purchasers as to the statements made therein.

     8. Expenses. The Company agrees to pay the following costs and expenses and
all  other  costs  and  expenses  incident  to  the  performance  by it  of  its
obligations  hereunder:  (i) the  preparation,  printing or  reproduction of the
Offering Memorandum (including financial statements thereto), and each amendment
or  supplement  thereto;  (ii)  the  printing  (or  reproduction)  and  delivery
(including postage,  air freight charges and charges for counting and packaging)
of such copies of the Offering Memorandum,  the Preliminary Offering Memorandum,
the Incorporated Documents,  and all amendments or supplements to any of them as
may be reasonably  requested for use in connection with the offering and sale of
the  Notes;  (iii)  the  preparation,  printing,  authentication,  issuance  and
delivery of certificates for the Notes,  including any stamp taxes in connection
with  the  original  issuance  and sale of the  Notes;  (iv)  the  printing  (or
reproduction)  and delivery of this Agreement,  the Indenture,  the Registration
Rights  Agreement,  the preliminary and supplemental  Blue Sky Memoranda and all
other  agreements  or  documents   printed  (or  reproduced)  and  delivered  in
connection with the offering of the Notes;  (v) the application for quotation of
the  Notes on  PORTAL;  (vi) the  qualification  of the Notes for offer and sale
under the  securities  or Blue Sky laws of the  several  states as  provided  in
Section 4(f) hereof  (including the reasonable fees,  expenses and disbursements
of counsel for the Initial Purchasers  relating to the preparation,  printing or
reproduction,  and  delivery  of  the  preliminary  and  supplemental  Blue  Sky
Memoranda and such  qualification);  (vii) the performance by the Company of its
obligations  under  the  Registration  Rights  Agreement;  (viii)  the  fees and
expenses  of the  Company's  accountants  and the fees and  expenses  of counsel
(including   local  and  special   counsel)  for  the  Company;   and  (ix)  the
transportation   and  other  expenses  incurred  by  or  on  behalf  of  Company
representatives  in connection with  presentations to prospective  purchasers of
the Notes.  The  Company  hereby  agrees that it will pay in full on the Closing
Date the fees and  expenses  referred  to in  clause  (vi) of this  Section 8 by
delivering to counsel for the Initial Purchasers on such date a check payable to
such counsel in the requisite amount.


                                      -18-
<PAGE>



     9. Effective Date of Agreement.  This Agreement shall become effective upon
the execution and delivery hereof by all the parties hereto.  Until such time as
this Agreement shall have become effective, it may be terminated by the Company,
by notifying the Initial Purchasers,  or by the Initial Purchasers, by notifying
the Company.

     Any  notice  under this  Section 9 may be given by  telegram,  telecopy  or
telephone but shall be subsequently confirmed by letter.

     10. Default by an Initial Purchaser. If any Initial Purchaser shall fail or
refuse to purchase  the Notes which it is  obligated  to purchase on the Closing
Date, and arrangements satisfactory to the non-defaulting Initial Purchasers and
the  Company  for the  purchase  of such  Notes  by the  non-defaulting  Initial
Purchasers or by another  party or parties  satisfactory  to the  non-defaulting
Initial  Purchasers  and the Company are not made within  thirty-six  (36) hours
after such default, this Agreement shall terminate without liability on the part
of the non-defaulting  Initial Purchasers or the Company. In any such case which
does not result in  termination  of this  Agreement,  either the  non-defaulting
Initial  Purchasers  or the Company shall have the right to postpone the Closing
Date, but in no event for longer than seven (7) days, in order that the required
changes,  if  any,  in  the  Offering  Memorandum  or  any  other  documents  or
arrangements  may be effected.  Any action taken under this paragraph  shall not
relieve a defaulting Initial Purchaser from liability in respect of such default
under this  Agreement.  The term "Initial  Purchaser" as used in this  Agreement
includes,  for all purposes of this Agreement,  any party not identified in this
Agreement who purchases Notes which a defaulting Initial Purchaser is obligated,
but fails or refuses, to purchase.

     11.   Termination  of  Agreement.   This  Agreement  shall  be  subject  to
termination  in the  absolute  discretion  of the  Initial  Purchasers,  without
liability on the part of the Initial Purchasers to the Company, by notice to the
Company, if prior to the Closing Date (i) trading in securities generally on the
New York Stock  Exchange,  American Stock Exchange or the Nasdaq National Market
shall have been suspended or materially  limited,  (ii) a general  moratorium on
commercial  banking  activities  in New York shall have been  declared by either
Federal or state authorities, or (iii) there shall have occurred any outbreak or
escalation of hostilities or other international or domestic calamity, crisis or
change in political,  financial or economic  conditions,  the effect of which on
the  financial  markets  of the  United  States  is such as to make  it,  in the
judgment of the Initial Purchasers,  impracticable or inadvisable to commence or
continue  the  offering of the Notes on the terms set forth on the cover page of
the Offering  Memorandum or to enforce  contracts for the resale of the Notes by
the Initial  Purchasers.  Notice of such termination may be given to the Company
by  telegram,  telecopy or  telephone  and shall be  subsequently  confirmed  by
letter.

     12.  Information  Furnished by the Initial  Purchasers.  The statements set
forth in the stabilization  legend on the inside front cover, the last paragraph
on the  cover  page  and in the  third  paragraph  under  the  caption  "Plan of
Distribution" in the Preliminary  Offering  Memorandum and Offering  Memorandum,
constitute  the  only  information  furnished  by or on  behalf  of the  Initial
Purchasers  as such  information  is referred to in Sections  5(b) and 6 hereof,
except that Smith Barney Inc. has  furnished  the  information  contained in the
eighth  paragraph  under the caption  "Plan of  Distribution"  contained  in the
Preliminary Offering Memorandum and the Offering Memorandum.

     13.  Miscellaneous.  Except as  otherwise  provided in Sections 4, 9 and 11
hereof,  notice given  pursuant to any provision of this  Agreement  shall be in
writing  and shall be  delivered  (i) if to the  Company,  at the  office of the
Company at 10065 Red Run Boulevard,  Owings Mills, MD 21117, Attention:  General
Counsel, with a copy to Fulbright & Jaworski L.L.P., 666 Fifth Avenue, New York,
NY 10103, Attention:  Roy L. Goldman, Esq. or (ii) if to the Initial Purchasers,
to Smith Barney Inc.,  388  Greenwich  Street,  New York,  NY 10013,  Attention:
Manager,  Investment  Banking Division,  with a copy to Dewey  Ballantine,  1301
Avenue of the Americas, New York, NY 10019, Attention: Frederick W. Kanner, Esq.

     This  Agreement  has been and is made solely for the benefit of the Initial
Purchasers, the Company, its directors, its officers and the controlling persons
referred to in Section 6 hereof and their respective  successors and assigns, to
the extent provided herein, and no other person shall acquire or have any


                                      -19-
<PAGE>



right under or by virtue of this Agreement. Neither the term "successor" nor the
term  "successors  and  assigns"  as used  in this  Agreement  shall  include  a
purchaser from the Initial  Purchasers of any of the Notes in his status as such
purchaser.

     14. Applicable Law;  Counterparts.  This Agreement shall be governed by and
construed in  accordance  with the laws of the State of New York  applicable  to
contracts  made and to be performed  within the State of New York without giving
effect to the choice of laws or conflict of laws principles thereof.

     This  Agreement  may be  signed  in  various  counterparts  which  together
constitute  one and  the  same  instrument.  If  signed  in  counterparts,  this
Agreement  shall not become  effective  unless at least one  counterpart  hereof
shall have been executed and delivered on behalf of each party hereto.






                                      -20-
<PAGE>



     Please  confirm  that the  foregoing  correctly  sets  forth the  agreement
between the Company and the Initial Purchasers.


                                          Very truly yours,

                                          INTEGRATED HEALTH SERVICES, INC.


                                          By:  /s/
                                               ---------------------------------
                                               Name:
                                               Title:



Confirmed as of the date first above mentioned.

SMITH BARNEY INC.
DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION
MORGAN STANLEY & CO. INCORPORATED
SALOMON BROTHERS INC


By:   SMITH BARNEY INC.



By:  /s/                                   
     ---------------------------------
     Name:                              
     Title:                             






                                      -21-
<PAGE>


                                   SCHEDULE I


                        INTEGRATED HEALTH SERVICES, INC.




Initial Purchaser                                               Principal Amount
                                                                     of Notes
                                                                  -------------
Smith Barney Inc...........................................        $247,500,000

Donaldson, Lufkin & Jenrette
  Securities Corporation...................................         67,500,000
Morgan Stanley & Co. Incorporated..........................         67,500,000

Salomon Brothers Inc.......................................         67,500,000
                                                                  -------------
Total......................................................
                                                                  $450,000,000











                                      -22-


                                  $450,000,000

                        INTEGRATED HEALTH SERVICES, INC.

                    9 1/2% Senior Subordinated Notes due 2007

                          REGISTRATION RIGHTS AGREEMENT



                                                                    May 22, 1997


SMITH BARNEY INC.
388 Greenwich Street
New York, New York 10013

DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION
277 Park Avenue
New York, New York 10022

MORGAN STANLEY & CO. INCORPORATED
1585 Broadway
New York, New York  10036

SALOMON BROTHERS INC
7 World Trade Center
New York, New York  10048



Dear Sirs:

     Integrated Health Services,  Inc., a Delaware  corporation (the "Company"),
proposes to issue and sell to Smith  Barney Inc.,  Donaldson,  Lufkin & Jenrette
Securities  Corporation,  Morgan Stanley & Co. Incorporated and Salomon Brothers
Inc (the "Initial Purchasers"), upon the terms set forth in a purchase agreement
of even date herewith (the "Purchase  Agreement"),  an aggregate of $450,000,000
principal amount of its 9 1/2% Senior Subordinated Notes due 2007 (the "Notes").
The Notes will be issued pursuant to an indenture (the "Indenture")  dated as of
May 30, 1997, between the Company and First Union National Bank of Virginia,  as
trustee (the  "Trustee").  As an inducement  to the Initial  Purchasers to enter
into  the  Purchase  Agreement  and  in  satisfaction  of  a  condition  to  the
obligations of the Initial  Purchasers  thereunder,  the Company agrees with the
Initial  Purchasers,  for the  benefit of the  holders of the Notes  (including,
without limitation, the Initial Purchasers), as follows:




<PAGE>




     1. Registered Exchange Offer. The Company shall prepare and, as promptly as
reasonably practicable after the date on which the Company delivers the Notes to
the Initial  Purchasers  (the  "Closing  Date"),  file with the  Securities  and
Exchange   Commission  (the   "Commission")  a  registration   statement  on  an
appropriate  form under the Securities Act of 1933, as amended (the  "Securities
Act"), with respect to a proposed offer (the "Registered Exchange Offer") to the
holders of the Notes to issue and deliver to such  holders,  in exchange for the
Notes, a like principal  amount of debt  securities of the Company  identical in
all material  respects to, and entitled to  substantially  the same benefits of,
the Notes  (the "New  Notes"),  shall use all  reasonable  efforts to cause such
registration  statement  to  become  effective  under  the  Securities  Act and,
following the declaration of the effectiveness of that  registration  statement,
shall use all reasonable  efforts to commence the Registered  Exchange Offer and
shall  cause  the same to remain  open for a period of not less than the  period
required under applicable Federal and state securities laws, and to be conducted
in  accordance  with  such  procedures  as may  be  required  by the  applicable
provisions of the  Securities  Exchange Act of 1934,  as amended (the  "Exchange
Act"), it being the objective of such  Registered  Exchange Offer to enable each
holder of Notes  electing to exchange  Notes for New Notes  (assuming  that such
holder is not an affiliate of the Company  within the meaning of the  Securities
Act, acquires the New Notes in the ordinary course of such holder's business and
has no  arrangements  with any person to participate in the  distribution of the
New Notes) to trade  such New Notes from and after  their  receipt  without  any
limitations or restrictions  under the Securities Act (subject to any applicable
requirement that broker-dealers deliver a prospectus meeting the requirements of
the Securities Act in connection with sales of New Notes received by them in the
Registered  Exchange Offer). In connection with such Registered  Exchange Offer,
the  Company  shall  take such  other  action,  including,  without  limitation,
appropriate  filings under state securities laws, as may be necessary to realize
the foregoing objective.  The New Notes may be issued in the Registered Exchange
Offer under (i) the Indenture or (ii) an indenture  substantially similar to the
Indenture, and will not be subject to the transfer restrictions described in the
Offering Memorandum  (subject to any applicable  requirement that broker-dealers
deliver  a  prospectus  meeting  the  requirements  of  the  Securities  Act  in
connection  with sales of New Notes received by them in the Registered  Exchange
Offer),  and the New Notes and the Notes will vote and  consent  together on all
matters as one class and neither the New Notes nor the Notes will have the right
to vote or consent as a separate  class on any matter.  The Company  agrees that
for a period of 90 days after  consummation of the Registered  Exchange Offer it
will make available a prospectus  meeting the requirements of the Securities Act
(which may be the prospectus  used in connection  with the  Registered  Exchange
Offer) to any  broker-dealer  for use in connection with any resale of New Notes
acquired by such broker-dealer in the Registered Exchange Offer.

     2. Shelf  Registration.  If,  because the  Registered  Exchange Offer would
violate any applicable law or the applicable interpretations of the Commission's
staff or because of any change in currently  prevailing  interpretations  of the
Commission's  staff,  the  Company is not  permitted  to effect  the  Registered
Exchange  Offer  as  contemplated  by  Section  1  hereof  or in the  event  the
Registered  Exchange  Offer is not for any other reason  consummated  within 240
days after the Closing Date, the Company shall take the following actions:

     (a) The Company shall, as promptly as reasonably  practicable after (i) the
Closing Date, in the event the Company is not permitted to effect the Registered
Exchange  Offer as  contemplated  by  Section 1 hereof  because  the  Registered
Exchange Offer would violate an applicable  law or an applicable  interpretation
of the  Commission's  staff or  because  of a change in a  currently  prevailing
interpretation  of the  Commission's  staff or (ii) 240 days  after the  Closing
Date,


                                      -2-
<PAGE>



if the Registered Exchange Offer is not for any other reason consummated by such
date, file with the Commission and thereafter  shall use all reasonable  efforts
to cause to be declared  effective a  registration  statement on an  appropriate
form under the Securities Act relating to the offer and sale of the Notes by the
holders thereof from time to time in accordance with the methods of distribution
set forth in such  registration  statement and Rule 415 under the Securities Act
(hereafter, the "Shelf Registration").

     (b) The Company shall use all reasonable  efforts to keep the  registration
statement relating to the Shelf Registration  continuously effective in order to
permit the prospectus  included therein to be usable by the holders of the Notes
for a period of two years from the date the  registration  statement is declared
effective or such shorter  period that will terminate when all the Notes covered
by the  registration  statement  have been sold  pursuant  to such  registration
statement;  provided,  that the  Company  shall be  deemed  not to have used all
reasonable  efforts  to keep the  registration  statement  effective  during the
requisite period if it voluntarily takes any action that would result in holders
of Notes covered thereby not being able to offer and sell such securities during
that period,  unless such action is required by applicable law,  including,  but
not limited to, reasonable periods necessary to prepare appropriate  disclosure.
The foregoing  proviso shall not apply to actions taken (or  contemplated  to be
taken) by the  Company in good  faith and for  business  reasons (a  "Suspension
Event"), including, without limitation, the acquisition or divestiture of assets
or the  offering  or  sale  of  securities,  so  long  as the  Company  promptly
thereafter complies with the requirements of Section 3(h) hereof, if applicable.
Any such  period  during  which  the  Company  fails  to keep  the  registration
statement effective and usable for offers and sales of Notes is referred to as a
"Suspension  Period." A Suspension Period shall commence on and include the date
that the Company  gives  notice  that the  registration  statement  is no longer
effective or the prospectus  included therein is no longer usable for offers and
sales of Notes and shall end on the date when each  seller of Notes  covered  by
such  registration  statement  either receives the copies of the supplemented or
amended prospectus  contemplated by Section 3(h) hereof or is advised in writing
by the Company that use of the prospectus may be resumed.

     (c) Notwithstanding any other provisions of this Agreement to the contrary,
the Company shall cause the  registration  statement and the related  prospectus
and any  amendment  or  supplement  thereto,  as of the  effective  date of such
registration statement,  amendment or supplement,  (i) to comply in all material
respects with the  applicable  requirements  of the Securities Act and the rules
and  regulations of the Commission and (ii) not to contain any untrue  statement
of a  material  fact or omit to state a  material  fact  required  to be  stated
therein or necessary to make the statements  therein not  misleading  other than
statements or omissions made in reliance upon and in conformity with information
furnished to the Company in writing by the Initial Purchasers  expressly for use
in such registration  statement and the related  prospectus and any amendment or
supplement thereto.

     3.  Registration  Procedures.  In  connection  with any Shelf  Registration
contemplated by Section 2 hereof and, to the extent  applicable,  the Registered
Exchange Offer contemplated by Section 1 hereof, the following  provisions shall
apply:

     (a) The  Company  shall  furnish to the  Initial  Purchasers,  prior to the
filing thereof with the  Commission,  a copy of the  registration  statement and
each amendment thereof and each supplement,  if any, to the prospectus  included
therein and shall obtain the consent (which shall not be  unreasonably  withheld
or delayed) of the Initial Purchasers to any such filing.


                                      -3-
<PAGE>



     (b) The Company shall advise the Initial  Purchasers and the holders of the
Notes and the New Notes (to the extent applicable) in writing:

         (i) when the registration  statement and any amendment thereto has been
   filed  with  the  Commission  and  when  the  registration  statement  or any
   post-effective amendment thereto has become effective;

         (ii) of any request by the  Commission for amendments or supplements to
   the  registration  statement  or  the  prospectus  included  therein  or  for
   additional information;

         (iii) of the issuance by the  Commission  of any stop order  suspending
   the  effectiveness  of the  registration  statement or the  initiation of any
   proceedings for that purpose;

         (iv) of the receipt by the Company of any notification  with respect to
   the  suspension of the  qualification  of the Notes and New Notes for sale in
   any  jurisdiction or the initiation or threatening of any proceeding for such
   purpose; and

         (v) of the  happening of any event (other than a Suspension  Event,  in
   which case the  Company  need only  notify  the  Initial  Purchasers  and the
   holders  of the Notes that a  Suspension  Event  exists)  that  requires  the
   Company to make changes in the  registration  statement or the  prospectus in
   order to make the statements  therein not  misleading  (which advice shall be
   accompanied by an instruction that such notice constitutes material nonpublic
   information,  and to suspend the use of the  prospectus  until the  requisite
   changes have been made, and which instruction shall require that such holders
   shall not communicate such material nonpublic  information to any third party
   and shall not sell or purchase, or offer to sell or purchase,  any securities
   of the Company after receipt of such advice and prior to the effectiveness of
   any action  required  to be taken by the  Company  pursuant  to Section  3(h)
   hereof).

     (c) The Company shall use all reasonable efforts to prevent the issuance or
obtain  the  withdrawal  of  any  order  suspending  the  effectiveness  of  the
registration statement at the earliest possible time.

     (d) The Company shall furnish to each holder of Notes  included  within the
coverage of the Shelf  Registration,  without  charge,  at least one copy of the
registration  statement  and any  post-effective  amendment  thereto,  including
financial  statements and schedules,  and, if the holder so requests in writing,
all exhibits (including those incorporated by reference).

     (e) The Company shall deliver to each holder of Notes  included  within the
coverage of the Shelf  Registration,  if any, without charge,  as many copies of
the  prospectus   (including  each  preliminary   prospectus)  included  in  the
registration  statement with respect to the Shelf Registration and any amendment
or  supplement  thereto as such  persons  may  reasonably  request.  The Company
consents,  subject  to the  provisions  of  the  Agreement,  to  the  use of the
prospectus or any amendment or supplement thereto by each of the selling holders
of Notes in  connection  with the offering and sale of the Notes  covered by the
prospectus,   or  any  amendment  or  supplement   thereto,   included  in  such
registration statement.

     (f)  Prior  to  any  public   offering  of  Notes  pursuant  to  the  Shelf
Registration, the


                                      -4-
<PAGE>



Company  shall  register or qualify or cooperate  with the holders of securities
included   therein  and  their   respective   counsel  in  connection  with  the
registration  or  qualification  of such  Notes  for  offer  and sale  under the
securities  or blue sky laws of such  jurisdictions  in the United States as any
holder of Notes reasonably  requests in writing and do any and all other acts or
things necessary or advisable to enable the offer and sale in such jurisdictions
of the securities covered by the Shelf  Registration;  provided that the Company
shall  not  be  required  to  (i)  qualify  generally  to  do  business  in  any
jurisdiction where it is not then so qualified,  (ii) take any action that would
subject it to the  service of  process  in suits,  other than as to matters  and
transactions relating to the Shelf Registration, in any jurisdiction where it is
not now  subject  or (iii)  take any action  which  would  subject it to general
service of process or to  taxation in any  jurisdiction  where it is not then so
subject.

     (g) The Company shall cooperate with the holders of the Notes to facilitate
the timely  preparation  and delivery of certificates  representing  Notes to be
sold in the  Shelf  Registration  free of any  restrictive  legends  and in such
denominations  and  registered  in such  names  as the  holders  may  request  a
reasonable  period  of time  prior  to  sales of  Notes  pursuant  to the  Shelf
Registration.

     (h) Upon the occurrence of any event  contemplated by Section 3(b)(v) above
(including,  without  limitation,  any Suspension  Event), the Company shall, as
promptly as reasonably  practicable,  prepare a post-effective  amendment to the
registration  statement or a supplement  to the related  prospectus  or file any
other  required  document so that, as thereafter  delivered to purchasers of the
Notes, the prospectus will not contain an untrue statement of a material fact or
omit to state any material  fact  necessary to make the  statements  therein not
misleading.

     (i) Not  later  than  the  effective  date of the  applicable  registration
statement, the Company will provide a CUSIP number for the New Notes and provide
the applicable trustee with printed  certificates for the Notes or New Notes, as
the case may be,  in a form  eligible  for  deposit  with The  Depository  Trust
Company.

     (j) The Company  will use all  reasonable  efforts to comply with all rules
and  regulations  of the  Commission  to the  extent  and so long  as  they  are
applicable to the Registered  Exchange Offer or the Shelf  Registration and will
make  generally  available  to its  security  holders (or  otherwise  provide in
accordance  with  Section  11(a) of the  Securities  Act) an earnings  statement
satisfying the provisions of Section 11(a) of the Securities  Act, no later than
45 days after the end of a  12-month  period  (or 90 days,  if such  period is a
fiscal  year)  beginning  with the first  month of the  Company's  first  fiscal
quarter  commencing  after the effective date of the Shelf  Registration,  which
statement shall cover such 12-month period.

     (k) The Company shall cause the  Indenture  (or an indenture  substantially
identical to the  Indenture in the case of a  Registered  Exchange  Offer) to be
qualified under the Trust Indenture Act of 1939, as amended.

     (l) The Company may require each holder of Notes to be sold pursuant to the
Shelf  Registration  to furnish to the Company such  information  regarding  the
holder and the  distribution  of such Notes as the Company may from time to time
reasonably require for inclusion in the registration statement.  The Company may
also require each holder of Notes participating in the Registered Exchange Offer
to  represent  to the  Company  that  at the  time  of the  consummation  of the
Registered  Exchange  Offer (i) such holder is not an  affiliate of the Company,
(ii) any New Notes  received by such  holder  will be  acquired in the  ordinary
course of its  business  and (iii)  such  holder  will  have no  arrangement  or
understanding with any person to participate in the distribution of the


                                       -5-
<PAGE>



Notes or the New Notes  within the meaning of the  Securities  Act.  Each holder
agrees by acquisition of Notes that, upon receipt of any notice from the Company
of the existence of any fact of the kind  described in Section  3(b)(v)  hereof,
such holder will forthwith discontinue  disposition of Notes until such holder's
receipt of the copies of the supplemented or amended Prospectus  contemplated by
Section 3(h)  hereof,  or until it is advised in writing by the Company that the
use of the prospectus may be resumed,  and has received copies of any additional
or supplemental  filings with respect to the  Prospectus.  If so directed by the
Company,  each holder will deliver to the Company (at the Company's expense) all
copies,  other than permanent file copies then in such holder's  possession,  of
the  prospectus  covering  such  Notes  current  at the time of  receipt of such
notice.

     4. Registration  Expenses.  The Company shall bear all expenses incurred in
connection with the  performance of its  obligations  under Sections 1 through 3
hereof and, in the event of a Shelf  Registration,  shall bear or reimburse  the
holders of the Notes for the reasonable  fees and  disbursements  of one firm of
counsel designated by the holders of a majority in principal amount of the Notes
to act as counsel for the holders of the Notes in connection therewith.

     5.  Indemnification.  (a) The Company agrees to indemnify and hold harmless
(i) each  Initial  Purchaser,  (ii)  each  holder  of  Notes  and/or  New  Notes
(including  broker-dealers receiving New Notes in the Registered Exchange Offer)
(each a "Holder"),  (iii) each person,  if any, who controls (within the meaning
of  Section  15 of the  Act or  Section  20 of the  Exchange  Act)  any  Initial
Purchaser  or any Holder  (any of the persons  referred to in this clause  (iii)
being hereinafter referred to as a "controlling person") and (iv) the respective
officers,  directors,  partners,  employees,  representatives  and agents of any
Initial  Purchaser or any Holder or any controlling  person (any person referred
to in clause (i), (ii),  (iii) or (iv) may hereinafter be referred to as a "Non-
Company Indemnitee"), to the fullest extent lawful, from and against any and all
losses,  claims,  damages,  liabilities  and  judgments  caused  by  any  untrue
statement  or alleged  untrue  statement  of a material  fact  contained  in any
registration  statement or prospectus (or any amendments or supplements thereto)
prepared in accordance with this Agreement,  including any document incorporated
by reference  therein,  or caused by any  omission or alleged  omission to state
therein a material fact  required to be stated  therein or necessary to make the
statements  therein not  misleading,  except,  with  respect to any  Non-Company
Indemnitee,  insofar as such losses, claims,  damages,  liabilities or judgments
(1) are caused by any such  untrue  statement  or  omission  or  alleged  untrue
statement or omission based upon information furnished in writing to the Company
by such Non- Company Indemnitee expressly for use therein or (2) with respect to
any  preliminary  prospectus,   result  from  the  fact  that  such  Non-Company
Indemnitee  sold  Notes or New Notes to a person  to whom  there was not sent or
given, at or prior to the written confirmation of such sale, a copy of the final
prospectus, as amended or supplemented, if required under the Securities Act and
if  the  Company  shall  have  previously   furnished  copies  thereof  to  such
Non-Company   Indemnitee  in  accordance  with  this  Agreement  and  the  final
prospectus,  as  amended  or  supplemented,  would have  corrected  such  untrue
statement or omission.

     (b) In case any action shall be brought against any Non-Company  Indemnitee
based  upon any  registration  statement  or  prospectus,  or any  amendment  or
supplement  thereto,  and with respect to which  indemnity may be sought against
the Company,  such  Non-Company  Indemnitee shall promptly notify the Company in
writing  and the  Company  shall  assume  the  defense  thereof,  including  the
employment of counsel reasonably satisfactory to such Non-Company Indemnitee and
payment of all fees and expenses.  Such  Non-Company  Indemnitee  shall have the
right to employ  separate  counsel  in any such  action and  participate  in the
defense  thereof,  but the fees and  expenses  of counsel  shall be paid by such
Non-Company Indemnitee, unless (i) the employment of such


                                      -6-
<PAGE>



counsel shall have been specifically  authorized in writing by the Company, (ii)
the Company shall have failed to assume the defense and employ  counsel or (iii)
the named parties to any such action  (including any impleaded  parties) include
both such Non-Company Indemnitee and the Company and such Non-Company Indemnitee
shall have been advised by counsel that it would be  inappropriate  for the same
counsel to represent such Non-Company  Indemnitee and the Company (in which case
the  Company  shall not have the right to assume the  defense of such  action on
behalf of such Non-Company  Indemnitee,  it being understood,  however, that the
Company  shall not,  in  connection  with any one such  action or  separate  but
substantially similar or related actions in the same jurisdiction arising out of
the same  general  allegations  or  circumstances,  be  liable  for the fees and
expenses of more than one separate  firm of attorneys  (in addition to any local
counsel) for the  Non-Company  Indemnitees,  which firm shall be  designated  in
writing by the Non-Company  Indemnitees  and whose fees and expenses  reasonably
incurred  shall be  reimbursed as they are  incurred).  The Company shall not be
liable for any  settlement  of any such  action  effected  without  the  written
consent of the Company,  but if settled with the written consent of the Company,
the Company  agrees to indemnify  and hold harmless any  Non-Company  Indemnitee
from and  against  any  amounts  payable  pursuant  to such  written  consent in
connection  with such  settlement.  Notwithstanding  the  immediately  preceding
sentence,  if in any case  where the fees and  expenses  of  counsel  are at the
expense of the Company and a  Non-Company  Indemnitee  shall have  requested the
Company to reimburse such  Non-Company  Indemnitee for such fees and expenses of
counsel  as  incurred,  the  Company  agrees  that it  shall be  liable  for any
settlement  of any  action  effected  without  its  written  consent if (i) such
settlement  is entered into more than 30 business  days after the receipt by the
Company of the  aforesaid  request  and (ii) the  Company  shall have  failed to
reimburse  such  Non-Company  Indemnitee  in  accordance  with such  request for
reimbursement  prior to the date of such  settlement.  The  Company  shall  not,
without the prior written  consent of such  Non-Company  Indemnitee,  effect any
settlement  of any  pending or  threatened  proceeding  in respect of which such
Non-Company  Indemnitee is or could have been a party and  indemnity  could have
been sought  hereunder by such  Non-Company  Indemnitee,  unless such settlement
includes  an  unconditional  release  of such  Non-Company  Indemnitee  from all
liability on claims that are the subject matter of such proceeding.

     (c) Each Holder agrees to indemnify and hold harmless (i) the Company, (ii)
each of the  Initial  Purchasers,  (iii)  each  other  Holder,  (iv) any  person
controlling  (within  the  meaning of Section 15 of the Act or Section 20 of the
Exchange Act) the Company,  any Initial  Purchaser and each other Holder and (v)
the respective officers,  directors,  partners,  employees,  representatives and
agents of each of the parties  referred to in clauses (i), (ii), (iii) and (iv),
to the same extent as the  foregoing  indemnity  from the Company to each of the
Non-Company  Indemnitees,  but only with respect to information relating to such
Holder that was  furnished  in writing by such Holder  expressly  for use in any
registration  statement  (or any amendment or  supplement  thereto)  prepared in
accordance  with this  Agreement.  In no event shall the liability of any Holder
hereunder be greater in amount than the dollar  amount of the proceeds  received
by such  Holder  upon the sales of the Notes or New  Notes  giving  rise to such
indemnification obligation.

     (d) If the indemnification provided for in this Section 5 is unavailable to
an indemnified party in respect of any losses, claims,  damages,  liabilities or
judgments  referred  to  herein,  then  each  indemnifying  party,  in  lieu  of
indemnifying  such  indemnified  party,  shall  contribute to the amount paid or
payable by such indemnified party as a result of such losses,  claims,  damages,
liabilities  and judgments in such  proportion as is  appropriate to reflect the
relative fault of the  indemnifying  party, on the one hand, and the indemnified
party,  on the other hand, in connection  with the statements or omissions which
resulted in such losses, claims, damages,


                                      -7-
<PAGE>



liabilities   or   judgments,   as  well  as  any   other   relevant   equitable
considerations.  The relative fault of the indemnifying  party, on the one hand,
and the indemnified  party, on the other hand,  shall be determined by reference
to,  among other  things,  whether the untrue or alleged  untrue  statement of a
material  fact or the  omission  or alleged  omission  to state a material  fact
relates to information  supplied by the indemnifying  party, on the one hand, or
the  indemnified  party,  on the other hand, and the parties'  relative  intent,
knowledge,  access to  information  and  opportunity  to correct or prevent such
statement or omission.

     The Company, each Initial Purchaser and each Holder agree that it would not
be just and  equitable  if  contribution  pursuant  to this  Section  5(d)  were
determined by pro rata  allocation  or by any other method of  allocation  which
does  not  take  account  of the  equitable  considerations  referred  to in the
immediately preceding paragraph.  The losses,  claims,  damages,  liabilities or
judgments  of an  indemnified  party  referred to in the  immediately  preceding
paragraph  shall be deemed to  include,  subject  to the  limitations  set forth
above, any legal or other expenses reasonably incurred by such indemnified party
in connection with  investigating or defending any such action or claim prior to
the indemnifying party's assumption of the defense thereof or subsequent thereto
to  the  extent  permitted  by the  second  sentence  of  Section  5(b)  hereof.
Notwithstanding  the  provisions of this Section 5, none of the Holders shall be
required to contribute,  in the aggregate, any amount in excess of the amount by
which the total amount received by such Holder with respect to the sale of Notes
or New Notes  exceeds the amount of any damages  which such Holder has otherwise
been  required to pay by reason of such untrue or alleged  untrue  statement  or
omission or alleged omission.  No person guilty of fraudulent  misrepresentation
(within the meaning of Section 11(f) of the Securities Act) shall be entitled to
contribution   from  any  person   who  was  not   guilty  of  such   fraudulent
misrepresentation.  The  obligations  of Holders to contribute  pursuant to this
Section 5(d) are several in proportion  to the  respective  principal  amount of
Notes and/or New Notes held by each of the Holders hereunder and not joint.

     6. Additional Interest Under Certain Circumstances.

     (a)  Additional  interest  (the  "Penalty  Interest")  shall be assessed as
follows:

         (i) If a registration  statement with respect to a Registered  Exchange
   Offer or a Shelf Registration is not filed with the Commission within 90 days
   following the Closing Date, then commencing on the 91st day after the Closing
   Date,  Penalty  Interest  shall be  accrued  on the Notes  over and above the
   accrued  interest  at a rate  of  .25%  per  annum  for  the  first  90  days
   immediately  following  the 90th day after the  Closing  Date,  such  Penalty
   Interest rate  increasing by an additional .25% per annum at the beginning of
   each subsequent 90-day period;

         (ii) If a registration  statement with respect to a Registered Exchange
   Offer or a Shelf  Registration is filed as contemplated by subsection 6(a)(i)
   above  and is not  declared  effective  by the  Commission  within  180  days
   following  the  Closing  Date,  then,  commencing  on the 181st day after the
   Closing Date,  Penalty  Interest shall be accrued on the Notes over and above
   the  accrued  interest  at a rate of .25%  per  annum  for the  first 90 days
   immediately  following  the 180th day after the Closing  Date,  such  Penalty
   Interest rate  increasing by an additional .25% per annum at the beginning of
   each subsequent 90 day period; and

         (iii) If either (A) the Company has not exchanged New Notes for all


                                      -8-
<PAGE>



   Notes  validly  tendered  in  accordance  with the  terms  of the  Registered
   Exchange  Offer  on or  prior  to  40  days  after  the  date  on  which  the
   registration  statement  with respect to the  Registered  Exchange  Offer was
   declared  effective,  or (B) if  applicable,  a  registration  statement with
   respect  to a  Shelf  Registration  has  been  declared  effective  and  such
   registration  statement  ceases to be  effective  prior to two years from its
   original  effective  date  (other  than  by  reason  of the  occurrence  of a
   Suspension  Event),  then Penalty Interest shall be accrued on the Notes over
   and above the  accrued  interest at a rate of .25% per annum for the first 60
   days immediately  following (x) the 40th day after such effective date in the
   case of (A) above, or (y) the day such registration statement with respect to
   a Shelf  Registration  ceases to be  effective  (other  than by reason of the
   occurrence  of a  Suspension  Event) in the case of (B) above,  such  Penalty
   Interest rate  increasing by an additional .25% per annum at the beginning of
   each subsequent 60-day period;

provided,  however,  that the Penalty  Interest rate on the Notes may not exceed
1.0% per annum at any time; and provided,  further,  that (1) upon the filing of
the  registration  statement  with respect to a Registered  Exchange  Offer or a
Shelf Registration (in the case of (i) above), (2) upon the effectiveness of the
registration  statement  filed with respect to a Registered  Exchange Offer or a
Shelf  Registration (in the case of (ii) above), or (3) upon the exchange of New
Notes  for all  Notes  validly  tendered  in  accordance  with the  terms of the
Registered  Exchange  Offer,  or  upon  the  effectiveness  of the  registration
statement filed with respect to a Shelf  Registration which had ceased to remain
effective  prior to two years from its original  effective  date (in the case of
(iii)  above),  Penalty  Interest  on the Notes as a result of such  clause (i),
(ii), or (iii) shall immediately cease to accrue. The Penalty Interest specified
in this  Section 6(a) shall be payable by the Company to the holders of Notes at
the times,  in the manner and subject to the same terms and conditions set forth
in the  Indenture,  as nearly as may be, as though the rate set out in the Notes
had been increased,  which payments shall be calculated pursuant to Section 6(b)
below. The interest rate on the Notes,  inclusive of Penalty Interest,  shall in
no event exceed 10 1/2% per annum.

     (b) Any amounts of Penalty  Interest due pursuant to clauses (i),  (ii), or
(iii) of Section  6(a) above  will be  payable in cash on the  interest  payment
dates of the Notes.

     The  amount of Penalty  Interest  will be  determined  by  multiplying  the
applicable  Penalty  Interest  rate  by  the  principal  amount  of  the  Notes,
multiplied  by a  fraction,  the  numerator  of which is the number of days such
Penalty Interest rate was applicable during such period (determined on the basis
of a 360-day year  comprised of twelve 30-day  months),  and the  denominator of
which is 360.

     (c) If the Company effects the Registered  Exchange Offer, the Company will
be entitled to close the Registered Exchange Offer provided that it has accepted
all Notes  theretofore  validly  tendered  in  accordance  with the terms of the
Registered  Exchange Offer. Notes not tendered in the Registered  Exchange Offer
shall bear  interest  at the same rates in effect at the time of issuance of the
Notes.

     7. Miscellaneous.

     (a)  Amendments  and Waivers.  The  provisions of this Agreement may not be
amended,  modified or  supplemented,  and waivers or consents to departures from
the  provisions  hereof may not be given,  unless the Company has  obtained  the
written  consent of holders of a majority in aggregate  principal  amount of the
Notes.


                                      -9-
<PAGE>



     (b) Notices. All notices and other communications provided for or permitted
hereunder shall be made in writing by  hand-delivery,  first-class  mail, telex,
telecopier or air courier which guarantees overnight delivery:

         (1) If to a holder of Notes or New Notes,  at the most current  address
     given by such holder to the Company in  accordance  with the  provisions of
     this Section 7(b), which address initially is, with respect to each holder,
     the  address of such holder to which  confirmation  of the sale of Notes or
     New Notes to such holder was first sent,  with a copy in like manner to the
     Initial Purchasers c/o Smith Barney Inc. at 388 Greenwich Street, New York,
     New York 10013.

         (2) If to an Initial Purchaser, to the address specified in 7(b)(1);

         (3) If to the Company, at the following address:

         Integrated Health Services, Inc.
         10065 Red Run Boulevard
         Owings Mills, Maryland 21117
         Attention:  General Counsel

     All such  notices  and  communications  shall be  deemed  to have been duly
given:  at the time delivered by hand, if personally  delivered;  three business
days after  being  deposited  in the mail,  postage  prepaid,  if  mailed;  when
answered back, if telexed;  when receipt  acknowledged  by recipient's  telecopy
operator,  if  telecopied;  and on the day  delivered,  if sent by overnight air
courier guaranteeing next day delivery.

     (c)  Successors and Assigns.  This Agreement  shall inure to the benefit of
and be  binding  upon  the  successors  and  assigns  of  each  of the  parties,
including,  without limitation,  and without the need for an express assignment,
subsequent holders of the Notes and the New Notes.

     (d)  Counterparts.  This  Agreement  may  be  executed  in  any  number  of
counterparts and by the parties hereto in separate  counterparts,  each of which
when so  executed  shall be  deemed  to be an  original  and all of which  taken
together shall constitute one and the same agreement.

     (e)  Headings.  The  headings  in this  Agreement  are for  convenience  of
reference only and shall not limit or otherwise affect the meaning hereof.

     (f)  Governing  Law. This  Agreement  shall be governed by and construed in
accordance  with  the laws of the  State  of New  York,  without  regard  to its
conflicts of laws rules.

     (g) Severability. If any one or more of the provisions contained herein, or
the  application  thereof  in any  circumstance,  is held  invalid,  illegal  or
unenforceable,  the validity,  legality and enforceability of any such provision
in every other respect and of the remaining  provisions  contained  herein shall
not be affected or impaired thereby.


                                      -10-
<PAGE>



     Please  confirm  that the  foregoing  correctly  sets  forth the  agreement
between the Company and the Initial Purchasers.

                                         Very truly yours,

                                         INTEGRATED HEALTH SERVICES, INC.



                                          By:  /s/
                                               ---------------------------------
                                               Name:
                                               Title:



Accepted in New York, New York

May 22, 1997

SMITH BARNEY INC.
DONALDSON, LUFKIN & JENRETTE
  SECURITIES CORPORATION
MORGAN STANLEY & CO. INCORPORATED
SALOMON BROTHERS INC

By:  SMITH BARNEY INC.



By: /s/                               
   -----------------------------------
   Name:                              
   Title:                             


                                      -11-

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<FISCAL-YEAR-END>                              DEC-31-1997
<PERIOD-START>                                 JAN-01-1997
<PERIOD-END>                                   JUN-30-1997
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