INTEGRATED HEALTH SERVICES INC
SC 14D1, 1997-08-07
SKILLED NURSING CARE FACILITIES
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                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549
                                SCHEDULE 14D-1
                      Tender Offer Statement Pursuant to
           Section 14(d)(1) of the Securities Exchange Act of 1934
                                     and
                                 SCHEDULE 13D
                              (Amendment No. 1)
      (Pursuant to Section 13(d) of the Securities Exchange Act of 1934)

                       COMMUNITY CARE OF AMERICA, INC.
                          (Name of Subject Company)

                          IHS ACQUISITION XXVI, INC.
                         a wholly owned subsidiary of

                       INTEGRATED HEALTH SERVICES, INC.
                                  (Bidders)

                   COMMON STOCK, PAR VALUE $.0025 PER SHARE
                          (Title of Class of Securities)

                                   20363B10
                    (Cusip Number of Class of Securities)

                           MARSHALL A. ELKINS, ESQ.
                       INTEGRATED HEALTH SERVICES, INC.
                           10065 RED RUN BOULEVARD
                         OWINGS MILLS, MARYLAND 21117
                           TELEPHONE: 410-998-8400
             (Name, Address and Telephone Number of Person Authorized
         to Receive Notices and Communications on Behalf of Bidders)

                                   COPIES TO:

        Carl E. Kaplan, Esq                  Leslie A. Glew, Esq.
     Fulbright & Jaworski L.L.P        Integrated Health Services, Inc.
          666 Fifth Avenue                 10065 Red Run Boulevard
      New York, New York 10103           Owings Mills, Maryland 21117
     Telephone: (212) 318-3000            Telephone: (410) 998-8400

================================================================================
   Transaction Valuation*                            Amount of Filing Fee**
    $30,391,204                                                $6,078.24
================================================================================

*    For purposes of calculating  fee only.  This amount assumes the purchase of
     7,597,801  shares of Common  Stock at $4.00 net per share.  Such  number of
     shares represents all outstanding shares as of August 4, 1997.

**   The amount of the filing fee,  calculated  in  accordance  with  Regulation
     240.0-11 of the Securities  Exchange Act of 1934,  equals 1/50 of 1% of the
     value of the shares to be purchased.

[ ]  Check box if any part of the fee is offset as provided  by Rule  0-11(a)(2)
     and identify the filing with which the offsetting fee was previously  paid.
     Identify the previous filing by registration  statement number, or the Form
     or Schedule and date of its filing.

Amount Previously Paid: N/A

Form or Registration No.: N/A

Filing Party: N/A

Date Filed: N/A

<PAGE>



CUSIP NO. 20363B10

<TABLE>
<CAPTION>
<S>      <C>
 1.      NAME OF REPORTING PERSON                                                                  
         S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON                                         

         Integrated Health Services, Inc. (I.R.S. #23-2428312)                                     

 2.      CHECK THE APPROPRIATE BOX IF A MEMBER OF GROUP                                    (a) [ ] 
         (SEE INSTRUCTIONS)                                                                (b) [ ] 

 3.      SEC USE ONLY                                                                              
 
 4.      SOURCES OF FUNDS (SEE INSTRUCTIONS)                                                       
         BK, WC                                                                                    
 
 5.      CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(e) OR 2(f)   [ ] 

 6.      CITIZENSHIP OR PLACE OF ORGANIZATION                                                      
         State of Delaware                                                                         

 7.      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON                              
         1,189,274 shares                                                                          

 8.      CHECK IF THE AGGREGATE AMOUNT IN ROW (7) EXCLUDES CERTAIN SHARES                      [ ] 
         (SEE INSTRUCTIONS)   
                                                                     
 9.      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (7)                                         
         13.5%                                                                                     

10.      TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)                                               
         CO

</TABLE>

<PAGE>



CUSIP NO. 20363B10

<TABLE>
<CAPTION>
<S>      <C>
 1.      NAME OF REPORTING PERSON                                                                  
         S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON                                         
         IHS Acquisition XXVI, Inc., a wholly owned subsidiary of Integrated Health Services,
         Inc. (I.R.S. #: Pending)

 2.      CHECK THE APPROPRIATE BOX IF A MEMBER OF GROUP                                     (a) [ ]
         (SEE INSTRUCTIONS)                                                                 (b) [ ]

 3.      SEC USE ONLY

 4.      SOURCES OF FUNDS (SEE INSTRUCTIONS)
         AF

 5.      CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(e) OR 2(f)    [ ]

 6.      CITIZENSHIP OR PLACE OF ORGANIZATION
         State of Delaware

 7.      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
         0 shares

 8.      CHECK IF THE AGGREGATE AMOUNT IN ROW (7) EXCLUDES CERTAIN SHARES                       [ ]
         (SEE INSTRUCTIONS)

 9.      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (7)
         0%

10.      TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
         CO

</TABLE>


<PAGE>



   This  Tender  Offer  Statement  and  Amendment  No. 1 to  Schedule  13D (this
"Statement") relates to the offer by IHS Acquisition XXVI, Inc. ("Purchaser"), a
Delaware  corporation  and  a  wholly-owned   subsidiary  of  Integrated  Health
Services,  Inc., a Delaware corporation ("Parent"),  to purchase all outstanding
shares of common stock, par value $.0025 per share (the "Shares"),  of Community
Care of America,  Inc., a Delaware  corporation (the  "Company"),  at a price of
$4.00 per Share,  net to the seller in cash,  upon the terms and  subject to the
conditions  set forth in the Offer to Purchase,  dated as of August 7, 1997 (the
"Offer to  Purchase"),  and the related Letter of  Transmittal  (which  together
constitute the "Offer"),  copies of which are attached hereto as Exhibits (a)(1)
and (a)(2),  respectively.  The Offer is being made pursuant to an Agreement and
Plan of Merger,  dated as of August 1, 1997, by and among Parent,  Purchaser and
the Company, which provides, among other things, that as promptly as practicable
after the  satisfaction  or, if permissible,  waiver of the conditions set forth
therein, Purchaser will be merged with and into the Company (the "Merger"), with
the  Company  continuing  as the  surviving  corporation,  and each  issued  and
outstanding  Share (other than any Shares held in the treasury of the Company or
owned by Purchaser, Parent or any subsidiary of Parent or the Company, and other
than Shares held by stockholders who shall not have voted in favor of the Merger
or consented  thereto in writing and who shall have demanded properly in writing
appraisal  for  such  Shares  in  accordance  with  Section  262 of the  General
Corporation  Law of the State of Delaware)  will be converted  into the right to
receive in cash,  without interest,  an amount equal to the price paid per Share
in the Offer.

   The  information   contained  in  this  Statement   concerning  the  Company,
including,  without  limitation,  information  concerning  the background of the
transaction,  the  deliberations,  approvals and  recommendations of the Special
Committee  (as defined in the Offer to  Purchase)  and the Board of Directors of
the  Company in  connection  with the  transaction,  the  opinion of the Special
Committee's  financial  advisors,   and  the  Company's  capital  structure  and
historical  and projected  financial  information,  was supplied by the Company.
Parent  and  Purchaser  take  no   responsibility   for  the  accuracy  of  such
information.

ITEM 1. SECURITY AND SUBJECT COMPANY.

   (a) The name of the subject  company is Community  Care of America,  Inc. Its
principal  executive  offices are located at 3050 North Horseshoe  Drive,  Suite
260, Naples, Florida 34104.

   (b) The class of equity securities being sought is all the outstanding shares
of common  stock,  par value  $.0025 per share (the  "Shares"),  of the Company.
Information  concerning the number of outstanding  Shares and the  consideration
being  offered  for the Shares set forth  under  "INTRODUCTION"  in the Offer to
Purchase is incorporated herein by reference.

   (c)  Information  concerning  the  principal  market in which the  Shares are
traded  and the  historical  high and low sales  prices  for the  Shares in such
market set forth in the Offer to  Purchase  under  "THE OFFER -- Price  Range of
Shares; Dividend Information" is incorporated herein by reference.

ITEM 2. IDENTITY AND BACKGROUND.

   (a)-(d) and (g).  This  Statement is being filed by the Purchaser and Parent.
The  Purchaser  and Parent are  Delaware  corporations  and the  Purchaser  is a
wholly-owned   subsidiary  of  Parent.   Information  concerning  the  principal
businesses  and the  addresses of the  principal  offices of the  Purchaser  and
Parent  set  forth  in the  Offer  to  Purchase  under  "THE  OFFER  --  Certain
Information  Concerning the Purchaser and the Parent" is incorporated  herein by
reference.  The names,  business  addresses,  present  principal  occupation  or
employment,  and the name,  principal business and address of any corporation or
other organization in which such employment or occupation is conducted, material
occupations,  positions,  offices or employments  during the last five years and
citizenship of each of the directors and executive officers of the Purchaser and
Parent set forth in Schedule I to the Offer to Purchase are incorporated  herein
by reference.

   (e) and (f). During the last five years,  none of the Purchaser or Parent or,
to the best  knowledge of the Purchaser or Parent,  any of the persons listed in
Schedule  I to the  Offer  to  Purchase  has been (i)  convicted  in a  criminal
proceeding  (excluding  traffic  violations or similar  misdemeanors)  or (ii) a
party

                                        1

<PAGE>



to a  civil  proceeding  of a  judicial  or  administrative  body  of  competent
jurisdiction and as a result of such proceeding was or is subject to a judgment,
decree or final order enjoining future violations of, or prohibiting  activities
subject to,  federal or state  securities  laws or finding any violation of such
laws.

ITEM 3. PAST CONTACTS, TRANSACTIONS OR NEGOTIATIONS WITH THE SUBJECT COMPANY.

   (a) The information set forth in the Offer to Purchase under "SPECIAL FACTORS
- --  Background  of the Offer and the  Merger,"  "SPECIAL  FACTORS  -- The Merger
Agreement,"  "SPECIAL  FACTORS -- Interests of Certain  Persons in the Offer and
the Merger" and "THE OFFER -- Certain  Information  Concerning the Purchaser and
the Parent" is incorporated herein by reference.

   (b) The information set forth in the Offer to Purchase under  "INTRODUCTION,"
"SPECIAL FACTORS -- Background of the Offer and the Merger," "SPECIAL FACTORS --
Purpose  and  Structure  of the  Offer and the  Merger;  Reasons  of Parent  and
Purchaser  for the  Offer and the  Merger,"  "SPECIAL  FACTORS  -- Plans for the
Company  After the Offer and the  Merger;  Certain  Effects of the Offer and the
Merger,"  "SPECIAL  FACTORS  -- The  Merger  Agreement,"  "THE  OFFER -- Certain
Information  Concerning  the  Company"  and "THE  OFFER --  Certain  Information
Concerning the Purchaser and the Parent" is incorporated herein by reference.

ITEM 4. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION.

   (a)-(c).  The information set forth in the Offer to Purchase under "THE OFFER
- -- Source and Amount of Funds" is incorporated herein by reference.

ITEM 5. PURPOSE OF THE TENDER OFFER AND PLANS OR PROPOSALS OF THE BIDDER.

   (a)-(e).   The   information  set  forth  in  the  Offer  to  Purchase  under
"INTRODUCTION,"  "SPECIAL  FACTORS --  Background  of the Offer and the Merger,"
"SPECIAL  FACTORS -- Purpose and Structure of the Offer and the Merger;  Reasons
of Parent and Purchaser for the Offer and the Merger," "SPECIAL FACTORS -- Plans
for the Company After the Offer and the Merger; Certain Effects of the Offer and
the Merger" and "SPECIAL FACTORS -- The Merger Agreement" is incorporated herein
by reference.

   (f) and (g).  The  information  set  forth in the  Offer  to  Purchase  under
"SPECIAL  FACTORS  -- Plans for the  Company  After  the  Offer and the  Merger;
Certain  Effects  of the Offer and the  Merger"  and "THE OFFER -- Effect of the
Offer on the Market for Shares,  Margin  Regulations and Registration  under the
Exchange Act" is incorporated herein by reference.

ITEM 6. INTEREST IN SECURITIES OF THE SUBJECT COMPANY.

   (a) and (b).  The  information  set  forth in the  Offer  to  Purchase  under
"SPECIAL FACTORS -- Beneficial  Ownership of Shares,"  "SPECIAL FACTORS -- Share
Ownership by Parent,  Purchaser and Their  Affiliates" and "THE OFFER -- Certain
Information  Concerning the Purchaser and the Parent" is incorporated  herein by
reference.

ITEM 7. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT
TO THE SUBJECT COMPANY'S SECURITIES.

   The  information  set forth in the Offer to  Purchase  under  "INTRODUCTION,"
"SPECIAL FACTORS -- Background of the Offer and the Merger," "SPECIAL FACTORS --
Purpose  and  Structure  of the  Offer and the  Merger;  Reasons  of Parent  and
Purchaser  for the  Offer and the  Merger,"  "SPECIAL  FACTORS  -- Plans for the
Company  After the Offer and the  Merger;  Certain  Effects of the Offer and the
Merger,"  "SPECIAL FACTORS -- The Merger  Agreement,"  "SPECIAL FACTORS -- Share
Ownership by Parent,  Purchaser and Their  Affiliates" and "THE OFFER -- Certain
Information  Concerning the Purchaser and the Parent" is incorporated  herein by
reference.

ITEM 8. PERSONS RETAINED, EMPLOYED OR TO BE COMPENSATED.

   The information set forth in the Offer to Purchase under  "INTRODUCTION"  and
"THE OFFER -- Fees and Expenses" is incorporated herein by reference.

                                        2

<PAGE>



ITEM 9. FINANCIAL STATEMENTS OF CERTAIN BIDDERS.

   The  information  set  forth in the Offer to  Purchase  under  "THE  OFFER --
Certain  Information  Concerning  the Purchaser and the Parent" is  incorporated
herein by reference.

ITEM 10. ADDITIONAL INFORMATION.

   (a). Not applicable.

   (b) and (c). The  information  set forth in the Offer to Purchase  under "THE
OFFER -- Certain Legal Matters" is incorporated herein by reference.

   (d). The information set forth under "THE OFFER -- Effect of the Offer on the
Market for Shares,  Margin  Regulations and Registration under the Exchange Act"
in the Offer to Purchase is incorporated herein by reference.

   (e). None.

   (f).  The  information  set forth in the Offer to  Purchase  and the  related
Letter of Transmittal,  and the Agreement and Plan of Merger, dated as of August
1, 1997, by and among the Parent, the Purchaser and the Company, copies of which
are  attached  hereto as Exhibit  (a)(1),  (a)(2) and (c)(1),  respectively,  is
incorporated herein by reference.

ITEM 11.  MATERIAL TO BE FILED AS EXHIBITS.

(a)(1)       Offer to Purchase, dated August 7, 1997.
(a)(2)       Form of Letter of Transmittal.
(a)(3)       Form of Notice of Guaranteed Delivery.
(a)(4)       Form of Letter  from  Shattuck  Hammond  Partners  Inc. to Brokers,
             Dealers, Commercial Banks, Trust Companies and Other Nominees.
(a)(5)       Form of Letter  from  Brokers,  Dealers,  Commercial  Banks,  Trust
             Companies and Other Nominees to their Clients.
(a)(6)       Form of Guidelines  for  Certification  of Taxpayer  Identification
             Number on Substitute Form W-9.
(a)(7)       Text of Joint  Press  Release  dated  August  1,  1997,  issued  by
             Integrated  Health  Services,  Inc. and Community  Care of America,
             Inc.
(b)(1)       Revolving Credit  Agreement,  dated as of May 15, 1996, as amended,
             among Integrated Health Services,  Inc., the lenders named therein,
             and Citibank, N.A., as administrative agent.
(c)(1)       Agreement  and Plan of Merger,  dated as of August 1,  1997,  among
             Parent, the Purchaser and the Company.
(c)(2)       Voting and Tender Agreement,  dated as of August 1, 1997, among the
             Purchaser, Parent and Dr. Robert N. Elkins.
(c)(3)       Voting and Tender Agreement,  dated as of August 1, 1997, among the
             Purchaser,    Parent   and   Equity-Linked   Investors   L.P.   and
             Equity-Linked Investors-II, L.P.
(c)(4)       Stockholders  Agreement dated June 30, 1993 among Robert N. Elkins,
             Robert N. Elkins, as voting trustee, Equity-Linked Investors, L.P.,
             Equity-Linked Investors-II, L.P. and the Company. *
(c)(5)       Voting  Agreement dated January 26, 1996 among Robert N. Elkins and
             certain stockholders of the Company. +
(c)(6)       Warrant Acquisition Agreement dated as of January 13, 1997, between
             the Company and the  Parent,  including  Form of Series A Warrants,
             Form of Series B Warrants and Registration Rights Agreement. +
(c)(7)       Warrant  Acquisition  Agreement  dated April 14,  1997  between the
             Company and the Parent. +
(c)(8)       Guaranty Agreement,  dated August 1, 1997, made by Robert N. Elkins
             to Parent.
(d)          None.
(e)          Not applicable.
(f)          None.
             
- ----------

*    Incorporated by reference to the Company's  Registration  Statement on Form
     S-1, Registration No. 33-92692.

+    Incorporated  by reference to the Company's  Annual Report on Form 10-K for
     the Fiscal Year ended December 31, 1996.


                                        3

<PAGE>



                                   SIGNATURES

   After due inquiry and to the best of my knowledge and belief, I certify
that the information set forth in this statement is true, complete and
correct.
Dated: August 7, 1997


                                             IHS ACQUISITION XXVI, INC.
     
                                             By /s/ Brian Davidson
                                                --------------------------------
                                                Name: Brian Davidson
                                                Title: Executive Vice President-
                                                       -Development

                                             INTEGRATED HEALTH SERVICES, INC.
     
                                             By /s/ Brian Davidson
                                                --------------------------------
                                                Name: Brian Davidson
                                                Title: Executive Vice President-
                                                       -Development

                                        4

<PAGE>



                                EXHIBIT INDEX

<TABLE>
<CAPTION>
                                                                                                      PAGE NO. IN
                                                                                                     SEQUENTIALLY
  EXHIBIT                                                                                              NUMBERED
    NO.                                              TITLE                                               COPY
- -----------  ------------------------------------------------------------------------------------- ----------------
<S>          <C>                                                                                   <C>
(a)(1)       Offer to Purchase, dated August 7, 1997.
(a)(2)       Form of Letter of Transmittal.
(a)(3)       Form of Notice of Guaranteed Delivery.
(a)(4)       Form of Letter  from  Shattuck  Hammond  Partners  Inc. to Brokers,
             Dealers, Commercial Banks, Trust Companies and Other Nominees.
(a)(5)       Form of Letter  from  Brokers,  Dealers,  Commercial  Banks,  Trust
             Companies and Other Nominees to their Clients.
(a)(6)       Form of Guidelines  for  Certification  of Taxpayer  Identification
             Number on Substitute Form W-9.
(a)(7)       Text of Joint  Press  Release  dated  August  1,  1997,  issued  by
             Integrated  Health  Services,  Inc. and Community  Care of America,
             Inc.
(b)(1)       Revolving Credit  Agreement,  dated as of May 15, 1996, as amended,
             among Integrated Health Services,  Inc., the lenders named therein,
             and Citibank, N.A., as administrative agent.
(c)(1)       Agreement  and Plan of Merger,  dated as of August 1,  1997,  among
             Parent, the Purchaser and the Company.
(c)(2)       Voting and Tender Agreement,  dated as of August 1, 1997, among the
             Purchaser, Parent and Dr. Robert N. Elkins.
(c)(3)       Voting and Tender Agreement,  dated as of August 1, 1997, among the
             Purchaser,    Parent   and   Equity-Linked   Investors   L.P.   and
             Equity-Linked Investors-II, L.P.
(c)(4)       Stockholders  Agreement dated June 30, 1993 among Robert N. Elkins,
             Robert N. Elkins, as voting trustee, Equity-Linked Investors, L.P.,
             Equity-Linked Investors-II, L.P. and the Company. *
(c)(5)       Voting  Agreement dated January 26, 1996 among Robert N. Elkins and
             certain stockholders of the Company. +
(c)(6)       Warrant Acquisition Agreement dated as of January 13, 1997, between
             the Company and the  Parent,  including  Form of Series A Warrants,
             Form of Series B Warrants and Registration Rights Agreement. +
(c)(7)       Warrant  Acquisition  Agreement  dated April 14,  1997  between the
             Company and the Parent. +
(c)(8)       Guaranty Agreement,  dated August 1, 1997, made by Robert N. Elkins
             to Parent.
(d)          None.
(e)          Not applicable.
(f)          None.

</TABLE>
- ----------
*    Incorporated by reference to the Company's  Registration  Statement on Form
     S-1, Registration No. 33-92692.

+    Incorporated  by reference to the Company's  Annual Report on Form 10-K for
     the Fiscal Year ended December 31, 1996.






                           OFFER TO PURCHASE FOR CASH


                     All Outstanding Shares of Common Stock
                                       of


                         COMMUNITY CARE OF AMERICA, INC.
                                       at
                               $4.00 Net Per Share
                                       by

                           IHS Acquisition XXVI, Inc.
                          a wholly-owned subsidiary of

                        INTEGRATED HEALTH SERVICES, INC.


THE OFFER AND  WITHDRAWAL  RIGHTS WILL EXPIRE AT 12:00  MIDNIGHT,  NEW YORK CITY
TIME, ON THURSDAY, SEPTEMBER 4, 1997, UNLESS THE OFFER IS EXTENDED.

     THE OFFER IS CONDITIONED UPON, AMONG OTHER THINGS,  (I) THERE BEING VALIDLY
TENDERED AND NOT WITHDRAWN  PRIOR TO THE  EXPIRATION OF THE OFFER SUCH NUMBER OF
SHARES OF COMMON STOCK OF COMMUNITY CARE OF AMERICA,  INC. (THE "COMPANY") WHICH
CONSTITUTES  AT LEAST A  MAJORITY  OF THE  OUTSTANDING  SHARES OF THE  COMPANY'S
COMMON  STOCK  ON A  FULLY-DILUTED  BASIS  ON THE  DATE OF  PURCHASE,  (II)  THE
EXPIRATION  OR  TERMINATION  OF ANY WAITING  PERIOD UNDER THE  HART-SCOTT-RODINO
ANTITRUST  IMPROVEMENTS ACT OF 1976, AS AMENDED, AND THE REGULATIONS  THEREUNDER
APPLICABLE  TO THE  PURCHASE  OF  SHARES  PURSUANT  TO THE  OFFER  AND (III) THE
SATISFACTION  OF  THE  OTHER  CONDITIONS  DESCRIBED  IN  "THE  OFFER  -  CERTAIN
CONDITIONS OF THE OFFER." THE OFFER IS NOT SUBJECT TO ANY FINANCING CONDITION.

     THE BOARD OF DIRECTORS OF THE COMPANY,  BY UNANIMOUS  VOTE OF ALL DIRECTORS
PRESENT AND VOTING (WITH THE TWO DIRECTORS WHO ARE ALSO  DIRECTORS OF INTEGRATED
HEALTH SERVICES, INC. ("PARENT") ABSTAINING OR NOT ATTENDING), BASED UPON, AMONG
OTHER THINGS,  THE UNANIMOUS  RECOMMENDATION AND APPROVAL OF A SPECIAL COMMITTEE
OF THE DIRECTORS OF THE COMPANY,  HAS DETERMINED THAT THE TERMS OF THE OFFER AND
MERGER  ARE FAIR TO,  AND IN THE BEST  INTERESTS  OF,  THE  STOCKHOLDERS  OF THE
COMPANY (OTHER THAN PARENT, THE PURCHASER AND THEIR AFFILIATES),  AND RECOMMENDS
THAT  STOCKHOLDERS  ACCEPT THE OFFER AND TENDER  THEIR  SHARES  PURSUANT  TO THE
OFFER. SEE "SPECIAL FACTORS -  RECOMMENDATIONS  OF THE SPECIAL COMMITTEE AND THE
COMPANY BOARD; FAIRNESS OF THE OFFER AND THE MERGER."
                             ---------------------

                                   IMPORTANT

     Any stockholder desiring to tender all or any portion of such stockholder's
shares  of the  Company's  common  stock,  par  value  $0.0025  per  share  (the
"Shares"),  should either (a) complete and sign the Letter of Transmittal  (or a
facsimile  thereof)  in  accordance  with  the  instructions  in the  Letter  of
Transmittal, have such stockholder's signature thereon guaranteed if required by
Instruction 1 to the Letter of Transmittal, and mail or deliver it together with
the certificates ("Share  Certificates")  representing  tendered Shares, and any
other required  documents,  to Citibank,  N.A. (the "Depositary") or tender such
Shares pursuant to the procedure for book-entry transfer set forth in "THE OFFER
- -  Procedure  for  Accepting  the Offer and  Tendering  Shares" or (b) request a
broker,  dealer,  commercial  bank, trust company or other nominee to effect the
transaction for the  stockholder.  A stockholder  whose Shares are registered in
the name of a broker,  dealer,  commercial  bank, trust company or other nominee
must  contact such  broker,  dealer,  commercial  bank,  trust  company or other
nominee in order to tender such Shares.

     Any stockholder  who desires to tender Shares and whose Share  Certificates
are not  immediately  available,  or who cannot comply with the  procedures  for
book-entry  transfer  on a timely  basis,  or who cannot  deliver  all  required
documents to the  Depositary  prior to the  expiration of the Offer,  may tender
such Shares by following the  procedures  for  guaranteed  delivery set forth in
"THE OFFER - Procedure for Accepting the Offer and Tendering Shares."

     Questions and requests for  assistance  may be directed to the  Information
Agent or the Dealer Manager at their respective  addresses and telephone numbers
set forth on the back cover page of this Offer to Purchase. Additional copies of
this Offer to  Purchase,  the Letter of  Transmittal,  the Notice of  Guaranteed
Delivery and other related materials may be obtained from the Information Agent,
the Dealer Manager, brokers, dealers, commercial banks and trust companies.


     THIS TRANSACTION HAS NOT BEEN APPROVED OR DISAPPROVED BY THE SECURITIES
AND EXCHANGE COMMISSION NOR HAS THE SECURITIES AND EXCHANGE COMMISSION PASSED
UPON THE FAIRNESS OR MERITS OF THIS TRANSACTION NOR UPON THE ACCURACY OR
ADEQUACY OF THE INFORMATION CONTAINED IN THIS DOCUMENT. ANY REPRESENTATION TO
THE CONTRARY IS UNLAWFUL.
                             ---------------------

                     The Dealer Manager for the Offer is:



                         SHATTUCK HAMMOND PARTNERS INC.

August 7, 1997


<PAGE>

                               TABLE OF CONTENTS

<TABLE>
<CAPTION>
SECTION                                                                                      PAGE
- ------------------------------------------------------------------------------------------   -----
<S>                                                                                          <C>
INTRODUCTION   ...........................................................................      1
SPECIAL FACTORS   ........................................................................      4
  1. Background of the Offer and the Merger  .............................................      4
  2. Recommendations of the Special Committee and the Company Board; Fairness of the
     Offer and the Merger  ...............................................................      9
  3. Opinions of the Company's Financial Advisors  .......................................     11
  4. Position of Parent and Purchaser Regarding the Fairness of the Offer and the Merger.      18
  5. Opinion of Financial Advisor to Parent  .............................................     18
  6. Purpose and Structure of the Offer and the Merger; Reasons of Parent and Purchaser
     for the Offer and the Merger   ......................................................     23
  7. Plans for the Company After the Offer and the Merger; Certain Effects of the Offer
     and the Merger  .....................................................................     24
  8. Rights of Stockholders in the Merger    .............................................     26
  9. The Merger Agreement  ...............................................................     26
 10. Interests of Certain Persons in the Offer and the Merger  ...........................     34
 11. Share Ownership by Parent, Purchaser and Their Affiliates ...........................     35
 12. Beneficial Ownership of Shares    ...................................................     37
THE OFFER   ..............................................................................     39
  1. Terms of the Offer; Expiration Date  ................................................     39
  2. Procedure for Accepting the Offer and Tendering Shares    ...........................     40
  3. Withdrawal Rights  ..................................................................     43
  4. Acceptance for Payment and Payment for Shares    ....................................     44
  5. Certain Federal Income Tax Consequences of the Offer   ..............................     45
  6. Price Range of Shares; Dividend Information   .......................................     46
  7. Effect of the Offer on the Market for Shares, Margin Regulations and Registration
     under the Exchange Act   ............................................................     47
  8. Certain Information Concerning the Company    .......................................     48
  9. Certain Information Concerning the Purchaser and the Parent  ........................     50
 10. Source and Amount of Funds  .........................................................     52
 11. Certain Conditions of the Offer   ...................................................     53
 12. Certain Legal Matters    ............................................................     54
 13. Fees and Expenses  ..................................................................     58
 14. Miscellaneous   .....................................................................     59
</TABLE>
SCHEDULE I     DIRECTORS AND EXECUTIVE OFFICERS OF PARENT AND
               PURCHASER
SCHEDULE II    DIRECTORS AND EXECUTIVE OFFICERS OF THE COMPANY
SCHEDULE III   AUDITED FINANCIAL STATEMENTS (AND RELATED NOTES)
               FOR THE COMPANY FOR THE FISCAL  YEARS ENDED  DECEMBER  31,  1994,
               1995 AND 1996 AND UNAUDITED  FINANCIAL  STATEMENTS  FOR THE THREE
               MONTHS ENDED MARCH 31, 1996 AND 1997
ANNEX A        OPINION OF SMITH BARNEY INC.
ANNEX B        OPINION OF WHEAT, FIRST SECURITIES, INC.
ANNEX C        RIGHTS OF DISSENTING STOCKHOLDERS UNDER THE
               DELAWARE GENERAL CORPORATION LAW


<PAGE>


TO THE STOCKHOLDERS OF
COMMUNITY CARE OF AMERICA, INC.



                                  INTRODUCTION


     IHS Acquisition XXVI, Inc., a Delaware  corporation (the "Purchaser") and a
wholly-owned  subsidiary of Integrated  Health  Services,  Inc. (the  "Parent"),
hereby  offers to purchase all  outstanding  shares of common  stock,  par value
$0.0025 per share (the "Shares"), of Community Care of America, Inc., a Delaware
corporation  (the  "Company"),  at $4.00 per  Share,  net to the seller in cash,
without  interest  (the  "Offer  Price"),  upon the  terms  and  subject  to the
conditions  set forth in this Offer to  Purchase  and in the  related  Letter of
Transmittal (which collectively constitute the "Offer").

     THE BOARD OF DIRECTORS OF THE COMPANY (THE "COMPANY  BOARD"),  BY UNANIMOUS
VOTE OF ALL  DIRECTORS  PRESENT AND VOTING (WITH THE TWO  DIRECTORS WHO ARE ALSO
DIRECTORS  OF PARENT  ABSTAINING  OR NOT  ATTENDING),  BASED  UPON,  AMONG OTHER
THINGS,  THE UNANIMOUS  RECOMMENDATION  AND APPROVAL OF A SPECIAL COMMITTEE (THE
"SPECIAL  COMMITTEE") OF THE DIRECTORS OF THE COMPANY,  HAS DETERMINED  THAT THE
TERMS OF THE OFFER AND THE MERGER (AS  HEREINAFTER  DEFINED) ARE FAIR TO, AND IN
THE BEST INTERESTS OF, THE  STOCKHOLDERS OF THE COMPANY (OTHER THAN PARENT,  THE
PURCHASER AND THEIR  AFFILIATES),  AND RECOMMENDS THAT  STOCKHOLDERS  ACCEPT THE
OFFER AND TENDER  THEIR  SHARES  PURSUANT  TO THE OFFER.  SEE  "SPECIAL  FACTORS
RECOMMENDATIONS OF THE SPECIAL COMMITTEE AND THE COMPANY BOARD;  FAIRNESS OF THE
OFFER AND THE MERGER."

     Each of Smith Barney Inc.  ("Smith  Barney") and Wheat,  First  Securities,
Inc. ("Wheat  First"),  financial  advisors to the Special  Committee and to the
Company  Board,  has  delivered to the Company  Board a written  opinion,  dated
August 1, 1997,  to the effect that,  as of such date and based upon and subject
to certain matters stated therein,  the $4.00 per Share cash consideration to be
received by the holders of the Shares (other than Parent and its  affiliates) in
the Offer and the  Merger was fair to such  holders  from a  financial  point of
view.  The full text of the Smith  Barney and Wheat First  opinions are attached
hereto as Annexes A and B,  respectively,  and should be read  carefully  and in
their entirety for the assumptions made,  matters  considered and limitations on
the review  undertaken by Smith Barney and Wheat First in connection  with their
respective  opinions.  The opinions of Smith Barney and Wheat First are directed
to the Company  Board and relate only to the fairness of the cash  consideration
to be received in the Offer and the Merger by holders of the Shares  (other than
Parent and its  affiliates)  from a financial  point of view, do not address any
other  aspect of the  Offer or the  Merger or  related  transactions  and do not
constitute a  recommendation  to any stockholder as to whether such  stockholder
should  tender  Shares in the Offer.  See  "SPECIAL  FACTORS -  Opinions  of the
Company's Financial Advisors."

     The Company has filed with the  Securities  and  Exchange  Commission  (the
"Commission") a  Solicitation/Recommendation  Statement on Schedule 14D-9, which
is being mailed to stockholders herewith.

     The Offer is conditioned upon, among other things,  (i) there being validly
tendered and not withdrawn  prior to the Expiration Date (as defined below) that
number of Shares which constitutes at least a majority of the outstanding Shares
on a fully-diluted basis on the date of purchase (the "Minimum Condition"), (ii)
the expiration or termination of any waiting period under the  Hart-Scott-Rodino
Antitrust  Improvements Act of 1976, as amended, and the regulations  thereunder
(the "HSR Act")  applicable to the purchase of Shares  pursuant to the Offer and
(iii) the satisfaction of the other conditions set forth in "THE OFFER - Certain
Conditions of the Offer." The Offer is not subject to any financing condition.

     The Company has advised the Purchaser that as of July 28, 1997,  there were
7,597,801 Shares outstanding and options and warrants outstanding to purchase an
additional  3,060,435 Shares,  including  warrants to purchase  1,189,274 Shares
owned by the Parent.  Therefore,  the Minimum  Condition  would be  satisfied if
5,329,119  Shares are validly  tendered  and not  properly  withdrawn.  Although
neither  Parent nor the Purchaser  owns any  outstanding  Shares,  the executive
officers and directors of Parent  beneficially own 1,636,095  Shares  (including
737,392 Shares  subject to a voting  agreement in favor of Dr. Robert N. Elkins,
Chairman of the Board and Chief Executive  Officer of Parent,  and 46,231 Shares
issuable  upon the  exercise of options),  and Parent owns  warrants to purchase
1,189,274  Shares.  Two related  stockholders  of the  Company  and Dr.  Elkins,
collectively owning 2,459,888  outstanding Shares (excluding 461,790 outstanding
Shares beneficially owned by Dr. Elkins, of which 449,790 Shares are



                                        1

<PAGE>






subject to a voting agreement in his favor and with respect to which he does not
have sole  dispositive  power),  have entered into Voting and Tender  Agreements
pursuant to which they have agreed,  among other things,  to tender their Shares
in the Offer. Such 2,459,888 outstanding Shares represent approximately 32.4% of
the outstanding Shares and approximately 46.2% of the 5,329,119 Shares needed to
satisfy the Minimum Condition. See "SPECIAL FACTORS - Share Ownership by Parent,
Purchaser and Their Affiliates."

     The  Purchaser  has been  advised by the Company  that,  to the best of its
knowledge,  and subject to  applicable  securities  laws,  all of the  Company's
executive officers and directors  currently intend to tender all Shares owned by
them  pursuant to the Offer.  The  Company's  executive  officers and  directors
currently own  1,467,196  Shares  (excluding  105,238  Shares  issuable upon the
exercise of stock options, 12,000 Shares owned by Dr. Elkins' spouse and 385,112
Shares  subject to a voting  agreement in favor of Dr.  Elkins,  with respect to
which he has no  dispositive  power,  and which are not owned by  directors  and
executive officers of the Company).  Such 1,467,196  outstanding Shares owned by
the Company's  executive  officers and directors,  which  represent 19.5% of the
outstanding Shares, include 1,136,157 Shares beneficially owned by directors and
executive  officers of the Parent  (excluding  46,231  Shares  issuable upon the
exercise of options and  excluding  Shares  subject to the voting  agreement  or
owned by Dr. Elkins' spouse),  representing 15.0% of the outstanding Shares. See
"SPECIAL FACTORS - Interests of Certain Persons in the Offer and the Merger."

     The Offer is being made pursuant to an Agreement and Plan of Merger,  dated
as of August 1, 1997 (the "Merger Agreement"), among the Company, the Parent and
the Purchaser. The Merger Agreement provides, among other things, for the making
of the  Offer  by the  Purchaser,  and  further  provides  that as  promptly  as
practicable following the completion of the Offer and the satisfaction or waiver
of certain other conditions (see "THE OFFER - Certain Conditions of the Offer"),
the  Purchaser  will be merged with and into the Company (the  "Merger") and the
Company will continue as the surviving corporation (the "Surviving Corporation")
in  the  Merger   and  become  a   wholly-owned   subsidiary   of  the   Parent.
Notwithstanding  the foregoing,  at the election of the Parent, any wholly-owned
subsidiary of the Parent may be  substituted  for the Purchaser as a constituent
corporation in the Merger.  At the effective time of the Merger (the  "Effective
Time"),  each Share  outstanding  immediately prior to the Effective Time (other
than  Shares  held by the  Purchaser,  the  Parent  or any  direct  or  indirect
subsidiary of the Parent, the Company or any of its subsidiaries, which shall be
canceled, and other than Shares, if any, held by stockholders who have not voted
in favor of the Merger or  consented  thereto in writing  and who have  properly
demanded appraisal rights with respect thereto under the General Corporation Law
of the State of Delaware (the "Delaware GCL")) will, by virtue of the Merger and
without any action on the part of the stockholder thereof, be converted into the
right to receive  $4.00 in cash or any higher  price paid per Share in the Offer
(the  "Merger  Consideration")  payable  to  the  stockholder  thereof,  without
interest thereon,  upon surrender of the certificate formerly  representing such
Share. The Merger Agreement is more fully described under "SPECIAL FACTORS - The
Merger Agreement."

     Consummation of the Merger is subject to a number of conditions,  including
approval  by the  stockholders  of the  Company if such  approval is required by
applicable  law. If the Purchaser  purchases not less than that number of Shares
needed to satisfy  the Minimum  Condition,  it will be able to effect the Merger
without the  affirmative  vote of any other  stockholder of the Company.  If the
Purchaser acquires at least 90% of the outstanding Shares,  Purchaser intends to
approve and  consummate  the Merger  without any action by, or any further prior
notice to, the other  stockholders  of the Company  pursuant  to the  short-form
merger  provisions of the Delaware GCL. If, however,  after  consummation of the
Offer  Purchaser  owns less than such number of Shares,  a vote of the Company's
stockholders will be required under the Delaware GCL to approve the Merger,  and
a significantly longer period of time will be required to effect the Merger. See
"SPECIAL FACTORS - Purpose and Structure of the Offer and the Merger; Reasons of
Parent  and  Purchaser  for the Offer and the  Merger"  and "THE  OFFER  Certain
Conditions of the Offer."


     The Merger Agreement  provides that following the satisfaction or waiver of
the  conditions  to the  Offer,  the  Purchaser  will  accept  for  payment,  in
accordance  with the terms of the Offer,  all Shares  validly  tendered  and not
withdrawn pursuant to the Offer as soon as practicable after the Expiration


                                       2

<PAGE>






Date. The initial expiration date of the Offer is 12:00 Midnight,  New York City
time, on Thursday,  September 4, 1997.  However,  certain  conditions may not be
satisfied as of such date.  See "THE OFFER - Certain  Conditions  of the Offer."
The Merger Agreement provides that the Purchaser may extend the Offer beyond the
scheduled  expiration date, if at the scheduled expiration date of the Offer any
of the  conditions to the  Purchaser's  obligation to accept for payment and pay
for the Shares shall not have been satisfied or waived, until such time that the
conditions are satisfied or waived, and under certain other  circumstances.  See
"SPECIAL FACTORS - The Merger Agreement."

     No appraisal  rights are available in connection  with the Offer;  however,
stockholders  who do not vote for the  Merger  and  comply  with the  applicable
provisions  of the Delaware GCL will have the right to seek  appraisal  and have
the "fair value" of their Shares (exclusive of any element of value arising from
the accomplishment or expectation of the Merger) judicially  determined and paid
to them,  regardless of whether the Merger is consummated with or without a vote
of the Company's stockholders.  See "SPECIAL FACTORS - Rights of Stockholders in
the Merger."


     THE OFFER DOES NOT CONSTITUTE A SOLICITATION  OF PROXIES FOR ANY MEETING OF
THE COMPANY'S STOCKHOLDERS. ANY SUCH SOLICITATION WOULD BE MADE ONLY PURSUANT TO
SEPARATE PROXY MATERIALS COMPLYING WITH THE REQUIREMENTS OF SECTION 14(a) OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED (THE "EXCHANGE ACT").


     Tendering  stockholders will not be obligated to pay brokerage commissions,
solicitation  fees or,  subject to  Instruction 6 of the Letter of  Transmittal,
stock  transfer  taxes on the  purchase of Shares by  Purchaser  pursuant to the
Offer.  However, any tendering  stockholder or other payee who fails to complete
and sign the  Substitute  Form W-9 that is included in the Letter of Transmittal
may be subject to a required backup federal income tax withholding of 31% of the
gross proceeds payable to such stockholder or other payee pursuant to the Offer.
See  "THE  OFFER -  Certain  Federal  Income  Tax  Consequences  of the  Offer."
Purchaser will pay all charges and expenses of Shattuck  Hammond  Partners Inc.,
as Dealer Manager (in such capacity, the "Dealer Manager"),  Citibank,  N.A., as
Depositary (in such capacity, the "Depositary"),  and MacKenzie Partners,  Inc.,
as Information Agent (in such capacity,  the "Information  Agent"),  incurred in
connection with the Offer. For a description of the fees and expenses to be paid
by Purchaser, see "THE OFFER - Fees and Expenses."

     The information  contained in this Offer to Purchase concerning the Company
was supplied by the Company. Parent and the Purchaser take no responsibility for
the accuracy of such  information.  The  information  contained in this Offer to
Purchase concerning the Offer, the Merger, Parent and the Purchaser was supplied
by  Purchaser.  The Company  takes no  responsibility  for the  accuracy of such
information.

     THIS  OFFER TO  PURCHASE  AND THE  RELATED  LETTER OF  TRANSMITTAL  CONTAIN
IMPORTANT INFORMATION WHICH SHOULD BE READ CAREFULLY BEFORE ANY DECISION IS MADE
WITH RESPECT TO THE OFFER. ALSO SEE "THE OFFER - MISCELLANEOUS"  FOR INFORMATION
REGARDING CERTAIN  ADDITIONAL  DOCUMENTS FILED WITH THE COMMISSION IN CONNECTION
WITH THE OFFER.



                                       3

<PAGE>





                                SPECIAL FACTORS



1. BACKGROUND OF THE OFFER AND THE MERGER.

     The Company develops and operates  skilled nursing  facilities in medically
underserved  rural  communities.  The Company began  operations in December 1993
with  its   acquisition   of  all  of  the  capital  stock  of  MeritWest   Inc.
("MeritWest"),  which  operated 28 long-term care  facilities,  of which 14 were
owned, 13 were leased and one was managed,  in six states. Dr. Robert N. Elkins,
a director of the Company and Chairman of the Board and Chief Executive  Officer
of Parent, was a founder and principal  stockholder of the Company. See "SPECIAL
FACTORS - Interests of Certain Persons in the Offer and the Merger." The Company
subsequently consummated a series of acquisitions and entered into various lease
and management  agreements.  The Company's  business strategy was to improve the
acquired  facilities  and use them as a  platform  to provide  an  expanded  and
coordinated  range of health care services,  while  continuing to seek expansion
opportunities.

     In August 1995,  the Company  completed an initial  public  offering of its
common stock.  The Company issued  3,450,000  Shares to the public at a price of
$9.50 per Share,  and raised net proceeds of  approximately  $27.6 million.  The
Company used the net proceeds of the offering  principally to repay indebtedness
and to redeem shares of preferred stock.

     At the time of  consummation  of the public  offering in August  1995,  the
Company  assumed the management of nine long-term  care  facilities  (the "Sandy
River Facilities") in Maine pursuant to a series of management agreements (which
also  contemplated the Company managing one additional  facility upon completion
of construction and the achievement of certain occupancy levels). As part of the
arrangement, the Company also obtained an option to acquire these ten facilities
pursuant to which the Company made a $5.0 million non-refundable deposit.

     During 1996, the Company sought to raise  additional funds through debt and
equity public  offerings  with the  objective of reducing its  revolving  credit
indebtedness and increasing working capital.  These offerings were unsuccessful,
in part due to investor  concerns related to the Medicare  decertification  of a
nursing  facility  operated by the Company and growing  concerns  regarding  the
ability of the Sandy River  Facilities to generate  sufficient  cash flow to pay
the Company's management fees and consequent write-off risks.

     In February  1996, the Company  engaged Smith Barney to pursue  alternative
courses of  obtaining a capital  infusion  for the  Company,  finding a suitable
joint venture partner or selling the Company.  During the first quarter of 1996,
approximately 34 parties were contacted on the Company's  behalf,  of which four
submitted initial  indications of interest.  However,  the Company was unable to
either obtain a capital infusion or to find a purchaser for the Company.

     The Sandy River  Facilities  continued to fail to generate  sufficient cash
flows to pay the  Company's  management  fees and, in August  1996,  the Company
terminated both its management agreement and purchase option agreements relating
to those  facilities.  The  Company  also  separately  determined  to close four
primary care clinics, four adult day care centers and one physician practice. As
a result principally of the termination of the agreements  relating to the Sandy
River  Facilities and the nine unrelated  closings,  the Company  recorded $19.2
million in charges during the second quarter of 1996.

     In October 1996, the Company requested that Smith Barney assist the Company
in again evaluating debt and equity financing  alternatives or the possible sale
of the Company. Approximately 40 parties were contacted on the Company's behalf,
of which five  submitted  initial  indications of interest.  However,  no viable
offers were submitted to the Company.

     The Company  recorded $10.7 million of charges during the fourth quarter of
1996.  These charges related  principally to: the termination of an agreement to
acquire  certain rural hospitals in Georgia and the transfer back to the sellers
of one hospital  acquired in connection with the proposed  transaction since the
Company was unable to secure  financing to complete  the  proposed  transaction;
costs  associated with  unsuccessful  debt and equity  offerings by the Company;
contractual  allowances  and  revenue  adjustments;   and  other  balance  sheet
adjustments.



                                       4

<PAGE>






     As a result of the foregoing, the Company recorded a total of $29.9 million
of write-offs  and charges during the year ended December 31, 1996. For the same
period,  the Company incurred a loss of $18.9 million and had negative cash flow
from  operating  activities.  As of December 31, 1996, the Company had a working
capital  deficiency  of $10.9 million and was in default with respect to certain
of its debt, lease and other agreements.  These circumstances raised doubt about
the Company's ability to continue as a going concern.


     In December  1996, as part of a financial  restructuring  plan, the Company
refinanced its bank revolving line of credit to extend the payment terms related
to $4.8 million of debt due at December 31, 1996. The Company also  subsequently
obtained the release of $4.1 million of security deposits through a modification
of agreements  with its principal  lessor to reduce rental payments and obtained
waivers of financial covenant violations and related defaults under certain debt
and lease agreements through February 1998.


     The  Company  also  entered  into a  number  of  transactions  with  Parent
commencing  in  December  1996.  Dr.  Elkins,  a  director  of the  Company  and
beneficial owner of approximately 21.0% of the Shares, is Chairman of the Board,
Chief Executive Officer and a significant stockholder of Parent. John Silverman,
a director of the  Company,  is also a  director,  officer  and  stockholder  of
Parent. Michael Blass, a director of the Company, has provided legal services to
Parent as well as the  Company.  Deborah  Lau, a  director  of the  Company  and
currently its  President,  had been an employee of Parent until she became Chief
Operating  Officer  of the  Company  in  October  1995 as  part of a  management
restructuring. Ms. Lau has no continuing contractual arrangements with Parent.


     The  Company  had  previously  (in January  1994)  entered  into a Medicare
consulting   agreement  with  Symphony  Care  Consulting,   Inc.   ("SCCI"),   a
wholly-owned  subsidiary of Parent. The agreement was amended on May 1, 1995 and
provided  for SCCI's  provision  to the  Company of Medicare  reimbursement  and
certification   services,   including  training,  cost  report  preparation  and
accounting services,  through January 1996. The Company paid to SCCI $410,000 in
1994,  $453,000 in 1995 and $148,000 in 1996 for these  services.  In 1996,  the
Company paid  Symphony  Rehabilitation  Services  ("SRS") and Symphony  Pharmacy
Services ("SPS"), both wholly-owned subsidiaries of Parent, $162,000 for therapy
services  and $98,000 for pharmacy  services,  respectively.  In  addition,  the
Company  paid  Parent  approximately  $500,000  in 1994 and  $186,000 in 1995 to
reimburse  Parent for expenses  incurred on behalf of the Company in  connection
with the start-up of the Company's operations, the MeritWest acquisition and due
diligence services in connection with the Company's public offering.  No amounts
were  paid to  Parent  in 1996.  The  Company  believes  that  the  terms of the
agreement  with SCCI and the amounts  paid to Parent,  SRS and SPS for  services
were on terms as favorable as could have been obtained from  unaffiliated  third
parties.


     On December  27,  1996,  the Company and Parent  entered  into a Management
Agreement (the  "Management  Agreement")  pursuant to which the Company  engaged
Parent  to  supervise,  manage  and  operate  the  financial,  accounting,  MIS,
reimbursement and ancillary services contracting functions for the Company until
December 31, 2001. The Management  Agreement  provides for the Company to pay to
Parent for its services,  until December 31, 1997, an amount equal to the lesser
of 2% of the Company's  gross revenues (as defined) or the Company's  annualized
cost of  performing  those  services  itself  based on the  period  July 1, 1996
through December 31, 1996.  Thereafter,  the management fee payable to Parent is
to be the lesser of 2% of the Company's  gross revenues or a percentage of gross
revenues determined by comparing the Company's cost of performing such functions
during the period July 1, 1996 through  December 31, 1996 to its gross  revenues
for that period.  The gross  revenues  percentage  may be increased from 2.0% to
2.5% by  mutual  agreement  of the  parties  following  Parent's  review  of the
Company.


     At the  same  time the  Company  and  Parent  entered  into the  Management
Agreement,  IHS Financial  Holdings,  Inc., a wholly-owned  subsidiary of Parent
("IHS  Holdings"),   also  entered  into  a  loan  agreement  (the  "First  Loan
Agreement")  which,  as amended on January  13,  1997,  entitles  the Company to
borrow,  until December 27, 1998, amounts on a revolving credit basis so that no
more than $5.0 million is outstanding at any time.  Loan advances are subject to
the consent of Parent, which consent



                                       5

<PAGE>






may not be unreasonably withheld.  This revolving credit facility bears interest
at a rate per annum equal to the annual  rate of interest  set forth in Parent's
revolving  credit  agreement with Citibank,  N.A., plus 2%. Repayment of amounts
advanced under this line of credit are  subordinated  to the payment of up to an
aggregate of $30 million of principal and interest on the Company's  obligations
to its two  principal  unaffiliated  third party  lenders.  In  connection  with
entering  into the  revolving  credit  facility,  the  Company  issued to Parent
warrants to  purchase an  aggregate  of 752,182  Shares,  one-half of which were
exercisable  until  January 13, 1999 at $3.22 per share (the average of the high
and low  trading  prices  of the  Shares  on  January  14 and 15,  1997) and the
remaining one-half of which were exercisable until January 13, 2002 at $6.44 per
Share.

     Parent  initially  declined the  opportunity to enter the rural  healthcare
market at the time the Company was formed. However, by the end of 1996, with the
changes  in the  healthcare  industry,  such  as the  expected  introduction  of
prospective pay for nursing homes and continued pressure on reimbursement rates,
as well as Parent's expansion of its home healthcare services in connection with
the  establishment of its post-acute care network system based on geriatric care
facilities and home healthcare,  Parent detemined that geriatric care facilities
serving medically  underserved rural communities could be an important strategic
component of its post-acute care network system. However, Parent was at the time
unwilling to enter this market through  acquisition  until it better  understood
the rural healthcare marketplace. Accordingly, the Parent believed that entering
into the  Management  Agreement  would provide it with an  opportunity to better
understand  the rural  healthcare  marketplace  without  making a large  capital
commitment.

     In  negotiating  the terms of the  Management  Agreement and the First Loan
Agreement,  Parent appointed a special committee consisting of two directors who
had no financial interest or other  relationship with the Company.  This special
committee  engaged  separate  legal  counsel and a financial  advisor,  Shattuck
Hammond Partners Inc. ("Shattuck Hammond"),  to advise it in connection with the
negotiation  of the  Management  Agreement,  the First  Loan  Agreement  and the
warrants issued in connection with the First Loan Agreement.

     On April 14, 1997,  Parent agreed to guarantee  certain  obligations of the
Company to the  Company's  principal  revolving  credit lender and to the lender
which has financed the Company's major  acquisitions.  To induce Parent to issue
such guarantees, the Company agreed to reimburse Parent for such amounts paid by
Parent on behalf of the Company,  including costs, fees and expenses, and to pay
Parent  interest at the rate of 15% per annum on all amounts  which become owing
to Parent from the Company with respect thereto.  In connection  therewith,  the
Company  also issued  warrants to Parent to  purchase  an  aggregate  of 379,900
Shares  until  April 15,  2002 at $1.9375  per Share (the  closing  price of the
Shares on April 14,  1997).  The  number of Shares  subject to each of the above
warrants and the exercise prices are subject to adjustment in certain instances,
including  if  the  Company   issues  Shares  of  Common  Stock  (or  securities
convertible into Common Stock) at less than the applicable  exercise price. As a
result of the  issuance of the warrants in April 1997,  the  warrants  issued to
Parent in January 1997 were adjusted to cover 809,374 Shares,  one-half of which
are  exercisable at $2.99 per Share until January 13, 1999 and one-half of which
are  exercisable  at $5.99 per Share until January 13, 2002. In connection  with
the  issuance  of each of the above  warrants,  the  Company  granted  to Parent
certain rights to cause the Shares  issuable upon exercise of the warrants to be
registered under the Securities Act of 1933, as amended (the "Securities  Act"),
at the Company's expense.

     In April 1997,  at the  Company's  direction,  Smith  Barney  began a third
attempt to solicit buyers for the Company. This time,  approximately 38 parties,
including  Parent,  were contacted.  By mid-May 1997, four parties had submitted
preliminary expressions of interest in acquiring the Company.

     On June 6, 1997,  the Board of  Directors  of the Company held a meeting at
which it authorized the formation of the Special Committee to solicit and review
any  acquisition  proposals,  to retain  counsel and an  investment  bank in the
Special  Committee's  discretion and to conduct an auction  process as it deemed
appropriate.  At that meeting,  Dr. Elkins indicated that Parent  management was
considering  the  possibility of submitting to its Board of Directors a proposal
to bid for the purchase of the Company.  Accordingly,  the Special Committee was
organized to include the directors of the Company other than Messrs.  Elkins and
Silverman, who are both directors of Parent.



                                       6

<PAGE>






     On June 11, 1997, the Special Committee held its first meeting. The Special
Committee  retained the law firm of Chadbourne & Parke LLP, which had previously
acted as special  counsel to the Company  Board on various  matters  relating to
representation of the Company in negotiations with Parent. The Special Committee
also decided,  upon advice of counsel, to seek an opinion in connection with any
acquisition  transaction  from an investment bank that had no previous  dealings
with Parent or the Company,  in addition to an opinion from Smith Barney,  since
Smith Barney from time to time provides investment banking services to Parent on
matters  unrelated  to the  Company.  The Special  Committee  directed  that its
counsel  prepare a form of merger  agreement  for  submission to the parties who
provided  preliminary  indications  of interest  and that each of the bidders be
contacted  with a view to  reducing  the  conditions  to the offers made by such
bidders and increasing the consideration  offered by them. The Special Committee
also  requested  that Parent be contacted to determine if it would be submitting
an offer, and also directed that its advisors prepare a press release announcing
that the Company was soliciting potential buyers for the Company.

     On June 13, 1997,  the Company  publicly  announced  that it was evaluating
credible indications of interest from potential buyers.

     Between  June 11, 1997 and June 24,  1997,  the Special  Committee  members
communicated informally by telephone regarding the auction process, selection of
an  investment  banker in  addition  to Smith  Barney to  render an  opinion  in
connection  with  a  transaction  and  related  matters.   During  this  period,
discussions  continued  with  the  parties  who  had  submitted  expressions  of
interest, including Parent.

     On June 24, 1997, the Special Committee, on behalf of the Company,  engaged
Wheat First to render an opinion in  connection  with any  proposed  transaction
that might result from the auction  process.  Also,  on June 24,  1997,  Michael
Blass resigned from the Special Committee. He indicated that he had been advised
that Parent had  decided to submit a bid to  purchase  the Company and felt that
his resignation was appropriate in light of the fact that his law firm,  Blass &
Driggs,  had  provided  and  continued  to provide  legal  services to Parent on
matters unrelated to the Company.

     During  1997,  Parent  continued  to expand its  post-acute  care  network,
particularly in the home healthcare area. In July 1997, Parent agreed to acquire
RoTech Medical  Corporation,  which provides  comprehensive  home healthcare and
primary care  physician  services,  principally  to patients in non- urban areas
(the "RoTech Acquisition"). The proposed RoTech Acquisition, as well as Parent's
acquisition of First American  Health Care of Georgia,  Inc. in October 1996 and
Arcadia Services, Inc. in July 1997, will significantly expand Parent's presence
in the rural  home  healthcare  market.  As a  result,  Parent  determined  that
operating  geriatric  care  facilities in the areas where it provided rural home
healthcare  services would benefit its home  healthcare  business and expand the
scope of its post-acute care network.  Accordingly,  Parent determined to pursue
the acquisition of the Company.

     On June 25, 1997,  Parent  delivered a bid to acquire all of the  Company's
outstanding  Shares in a merger  pursuant to which  stockholders  of the Company
would receive $3.50 per Share in cash.

     On June 26, 1997,  the Special  Committee  held a meeting,  attended by the
Company's  legal  and  financial  advisors,  to  discuss  the bids that had been
presented.  The Special  Committee  was informed  that one of the entities  that
initially provided an expression of interest had withdrawn its bid. With respect
to the bids submitted, the Special Committee was informed as follows:

       - One entity that had  previously  provided an  expression of interest in
   buying the Company at $3.00 per Share in cash had,  following  completion  of
   its due  diligence,  reduced its bid to $1.50 per Share in cash.  The Special
   Committee had a high degree of confidence  that the entity could finance such
   a  transaction.  However,  the  Special  Committee  believed  that  this  bid
   represented a very conservative valuation of the Company.

       -  Another  entity  bid $3.41 per  Share in cash.  The  bidder,  however,
   refused to disclose its financing sources unless the Special Committee agreed
   to engage  in  exclusive  negotiations  with such  bidder.  Further,  the bid
   provisions  required  establishment  of an  escrow  account  and  significant
   conditions relating to the restructuring of existing financing  arrangements,
   which the Company  believed made the  consummation  of any transaction at the
   bid price subject to significant risk of



                                       7

<PAGE>






   delay or  failure.  The bidder did not reveal its  financing  sources and was
   unwilling to permit the Company to conduct due diligence  with respect to the
   ability  of the  bidder to finance  the  transaction,  until such time as the
   Company was prepared to negotiate exclusively with the bidder.


       - Parent submitted a bid for $3.50 cash per Share. The Special  Committee
   noted that the offer  contained no financing  contingency  and that the offer
   had  already  been  approved  by a special  committee  of  Parent's  board of
   directors.


       -  A  fourth   entity   submitted  a  bid  calling  for  an  exchange  of
   publicly-traded  shares of such entity for Shares of the Company. The bid was
   nominally  valued  at  $4.10  per  Share,  based on the  market  price of the
   bidder's shares.  The Special Committee  requested that Wheat First and Smith
   Barney each analyze certain pro forma financial  information  relating to the
   combined entity resulting from a possible  transaction with this bidder.  The
   Special Committee also reviewed with its advisors certain issues relating to,
   among other things,  liquidity of the trading market for shares of the bidder
   following a merger, capitalization of the combined entity, earnings accretion
   or  dilution,  working  capital  needs,  regulatory  impact of the merger and
   timing issues.


     The Special Committee directed that its advisors focus their efforts on the
stock-for-stock  bidder and a cash  merger  with  Parent  with a view to seeking
increased consideration and minimizing conditions to closing.


     On July 1, 1997,  Parent  notified  the Company that it had raised its cash
offer to $4.00 per Share.


     On July 1, 1997, the  stock-for-stock  bidder raised its offer to $4.26 per
Share, again based on the current market price of its publicly-traded shares.


     On July 6, 1997, the Special  Committee met to review the sale process.  At
such meeting,  the Special Committee was updated as to the revised status of the
bids  received  from Parent and the  stock-for-stock  bidder,  and reviewed with
Wheat  First and Smith  Barney  certain  pro forma  financial  information  with
respect to the stock-for-stock  bidder following a merger with the Company.  For
the reasons  discussed  under  "SPECIAL  FACTORS-Recommendations  of the Special
Committee  and the Company  Board;  Fairness of the Offer and the  Merger,"  the
Special  Committee  determined that the proposed  transaction with Parent was in
the best interests of the Company's stockholders.


     The  Special  Committee  directed  its  advisors  to  enter  into  detailed
negotiations with Parent with a view to executing a definitive merger agreement.


     Between July 7 and July 31,  1997,  the Company and Parent  negotiated  the
terms of a definitive  merger  agreement.  During this  period,  the Company and
Parent also negotiated  terms of a $5.0 million secured loan financing which the
Company  requested  to  provide  it  working  capital  in order to avoid  making
additional asset dispositions.


     On July 18, 1997,  the Company and IHS Holdings  entered into a second loan
agreement,  which entitles the Company to borrow for working  capital  purposes,
until July 18,  1999,  amounts on a revolving  credit basis so that no more than
$5.0 million is outstanding  at any time.  Loan advances are to be made directly
to creditors of the Company,  including the Parent,  in payment of the Company's
obligations to such  creditors.  Proceeds used to pay the Company's  obligations
are directed by the Parent in accordance  with the  Management  Agreement.  This
revolving credit facility bears interest at a rate per annum equal to the annual
rate of interest set forth in Parent's revolving credit agreement with Citibank,
N.A.,  plus 4%.  Repayment  of  amounts  advanced  under this line of credit are
subordinated  to the payment of up to an aggregate of $13.6 million of principal
and interest on the  Company's  obligations  to one of the  Company's  principal
unaffiliated third-party lenders. The revolving credit facility is guaranteed in
full by Community Care of Nebraska,  Inc.,  ECA Holdings,  Inc., CCA of Midwest,
Inc.,  Quality Care of Columbus,  Inc.,  Quality Care of Lyons,  Inc. and W.S.T.
Care,  Inc.,  each a  wholly-owned  subsidiary  of the  Company  (together,  the
"Guarantors").  The  revolving  line of credit is secured  by the real  property
assets of the Company and its subsidiaries. At July 31, 1997, no borrowings were
outstanding under this facility.



                                       8

<PAGE>






     On July 30,  1997,  the  Special  Committee  met to review the terms of the
proposed  merger  agreement.  Wheat First and Smith Barney each made a financial
presentation  and advised the Special  Committee that,  subject to review of the
final  documentation for the transaction and certain other customary matters, it
was prepared to render an opinion to the effect that the cash  consideration  to
be received by holders of Shares (other than Parent and its  affiliates)  in the
Offer and the Merger was fair from a  financial  point of view to such  holders.
See "SPECIAL  FACTORS-Opinions of the Company's Financial  Advisors." After full
discussion,  the Special Committee members determined to recommend the Merger to
the Company Board for approval.

     On July 31, 1997, the Company Board met to review the terms of the proposed
Merger Agreement and the  recommendation of the Special  Committee.  Wheat First
and Smith Barney each made a financial  presentation  and orally rendered to the
Company  Board their  respective  opinions  (which  opinions  were  subsequently
confirmed  by delivery of written  opinions  dated  August 1, 1997,  the date of
execution of the Merger  Agreement)  to the effect that,  as of the date of such
opinions and based upon and subject to certain matters stated therein,  the cash
consideration  to be  received  by holders of Shares  (other than Parent and its
affiliates) in the Offer and the Merger was fair from a financial  point of view
to such  holders.  See "SPECIAL  FACTORS - Opinions of the  Company's  Financial
Advisors."  A  majority  of the  Company  Board,  including  a  majority  of the
non-employee  directors,  approved the Offer and the Merger.  Dr. Elkins did not
attend the meeting, and Mr. Silverman  abstained,  noting that he was a director
of Parent.

     On August 1, 1997,  representatives  of the Company  and Parent  signed the
definitive Merger  Agreement.  On the same date, the Company and Parent issued a
joint press release announcing the signing of the Merger Agreement.


2. RECOMMENDATIONS OF THE SPECIAL COMMITTEE AND THE COMPANY BOARD; FAIRNESS OF
    THE OFFER AND THE MERGER.

     At a meeting  held on July 30,  1997,  the  Special  Committee  unanimously
determined to recommend that the Company Board approve the Offer and the Merger.
At a meeting held on July 31, 1997, the Company Board,  by unanimous vote of all
directors  present and voting (with the two directors who are also  directors of
Parent  abstaining or not attending) based on the  recommendation of the Special
Committee,  determined  that the terms of the Offer and the Merger were fair to,
and in the best  interests of,  stockholders  of the Company (other than Parent,
the Purchaser and their affiliates), and approved the Offer and Merger.

     In reaching its conclusions,  the Special Committee  considered a number of
factors, including but not limited to the following:


       (i)  the  Company's   financial  condition  and  results  of  operations,
    including its  substantial  net losses since its initial public  offering in
    August 1995;  its reliance  since  inception on  financings as its principal
    source of liquidity;  and its difficulty  during the period since its public
    offering in obtaining financing;


       (ii) the cash  consideration  of $4.00  per Share to be  received  by the
     Company's  stockholders  in the Offer and Merger  represents a  substantial
     premium  over  recent  market  prices (the  closing  price of the Shares as
     reported  on the Nasdaq  National  Market on July 31,  1997,  the last full
     trading  day  prior to the  announcement  of the  execution  of the  Merger
     Agreement,  was  $3.1875)  and the Offer and the  Merger  will  enable  the
     Company's  stockholders  to sell their  Shares at a premium in an otherwise
     relatively illiquid market. See "SPECIAL FACTORS - Purpose and Structure of
     the Offer and the Merger; Reasons of Parent and Purchaser for the Offer and
     the Merger" and "THE OFFER - Price Range of Shares; Dividend Information";


       (iii) the Offer Price and Merger  consideration  represent a  substantial
      premium to the net book value of the  Shares  (which as of March 31,  1997
      was $2.04 per Share on a primary basis);


       (iv) the Company's current business and future  prospects,  including the
     fact that, without increased liquidity, the Company would be constrained in
     its growth;



                                       9

<PAGE>






          (v) partial  sales of the Company's  assets would present  significant
     risks  in  realizing  value  for  the  stockholders  due to  the  liquidity
     constraints on the Company and the effects that  write-offs  resulting from
     asset sales  would have on the  Company's  ability to  maintain  its Nasdaq
     listing and liquidity for the Shares;

          (vi)  uncertainty as to the realizable value to equity holders upon an
     orderly liquidation of the Company's assets;

          (vii) the fact that the  Company  had for more than a  year-and-a-half
     publicly  indicated  it was  seeking a buyer and had been  unsuccessful  in
     finding  a  credible  buyer  with  adequate   financing   sources  to  make
     consummation of a sale probable;

          (viii) the fact that, in the most recent auction process, commenced in
     April 1997, the most viable alternative bid was a stock-for-stock  proposal
     that  involved  significant  risks  which made such offer  unattractive  by
     comparison to the cash offer of Parent.  Although the  stock-for-stock  bid
     had a nominal  value in excess of the  Parent's  cash  offer,  based on the
     market price of the bidder's stock, the Special Committee believed that the
     resulting  post-merger  entity  would  not be a  suitable  vehicle  for the
     Company's   stockholders  to  realize  value.  The  Special  Committee  was
     influenced in its  determination  by the fact that the shares of the bidder
     were  trading  at  multiples  of  approximately  148 times  projected  1997
     earnings and 49 times  projected 1998 earnings,  whereas the mean multiples
     for  comparable  companies  in the  same  industry  were  17.1  times  1997
     projected  earnings  and 14.9 times 1998  projected  earnings.  The Special
     Committee  was  concerned  that  (A)  the  trading  multiple  could  not be
     justified  based on  historical  performance  and that a settling  of share
     prices of the  combined  entity  would  negatively  affect the value of the
     Company's  stockholders' holding in the post-merger entity, (B) the trading
     volume of the shares of the stock-for-stock bidder was low, and there was a
     very small institutional  investor base, so that the Company's stockholders
     would have had limited liquidity for their shares in a post-merger  entity,
     (C) the Company  required working capital to sustain  operations  pending a
     merger,  which it could  reasonably  expect  to  obtain  only by  divesting
     certain assets or obtaining  financing from a prospective  bidder,  and (D)
     divestitures  by the Company  would result in additional  write-offs  which
     would have  jeopardized  the post-merger  entity's  ability to maintain the
     minimum  net worth  required  to  maintain a Nasdaq  listing.  The  Special
     Committee  believed,  based  on  review  of  the  stock-for-stock  bidder's
     historical  working  capital  needs and  sources,  that  liquidity  for the
     Company's operations would be an issue of immediate concern if it pursued a
     transaction with the stock-for-stock bidder;

          (ix) the terms and  conditions of the Offer and the Merger,  including
     the lack of financing as a condition of either the Offer or the Merger, and
     that all stockholders will receive the same price and form of consideration
     for their Shares, whether in the Offer or the Merger;

          (x) the oral presentations  made by the Company's  financial and legal
     advisors to the Special  Committee at a meeting held on July 30, 1997 as to
     various  financial  and  other   considerations   deemed  relevant  to  the
     evaluation of the Offer and the Merger; and

          (xi) the belief on the part of members of the Special Committee, based
     upon their  investigation  regarding  the Company's  business,  its current
     financial  condition and results of operations,  and its future  prospects,
     that the cash  consideration  to be paid in the Offer and the Merger fairly
     reflects the  Company's  value that was  probable of being  obtained by the
     stockholders of the Company in a sale of the Company.

     At a meeting of the Company Board held on July 31, 1997, by unanimous  vote
of all  directors  present  and  voting  (with  the two  directors  who are also
directors of Parent abstaining or not attending),  based upon the recommendation
of  the  Special  Committee,  the  Company  Board  voted  to  recommend  to  the
stockholders  of the Company  that they accept the Offer and tender their Shares
pursuant  to the Offer.  Dr.  Elkins did not attend the  meeting of the  Company
Board at which this recommendation was made and Mr. Silverman abstained,  noting
that he was director of Parent.

     The  members  of  the  Company  Board,  including  the  Special  Committee,
evaluated the various  factors  listed above in light of their  knowledge of the
business,  financial condition and prospects of the Company,  and based upon the
advice of financial and legal advisors. The Company Board also took into



                                       10

<PAGE>

account the  financial  presentations  of the Company's  financial  advisors and
their respective oral opinions (subsequently confirmed in writing) to the effect
that,  as of the date of such  opinions  and based  upon and  subject to certain
matters  stated  therein,  the cash  consideration  to be received by holders of
Shares  (other than Parent and its  affiliates)  in the Offer and the Merger was
fair,  from a financial  point of view, to such holders.  In light of the number
and  variety  of  factors  that the  Company  Board  and the  Special  Committee
considered  in  connection  with their  evaluation  of the Offer and the Merger,
neither the Company  Board nor the Special  Committee  found it  practicable  to
assign relative weights to the foregoing factors and,  accordingly,  neither the
Company  Board nor the  Special  Committee  did so. In  addition  to the factors
listed above,  the Company Board and the Special  Committee each  considered the
fact that while  consummation  of the Offer would result in the  stockholders of
the Company  receiving a premium for their Shares over the trading prices of the
Shares prior to the public announcement of the Merger Agreement, consummation of
the Offer and the Merger would eliminate any opportunity for stockholders of the
Company  (other than Parent,  Purchaser and their  affiliates) to participate in
the potential future growth prospects of the Company.  The Company Board and the
Special  Committee  determined,  however,  that (i) the loss of  opportunity  is
reflected in the Offer Price,  and (ii) there is uncertainty as to the Company's
long-term financial prospects.

     In addition,  the Special  Committee and the Company Board  determined that
the  Offer and the  Merger  are  procedurally  fair to the  stockholders  of the
Company (other than Parent,  Purchaser,  and their  affiliates)  because,  among
other things: (i) the Special Committee, consisting of directors who are neither
designees  of Parent nor persons  having a current  business  relationship  with
Parent,  was  appointed to represent the  interests of the  stockholders  of the
Company (other than Parent,  Purchaser, and their affiliates);  (ii) the Special
Committee  retained  and was advised by  independent  legal  counsel;  (iii) the
Special  Committee  retained  Smith  Barney and Wheat  First as its  independent
financial advisors to assist it in evaluating the Offer and the Merger; and (iv)
the fact that the $4.00 per Share  price and the other terms and  conditions  of
the Merger  Agreement  resulted  from  active  arm's-length  bargaining  between
representatives  of the  Special  Committee,  on the  one  hand,  and a  special
committee of the Board of Directors of the Parent which did not include  persons
who were directors or stockholders of the Company, on the other.

     Each of the Company  Board and the Special  Committee  recognized  that the
Merger  is  not  structured  to  require  the  approval  of a  majority  of  the
stockholders  of the Company (other than Parent or  Purchaser),  and that if the
Offer is consummated  Parent and Purchaser will have sufficient  voting power to
approve the Merger without the affirmative vote of any other  stockholder of the
Company.  Pursuant to the Merger  Agreement,  the  purchase by  Purchaser of all
Shares  validly  tendered in the Offer and not  withdrawn  is a condition to the
Merger.

     In making their respective determinations and recommendations,  each of the
Company Board and the Special Committee was aware of the matters set forth under
"SPECIAL FACTORS - Interests of Certain Persons in the Offer and Merger."


3. OPINIONS OF THE COMPANY'S FINANCIAL ADVISORS


     Smith  Barney Inc.  Smith  Barney was retained by the Company to act as its
financial  advisor in  connection  with the  proposed  Offer and the Merger.  In
connection  with such  engagement,  the  Company  requested  that  Smith  Barney
evaluate the  fairness,  from a financial  point of view,  to the holders of the
Shares  (other  than  Parent  and its  affiliates)  of the  consideration  to be
received by such  holders in the Offer and the Merger.  On July 30,  1997,  at a
meeting of the Special  Committee  held to evaluate the  proposed  Offer and the
Merger,  Smith Barney advised the Special  Committee that,  subject to review of
the final documentation for the transaction and certain other customary matters,
it was  prepared to render an opinion to the effect that the cash  consideration
to be received in the Offer and the Merger by holders of the Shares  (other than
Parent and its  affiliates)  was fair,  from a financial  point of view, to such
holders.  On July 31, 1997,  at a meeting of the Company  Board held to evaluate
the proposed Offer and the Merger,  Smith Barney  delivered to the Company Board
an oral  opinion  (which  opinion was  subsequently  confirmed  by delivery of a
written  opinion  dated  August 1,  1997,  the date of  execution  of the Merger
Agreement), to the effect that, as



                                       11

<PAGE>






of the date of such opinion and based upon and subject to certain matters stated
therein,  the cash  consideration  to be received in the Offer and the Merger by
holders of the Shares (other than Parent and its  affiliates)  was fair,  from a
financial point of view, to such holders.

     In arriving at its opinion,  Smith Barney reviewed the Merger Agreement and
held   discussions   with  certain   senior   officers,   directors   and  other
representatives  and  advisors of the Company and certain  senior  officers  and
other  representatives  of  Parent  concerning  the  business,   operations  and
prospects  of the Company.  Smith Barney  examined  certain  publicly  available
business and  financial  information  relating to the Company as well as certain
financial  forecasts and other  information  and data for the Company which were
provided to or otherwise  discussed  with Smith Barney by the  management of the
Company.  Smith Barney  reviewed the financial terms of the Offer and the Merger
as set forth in the Merger Agreement in relation to, among other things: current
and historical  market prices and trading volumes of the Shares;  the historical
and  projected  earnings  and  other  operating  data  of the  Company;  and the
capitalization  and  financial  condition  of the  Company.  Smith  Barney  also
considered,  to the extent  publicly  available,  the financial terms of certain
other  similar  transactions  recently  effected  which Smith Barney  considered
relevant in evaluating the Offer and the Merger and analyzed certain  financial,
stock market and other publicly available information relating to the businesses
of  other  companies  whose  operations  Smith  Barney  considered  relevant  in
evaluating those of the Company. In connection with its engagement, Smith Barney
was requested to approach,  and held discussions  with, third parties to solicit
indications  of  interest  in a possible  acquisition  of or  investment  in the
Company.  In  addition  to the  foregoing,  Smith  Barney  conducted  such other
analyses and  examinations  and considered  such other  financial,  economic and
market  criteria as Smith Barney deemed  appropriate in arriving at its opinion.
Smith  Barney  noted that its opinion  was  necessarily  based upon  information
available,  and financial,  stock market and other conditions and  circumstances
existing and disclosed, to Smith Barney as of the date of its opinion.

     In  rendering  its  opinion,  Smith  Barney  assumed  and  relied,  without
independent  verification,  upon the accuracy and  completeness of all financial
and other  information and data publicly  available or furnished to or otherwise
reviewed by or discussed with Smith Barney.  With respect to financial forecasts
and other information and data provided to or otherwise reviewed by or discussed
with Smith Barney,  the management of the Company advised Smith Barney that such
forecasts  and other  information  and data were  reasonably  prepared  on bases
reflecting  the  best  currently   available  estimates  and  judgments  of  the
management of the Company as to the future financial performance of the Company.
Smith Barney did not make and was not provided with an independent evaluation or
appraisal of the assets or liabilities  (contingent or otherwise) of the Company
nor did Smith Barney make any physical inspection of the properties or assets of
the  Company.  Although  Smith Barney  evaluated  the cash  consideration  to be
received by holders of the Shares (other than Parent and its affiliates)  from a
financial point of view, Smith Barney was not asked to and did not recommend the
specific consideration payable in the Offer and the Merger, which was determined
through  negotiation  between the Company and Parent.  No other limitations were
imposed by the Company on Smith Barney with respect to the  investigations  made
or procedures followed by Smith Barney in rendering its opinion.

     THE FULL TEXT OF THE WRITTEN  OPINION OF SMITH BARNEY DATED AUGUST 1, 1997,
WHICH SETS FORTH THE ASSUMPTIONS MADE, MATTERS CONSIDERED AND LIMITATIONS ON THE
REVIEW UNDERTAKEN,  IS ATTACHED HERETO AS ANNEX A AND IS INCORPORATED  HEREIN BY
REFERENCE. HOLDERS OF THE SHARES ARE URGED TO READ THIS OPINION CAREFULLY IN ITS
ENTIRETY.  THE OPINION OF SMITH  BARNEY IS DIRECTED TO THE BOARD OF DIRECTORS OF
THE COMPANY AND RELATES  ONLY TO THE  FAIRNESS OF THE CASH  CONSIDERATION  TO BE
RECEIVED IN THE OFFER AND THE MERGER BY HOLDERS OF THE SHARES (OTHER THAN PARENT
AND ITS  AFFILIATES)  FROM A FINANCIAL POINT OF VIEW, DOES NOT ADDRESS ANY OTHER
ASPECT  OF THE  OFFER  OR THE  MERGER  OR  RELATED  TRANSACTIONS  AND  DOES  NOT
CONSTITUTE A  RECOMMENDATION  TO ANY STOCKHOLDER AS TO WHETHER SUCH  STOCKHOLDER
SHOULD  TENDER  SHARES IN THE OFFER.  THE SUMMARY OF THE OPINION OF SMITH BARNEY
SET FORTH IN THIS OFFER TO PURCHASE IS QUALIFIED IN ITS ENTIRETY BY REFERENCE TO
THE FULL TEXT OF SUCH OPINION.

     In preparing its opinion, Smith Barney performed a variety of financial and
comparative analyses,  including those described below, and provided the Special
Committee and the Company Board with a written presentation with respect to such
analyses. A copy of Smith Barney's written presentation has



                                       12

<PAGE>


been filed as an exhibit to the Rule 13e-3  Transaction  Statement  on  Schedule
13E-3 filed with the Commission  with respect to the Offer and will be available
for  inspection  and copying at the principal  executive  offices of the Company
during regular  business  hours by any interested  stockholder of the Company or
representatives  of such  stockholder who have been so designated in writing and
may be inspected and copied,  and obtained by mail,  from the  Commission in the
manner specified under "THE OFFER-Certain  Information  Concerning the Company."
The summary of such  analyses does not purport to be a complete  description  of
Smith Barney's analyses underlying Smith Barney's opinion or presentation to the
Special Committee or the Company Board. The preparation of a fairness opinion is
a complex  analytic  process  involving  various  determinations  as to the most
appropriate  and relevant  methods of financial  analyses and the application of
those methods to the particular circumstances and, therefore, such an opinion is
not  readily  susceptible  to summary  description.  Accordingly,  Smith  Barney
believes  that its analyses  must be  considered  as a whole and that  selecting
portions of its  analyses  and  factors,  without  considering  all analyses and
factors,  could  create  a  misleading  or  incomplete  view  of  the  processes
underlying  such  analyses  and  opinion.  In its  analyses,  Smith  Barney made
numerous assumptions with respect to the Company,  Parent, industry performance,
general business,  economic,  market and financial conditions and other matters,
many of which are beyond the control of the Company  and Parent.  The  estimates
contained  in  such  analyses  and  the  valuation  ranges  resulting  from  any
particular  analysis  are  not  necessarily   indicative  of  actual  values  or
predictive of future results or values,  which may be significantly more or less
favorable than those suggested by such analyses. In addition,  analyses relating
to the value of  businesses  or securities do not purport to be appraisals or to
reflect  the prices at which  businesses  or  securities  actually  may be sold.
Accordingly,  such analyses and estimates are inherently  subject to substantial
uncertainty.  Smith Barney's  opinion and analyses were only one of many factors
considered by the Special Committee and the Company Board in their evaluation of
the Merger and should not be viewed as determinative of the views of the Special
Committee,  the Company  Board or  management of the Company with respect to the
cash  consideration to be received in the Offer and the Merger by holders of the
Shares (other than Parent or its affiliates) or the proposed Offer or Merger.


     Selected Company  Analysis.  Using publicly  available  information,  Smith
Barney analyzed,  among other things, the market values and trading multiples of
the Company and the  following  21 selected  publicly  traded  companies  in the
healthcare  industry,  consisting of: Advocat,  Inc.; Arbor Health Care Company;
Beverly Enterprises,  Inc.;  Extendicare,  Inc.; Genesis Health Ventures,  Inc.;
GranCare,  Inc.;  Harborside  Healthcare Corp.;  Health Care & Retirement Corp.;
Horizon/CMS  Healthcare Corp.;  Parent;  Living Centers of America,  Inc.; Manor
Care, Inc.; Mariner Health Group, Inc.; The Multicare Companies,  Inc.; National
Healthcare L.P.; Regency Health Services, Inc.; Retirement Care Associates Inc.;
Summit Care Corporation;  Sun Healthcare  Group,  Inc.; Unison Healthcare Group;
and Vencor Inc. (collectively,  the "Selected Companies"). Smith Barney compared
market values as multiples of latest 12 months and  estimated  calendar 1997 and
1998 net  income,  adjusted  market  values  (equity  value,  plus net  debt) as
multiples of, among other things, earnings before interest,  taxes, depreciation
and amortization  ("EBITDA") and adjusted  enterprise values (equity value, plus
net debt and capitalized  rents) as multiples of, among other things,  latest 12
months revenues and earnings before interest, taxes, depreciation,  amortization
and rent  ("EBITDAR").  Net income  projections for the Selected  Companies were
based  on  estimates  of  selected  investment  banking  firms  and  net  income
projections  for the Company were based on internal  estimates of the management
of the Company.  All multiples were based on closing stock prices as of July 29,
1997.  Applying a range of selected  multiples  for the  Selected  Companies  of
latest 12 months net  income,  estimated  calendar  1997 and 1998 net income and
latest 12 months EBITDA, revenues and EBITDAR of 18.0x to 26.5x, 13.7x to 20.5x,
11.9x to 17.9x, 7.7x to 11.5x, 1.0x to 1.4x and 7.6x to 11.4x, respectively,  to
corresponding  financial  data for the Company  resulted in an equity  reference
range for the Company of approximately  $1.17 to $2.67 per Share, as compared to
the cash consideration in the Offer and the Merger of $4.00 per Share.


     Selected  Merger and  Acquisition  Transactions  Analysis.  Using  publicly
available  information,  Smith Barney  analyzed  the purchase  price and implied
transaction  value multiples paid in 28 selected  transactions in the healthcare
industry,  consisting of  (acquiror/target):  Genesis Health Ventures,  Inc./The
Multicare Companies,  Inc.; Apollo Management,  L.P. & Living Centers of America
Inc./ Living Centers of America Inc.;  Living Centers of America Inc./ GranCare,
Inc.; Vencor Inc./ Transitional Hospitals



                                       13

<PAGE>






Corporation;  Sun Healthcare  Group,  Inc./  Retirement Care  Associates,  Inc.;
HEALTHSOUTH Corporation/Horizon/CMS Healthcare Corporation; Vencor Inc./TheraTx,
Inc.;  Genesis Health Ventures,  Inc./Geriatric & Medical  Companies,  Inc.; The
Multicare Companies,  Inc./ADS Group; Marriott  International  Inc./Forum Group,
Inc.; The Multicare  Companies,  Inc./Concord  Health Group,  Inc.;  Manor Care,
Inc./Beverly  Enterprises,  Inc.;  Living  Centers  of  America  Inc./Rehability
Corporation;  Grancare,  Inc./Evergreen Healthcare,  Inc.; Vencor Inc./Hillhaven
Corporation;  Living  Centers  of America  Inc./Brian  Care  Centers;  Hillhaven
Corporation/Nationwide  Care,  Inc.;  Mariner  Health  Care  Inc./  Convalescent
Services,  Inc.; Horizon  Healthcare  Inc./peopleCARE  HERITAGE Group;  TheraTX,
Inc./ PersonaCare,  Inc.; Regency Health Services Inc./Care  Enterprises,  Inc.;
The Multicare  Companies,  Inc./  Providence  Health Care Inc.;  Mariner  Health
Group,  Inc./Pinnacle  Care Group; Sun Healthcare  Group,  Inc./Mediplex  Group,
Inc.; Integrated Health Services, Inc./Central Park Lodges, Inc.; Genesis Health
Ventures,  Inc./Meridian  Healthcare,  Inc.;  Horizon  Healthcare Inc./ Greenery
Rehabilitation Group Incorporated; and Living Centers of America Inc./Vari-Care,
Inc. (collectively, the "Selected Transactions"). Smith Barney compared purchase
prices as  multiples  of,  among  other  things,  latest 12 months  net  income,
transaction values as multiples of, among other things,  latest 12 months EBITDA
and adjusted  transaction values  (transaction  value, plus rents capitalized at
12.5%) as multiples of latest 12 months revenues and EBITDAR.  All multiples for
the Selected  Transactions  were based on  information  available at the time of
announcement of the transaction.  Applying a range of selected multiples for the
Selected  Transactions  of latest 12 months net  income,  EBITDA,  revenues  and
EBITDAR  of 17.8x  to  26.8x,  8.1x to  12.1x,  1.3x to 1.9x and 7.8x to  11.6x,
respectively,  to  corresponding  financial data for the Company  resulted in an
equity  reference  range for the  Company  of  approximately  $0.73 to $3.35 per
Share,  as  compared  to the cash  consideration  in the Offer and the Merger of
$4.00 per Share.

     No company, transaction or business used in the "Selected Company Analysis"
or "Selected  Merger and Acquisition  Transactions  Analysis" as a comparison is
identical to the Company or the Offer and the Merger.  Accordingly,  an analysis
of the  results  of the  foregoing  is not  entirely  mathematical;  rather,  it
involves  complex   considerations  and  judgments  concerning   differences  in
financial and operating  characteristics and other factors that could affect the
acquisition,  public trading or other values of the Selected Companies, Selected
Transactions or the business  segment,  company or transaction to which they are
being compared.

     Discounted  Cash Flow Analysis.  Smith Barney  performed a discounted  cash
flow  analysis  of the  projected  free cash flow of the  Company for the fiscal
years 1998 through 2002,  based on internal  estimates of the  management of the
Company for fiscal year 1998 and extrapolated thereafter assuming annual revenue
growth rates of 6%, 8% and 10%. The stand-alone discounted cash flow analysis of
the Company was determined by (i) adding (x) the present value of projected free
cash flows over the five-year period from 1998 to 2002 and (y) the present value
of the Company's  estimated terminal value in year 2002 and (ii) subtracting the
current net debt of the Company.  The range of estimated terminal values for the
Company at the end of the five-year  period was calculated by applying  terminal
value  multiples  ranging  from  5.0x to 7.0x to the  Company's  projected  2002
EBITDA,  representing  the Company's  estimated  value beyond the year 2002. The
cash flows and terminal  values of the Company were  discounted to present value
using discount rates ranging from 18% to 20%. Utilizing such terminal values and
discount rates,  this analysis  resulted in implied equity  reference ranges for
the  Company  of  approximately  $2.74 to $5.45  per Share  (assuming  an annual
revenue growth rate for the Company of 10%),  $2.07 to $4.56 per Share (assuming
an annual  revenue  growth rate for the  Company of 8%),  and $1.46 to $3.78 per
Share  (assuming  an annual  revenue  growth  rate for the  Company  of 6%),  as
compared  to the cash  consideration  in the Offer  and the  Merger of $4.00 per
Share.

     Other Factors and  Comparative  Analyses.  In rendering its opinion,  Smith
Barney considered  certain other factors and conducted certain other comparative
analyses, including, among other things, a review of (i) indications of interest
received from, and discussions  with, third parties other than Parent;  (ii) the
Company's  historical  and  projected  financial  results;  (iii) the history of
trading  prices  and volume for the  Shares  and the  relationship  between  the
movement of such common stock and  movements  in the common stock of  comparable
companies;  (iv) the  ownership  profile of the Company;  and (v) a business and
financial profile of Parent.



                                       14

<PAGE>






     Pursuant to the terms of Smith Barney's engagement,  the Company has agreed
to pay Smith Barney for its services in connection  with the Merger an aggregate
financial advisory fee of $1.8 million. The Company has also agreed to reimburse
Smith  Barney for  travel and other  out-of-pocket  expenses  incurred  by Smith
Barney in performing its services,  including the fees and expenses of its legal
counsel,  and to indemnify  Smith  Barney and related  persons  against  certain
liabilities,  including  liabilities under the federal  securities laws, arising
out of Smith Barney's engagement.

     Smith  Barney has advised  the  Company  that,  in the  ordinary  course of
business,  Smith  Barney  and its  affiliates  may  actively  trade  or hold the
securities of the Company and Parent for their own account or for the account of
customers  and,  accordingly,  may at any time hold a long or short  position in
such  securities.  Smith  Barney  has in the past  provided  investment  banking
services to the Company and Parent  unrelated to the proposed  Offer and Merger,
for which services Smith Barney has received  compensation.  In addition,  Smith
Barney and its affiliates  (including  Travelers  Group Inc. and its affiliates)
may maintain relationships with the Company and Parent.


     Smith Barney is an internationally  recognized  investment banking firm and
was selected by the Company based on Smith  Barney's  experience,  expertise and
familiarity with the Company and its business. Smith Barney regularly engages in
the valuation of businesses and their  securities in connection with mergers and
acquisitions,    negotiated    underwritings,    competitive   bids,   secondary
distributions  of  listed  and  unlisted  securities,   private  placements  and
valuations for estate, corporate and other purposes.


     Wheat, First Securities, Inc. The Special Committee, on behalf the Company,
retained  Wheat First to render an opinion as to the fairness,  from a financial
point of view, to the holders of Shares  (other than Parent and its  affiliates)
of the Offer.  Wheat First is a nationally  recognized  investment  banking firm
regularly  engaged  in the  valuation  of  businesses  and their  securities  in
connection with mergers and acquisitions, negotiated underwritings,  competitive
biddings,  secondary  distributions of listed and unlisted  securities,  private
placements and valuations for estate,  corporate and other purposes. Wheat First
regularly  publishes  research reports regarding the long-term care industry and
the  businesses  and  securities of publicly  owned  companies in that industry,
including the Company.


     Representatives  of  Wheat  First  attended  the  meeting  of  the  Special
Committee on July 30, and the meeting of the Company  Board of Directors on July
31, 1997 at which the Merger  Agreement was  considered  and approved.  At these
meetings,  Wheat First  expressed an oral opinion  that,  as of such dates,  the
Offer was fair,  from a  financial  point of view,  to the  stockholders  of the
Company  (other than Parent and its  affiliates).  A letter dated August 1, 1997
confirmed the opinion.

     THE  FULL  TEXT  OF  WHEAT  FIRST'S  OPINION,   WHICH  SETS  FORTH  CERTAIN
ASSUMPTIONS MADE, MATTERS  CONSIDERED AND LIMITATIONS ON REVIEW  UNDERTAKEN,  IS
ATTACHED  AS ANNEX B TO THIS OFFER TO  PURCHASE.  THE  SUMMARY OF THE OPINION OF
WHEAT FIRST SET FORTH IN THIS OFFER TO PURCHASE IS  QUALIFIED IN ITS ENTIRETY BY
REFERENCE  TO THE OPINION  ITSELF.  NO  LIMITATIONS  WERE IMPOSED BY THE SPECIAL
COMMITTEE  OR BY  THE  COMPANY  BOARD  UPON  WHEAT  FIRST  WITH  RESPECT  TO THE
INVESTIGATIONS MADE OR PROCEDURES FOLLOWED BY IT IN RENDERING THE OPINION. WHEAT
FIRST'S  OPINION IS DIRECTED  ONLY TO THE  FAIRNESS,  FROM A FINANCIAL  POINT OF
VIEW, OF THE OFFER TO THE STOCKHOLDERS OF THE COMPANY (OTHER THAN PARENT AND ITS
AFFILIATES)  AND DOES NOT CONSTITUTE A  RECOMMENDATION  TO ANY STOCKHOLDER AS TO
HOW SUCH STOCKHOLDER SHOULD VOTE ON THE MERGER.

     A copy of Wheat First's written  presentation  has been filed as an exhibit
to the Rule  13e-3  Transaction  Statement  on  Schedule  13E-3  filed  with the
Commission  and will be available  for  inspection  and copying at the principal
executive offices of the Company during regular business hours by any interested
stockholder of the Company or representative of such stockholder who has been so
designated  in writing and may be  inspected  and copied,  and obtained by mail,
from the Commission in the manner specified in "THE OFFER - Certain  Information
Concerning the Company."


     In  arriving  at  its  opinions,  Wheat  First  reviewed  certain  publicly
available business and financial  information relating to the Company and Parent
and certain other information  provided to it, including the following:  (i) the
Company's  Annual  Reports  to  Stockholders,  Annual  Reports  on Form 10-K and
related  financial  information for the two fiscal years ended December 31, 1996
and 1995; (ii) the Company's Quarterly Report on Form 10-Q and related financial
information for the quarter ended March



                                       15

<PAGE>






31, 1997; (iii) Parent's Annual Reports to stockholders,  Annual Reports on Form
10-K and related financial information for the three fiscal years ended December
31, 1996, 1995 and 1994; (iv) Parent's Quarterly Report on Form 10-Q and related
financial information for the quarter ended March 31, 1997; (v) certain publicly
available  information  with  respect to  historical  market  prices and trading
activities for the Shares and the Parent's common stock and for certain publicly
traded  companies  which Wheat First  deemed  relevant;  (vi)  certain  publicly
available  information  with  respect to certain  comparable  companies  and the
financial  terms of certain  other  mergers and  acquisitions  which Wheat First
deemed relevant; (vii) the Merger Agreement;  (viii) other financial information
concerning the  businesses  and operations of the Company and Parent,  including
certain audited financial  information and certain internal  financial  analyses
and forecasts for the Company prepared by the senior  management of the Company;
and (ix) such  financial  studies,  analyses,  inquiries and other matters as it
deemed  necessary.  In  addition,  Wheat  First met with  members  of the senior
management of the Company to discuss the business and prospects of the Company.

     In  connection  with its review,  Wheat  First  relied upon and assumed the
accuracy and completeness of all of the foregoing  information provided to it or
publicly available,  including the representations and warranties of the Company
and Parent  included in the Merger  Agreement,  and Wheat First  relied upon the
management  of the Company as to the  reasonableness  and  achievability  of its
financial and  operational  forecasts and  projections,  and the assumptions and
bases  therefor,  provided to Wheat First,  and assumed that such  forecasts and
projections  will be realized in the amounts and in the time  periods  currently
estimated by such managements.  Wheat First also assumed that the Merger will be
consummated in accordance with the terms and conditions of the Merger  Agreement
in due course without unnecessary delay.

     Additionally,  Wheat First  considered  certain  financial and stock market
data of the  Company and Parent and  compared  that data with  similar  data for
certain  publicly held  long-term  care  companies and  considered the financial
terms of certain other comparable transactions that recently have been announced
or effected,  as further discussed below. The Wheat First opinion is necessarily
based on economic and market  conditions and other  circumstances  as they exist
and can be evaluated by Wheat First as of the date thereof.

     In connection with rendering its opinions,  Wheat First performed a variety
of financial  analyses.  The preparation of a fairness  opinion involves various
determinations  as to the most  appropriate  and  relevant  methods of financial
analysis and the  application of those methods to the  particular  circumstances
and,  therefore,  such an opinion is not readily susceptible to partial analysis
or  summary  description.  Moreover,  the  evaluation  of the  fairness,  from a
financial point of view, of the Offer to the Company's  stockholders was to some
extent a subjective  one based on the experience and judgment of Wheat First and
not merely the result of mathematical  analysis of financial data.  Accordingly,
notwithstanding the separate factors summarized below, Wheat First believes that
its analyses must be considered  as a whole and that  selecting  portions of its
analyses and of the factors  considered by it, without  considering all analyses
and  factors,  could  create  an  incomplete  view  of  the  evaluation  process
underlying its opinion.  The ranges of valuations  resulting from any particular
analysis  described  below  should not be taken to be Wheat  First's view of the
actual value of the Company.

     In performing  its analyses,  Wheat First made  numerous  assumptions  with
respect to industry  performance,  business  and economic  conditions  and other
matters,  many of which are beyond  the  control of the  Company.  The  analyses
performed  by Wheat First are not  necessarily  indicative  of actual  values or
future results, which may be significantly more or less favorable than suggested
by such analyses. Additionally, analyses relating to the values of businesses do
not  purport  to be  appraisals  or to reflect  the  prices at which  businesses
actually may be sold. In rendering its opinion, Wheat First assumed that, in the
course of obtaining the necessary regulatory approvals for the Merger Agreement,
no conditions  will be imposed that will have a material  adverse  effect on the
contemplated benefits of the Merger, on a pro forma basis, to the Company.

     Wheat  First's  opinion  is  just  one  of  the  many  factors  taken  into
consideration  by the Special  Committee and the Company Board in determining to
approve  the Merger  Agreement.  Wheat  First's  opinion  does not  address  the
relative merits of the Offer and the Merger as compared to any alternative



                                       16

<PAGE>


business  strategies  that might exist for the Company,  nor does it address the
effect of any other business combination in which the Company might engage.

     The  following  is a summary of the  analyses  performed  by Wheat First in
connection with its oral opinion  delivered to the Special Committee on July 30,
1997 and its oral opinion  (subsequently  confirmed in writing) delivered to the
Company Board on July 31, 1997:

     Comparable  Acquisitions  Analysis:  Wheat First  performed  an analysis of
purchase  prices in 50 long-term care  transactions  announced  since January 1,
1996.  Wheat First deemed seven of these  transactions  (Sun Healthcare  Group's
contemplated  acquisition of Regency Health  Services;  Genesis Health Ventures'
contemplated  acquisition of The Multicare  Companies;  Grancare's  contemplated
merger with Living Centers of America; HEALTHSOUTH's contemplated acquisition of
Horizon/CMS  Healthcare;  Sun  Healthcare  Group's  contemplated  acquisition of
Retirement Care Associates;  Vencor's  acquisition of TheraTx; and The Multicare
Companies'  acquisition of Concord Health Group) to be generally  comparable and
three of these  transactions  to be most  comparable.  The three most comparable
transactions (Sun Healthcare Group's contemplated  acquisition of Regency Health
Services;  Sun Healthcare  Group's  contemplated  acquisition of Retirement Care
Associates;  and The Multicare  Companies'  acquisition of Concord Health Group)
were  selected  based on their  respective  sizes,  profitability  and  scope of
business  operations of the acquired companies which were most comparable to the
Company.  Multiples  of  revenue,  EBITDAR  (earnings  before  interest,  taxes,
depreciation,  amortization  and rent) and number of beds were  compared  to the
multiples implied by the consideration  offered to the stockholders in the Offer
and the Merger or enterprise  value  (defined as equity value plus net debt plus
eight times annual rent).

     The following  comparisons of the implied consideration or enterprise value
based  on the  Offer  Price  were  based  on  financial  data  as of and for the
twelve-month  period  ended March 31, 1997 for the Company and the twelve  month
reporting period prior to the announcement of each transaction for each acquiree
in the selected  transactions:  (i) an enterprise value over revenue multiple of
1.3x versus the median multiple in the seven generally  comparable  transactions
of 1.6x and the three most  comparable  transactions of 1.9x; (ii) an enterprise
value  over  EBITDAR  multiple  of 17.0x  versus the  median  multiple  in seven
generally  comparable  transactions  of  8.6x  and  the  three  most  comparable
transactions of 11.6x;  and (iii) an enterprise  value over number of beds value
of  $38,589  versus  the  median  value  in  the  seven   generally   comparable
transactions of $62,573 and the three most comparable transactions of $44,050.

     Comparable Companies Analysis:  Wheat First performed an analysis of market
valuation,  as of July 30, 1997, of 17 publicly-traded  long-term care companies
(Advocat,  Arbor Health Care,  Beverly  Enterprises,  Genesis  Health  Ventures,
Grancare, Harborside Healthcare, Health Care and Retirement, Horizon Healthcare,
Parent,  Living Centers of America,  Manor Care,  Mariner Health,  The Multicare
Companies, Regency Health, Sun Healthcare,  Unison Healthcare and Vencor). Based
on size, profitability and scope of business operations, Wheat First deemed four
of  these  companies  to be  most  comparable  to  the  Company.  The  following
comparisons were based on financial data as of and for the  twelve-month  period
ended  March 31,  1997 for the  Company  and the twelve  month  prior  reporting
periods for each  publicly-traded  company: (i) an enterprise value over revenue
multiple  of 1.3x  versus the median  multiple  of 1.4x and the most  comparable
companies  of 1.2x;  (ii) an  enterprise  value over EBITDAR of 17.0x versus the
median multiple of 8.8x and the most comparable  companies of 8.2x; and (iii) an
enterprise value over number of beds value of $38,589 versus the median multiple
of $85,679 and the most comparable companies of $54,679.

     Premiums Paid  Analysis:  Wheat First  compared the premium  implied by the
Offer to 53  similar  sized  transactions  based on equity  values.  The one day
premium  implied  by the Offer was 23.1%  versus  the  median of the  comparable
transactions  of  18.9%;  the one week  premium  implied  by the Offer was 33.3%
versus the median of the comparable transactions of 22.2%; the four week premium
implied by the Offer was 8.5% versus the median of the  comparable  transactions
of 29.1%;  the three  month  premium  implied by the Offer was 88.2%  versus the
median  of the  comparable  transactions  of 29.2%;  and the six  month  premium
implied by the Offer was 28.0% versus the median of the comparable  transactions
of 31.2%.

     No company or  transaction  used as a comparison  in the above  analysis is
identical  to the  Company,  Parent or the  Merger  Agreement.  Accordingly,  an
analysis of the results of the foregoing necessarily



                                       17

<PAGE>


involves  complex   considerations  and  judgments  concerning   differences  in
financial and operating  characteristics of the companies and other factors that
could affect the public  trading of the  companies  used for  comparison  in the
above analysis.

     The Wheat First opinion is based solely upon the  information  available to
Wheat First and the economic,  market and other circumstances as they existed as
of August 1, 1997.  Events occurring after that date could materially affect the
assumptions  and  conclusions  contained  in the  opinion.  Wheat  First did not
undertake to reaffirm or revise its opinion or  otherwise  comment on any events
occurring after the date thereof.

     As compensation for Wheat First's services, the Company agreed to pay Wheat
First a fee of  $250,000  payable  after  the  delivery  by  Wheat  First of its
opinion. The Company has agreed also to reimburse Wheat First for its reasonable
out-of-pocket  expenses incurred in connection with the activities  contemplated
by its  engagement,  regardless of whether the Merger  Agreement is consummated.
The  Company  has  further  agreed to  indemnify  Wheat  First  against  certain
liabilities under federal  securities laws. The payment of the above fee was not
contingent  upon Wheat First  rendering a favorable  opinion with respect to the
Merger  Agreement.  The Special  Committee  selected Wheat First to serve as its
financial  advisor in connection with the Merger Agreement on the basis of Wheat
First's expertise.  In the ordinary course of its business,  Wheat First and its
affiliates  may actively  trade in the equity  securities of the Company for its
account and the accounts of its  customers,  and therefore may from time to time
hold long or short positions in such securities.

4. POSITION OF PARENT AND PURCHASER REGARDING THE FAIRNESS OF THE OFFER AND THE
   MERGER


     Parent and Purchaser  believe that the  consideration to be received by the
stockholders of the Company (other than Parent,  Purchaser and their affiliates)
pursuant  to the Offer and the Merger is fair to such  stockholders.  Parent and
Purchaser base their belief on the following  factors:  (i) a Special  Committee
consisting  of  directors  who are neither  directors or designees of Parent nor
persons  having a current  business  relationship  with Parent was  appointed to
represent the interests of the  stockholders  of the Company (other than Parent,
Purchaser and their  affiliates);  (ii) the Special  Committee  retained and was
advised by independent legal and financial advisors; (iii) the Special Committee
and the Company Board (with the two  directors who are also  directors of Parent
either  abstaining or not attending the meeting) each  determined that the Offer
and the Merger are fair to, and in the best  interests of, the  stockholders  of
the Company (other than Parent,  Purchaser and their  affiliates),  approved the
Merger Agreement and the transactions  contemplated thereby and recommended that
the stockholders of the Company accept the Offer and the Merger;  (iv) the $4.00
per Share  price to be paid in the Offer and the Merger and the other  terms and
conditions of the Merger Agreement resulted from active arm's-length  bargaining
between representatives of the Special Committee, on the one hand, and a special
committee  of the Board of Directors of Parent which did not include any persons
who were  directors  or  stockholders  of the  Company,  on the  other;  (v) the
consideration  to be paid in the Offer and the  Merger  represents  a premium of
approximately  25% over the  reported  closing  price for the Shares on the last
trading day prior to the public  announcement of the Merger Agreement;  and (vi)
the historical  financial  performance of the Company and its financial results,
which  include  operating  losses  in 1996  and the  first  quarter  of 1997 and
substantial  liquidity  problems  requiring  loans and  guarantees  from Parent.
Parent and  Purchaser  have  reviewed  the  factors  considered  by the  Special
Committee and the Company Board in support of their  decisions,  as described in
the  Solicitation/Recommendation  Statement  on  Schedule  14D-9 and above  (see
"-Recommendations  of the Special  Committee and the Company Board;  Fairness of
the Offer and the Merger"), and have no basis to question their consideration of
or reliance on such factors. In reaching their conclusions, Parent and Purchaser
also  considered  generally  the current and  historical  market  prices for the
Shares.  Neither Parent nor Purchaser  found it  practicable to assign,  nor did
either of them assign,  relative weights to the individual factors considered in
reaching their conclusions as to fairness.

5. OPINION OF FINANCIAL ADVISOR TO PARENT

     The Board of  Directors of Parent (the "Parent  Board")  retained  Shattuck
Hammond to provide financial  advisory and investment banking services to Parent
in connection with Parent's acquisition of



                                       18

<PAGE>






the outstanding  Shares of the Company,  and to provide an opinion to the Parent
Board as to the fairness of such  transaction  to Parent's  stockholders  from a
financial point of view.

     On June 11,  1997,  Shattuck  Hammond  delivered  to the  Parent  Board its
preliminary oral opinion,  as investment bankers,  that Parent's  acquisition of
the outstanding  Shares  (inclusive of estimated  common stock  equivalents) for
$3.50 per share would be fair to Parent's stockholders from a financial point of
view. On June 13, 1997,  Parent asked  Shattuck  Hammond  whether,  in the event
Parent were to increase its offer for the outstanding Shares to $4.00 per Share,
Shattuck Hammond would be able, based on its analyses, to render an opinion that
an acquisition by Parent of the outstanding  Shares for $4.00 per Share would be
fair to Parent's  stockholders from a financial point of view. On June 20, 1997,
Shattuck Hammond delivered to the Parent Board its written opinion (the "June 20
Opinion") that Parent's acquisition of the outstanding Shares at $3.50 per Share
would be fair to  Parent's  stockholders  from a  financial  point  of view.  In
addition,  on June 20, 1997,  Shattuck  Hammond orally informed the Parent Board
that  Shattuck  Hammond was prepared to issue a written  opinion  that  Parent's
acquisition of the outstanding  Shares at up to $4.00 per Share would be fair to
Parent's  stockholders  from a financial point of view. In its oral presentation
to the Parent Board on June 20, 1997,  Shattuck  Hammond noted that in preparing
its opinion, it had not taken into account certain potential  additional savings
which could result from the contemplated  transaction,  such as interest savings
due to refinancing of existing Company debt (inclusive of operating leases), and
potential  cost  savings  resulting  from  reduced  insurance  premiums  for the
Company.  On July 3, 1997,  as a result of Parent's  decision to offer $4.00 per
Share for the outstanding Shares,  Shattuck Hammond withdrew the June 20 Opinion
and delivered to the Parent Board its written opinion that Parent's  acquisition
of the outstanding  Shares (inclusive of estimated common stock equivalents) for
$4.00 per Share (the "Transaction") would be fair to Parent's  stockholders from
a financial point of view (such opinion,  the "Shattuck Hammond Opinion").  (The
Shattuck Hammond Opinion also did not take into account the potential additional
savings referred to in the second preceding sentence.)

     The  Shattuck  Hammond  Opinion did not state that any  specific  price per
Share constituted the appropriate  price per Share for the Transaction,  did not
recommend  the  amount  of  consideration  to be paid and did not  constitute  a
recommendation  as to any action that the Parent  Board or  stockholders  should
take in  connection  with the  Transaction.  The  Shattuck  Hammond  Opinion  is
directed  only to the  fairness  from a  financial  point of view to  holders of
Parent  stock of Parent's  acquisition  of the Shares  (inclusive  of  estimated
common stock equivalents) at $4.00 per Share.  Shattuck Hammond has expressed no
opinion  as to the  structure,  terms  or  effect  of any  other  aspect  of the
Transaction,   including,  without  limitation,  the  tax  consequences  of  the
Transaction  to  Parent  or the  Company  or any  stockholder  of  Parent or the
Company.  Shattuck  Hammond has not been  requested  to and has not rendered any
opinion as to the fairness of the  Transaction  to either the Board of Directors
or stockholders of the Company.

     In  connection  with the Shattuck  Hammond  Opinion,  Shattuck  Hammond (i)
reviewed  certain   publicly   available   business  and  historical   financial
information  relating to each of Parent and the Company,  (ii) reviewed  certain
financial  information  and other data  provided to it by Parent and the Company
that is not publicly available relating to the business and prospects of each of
Parent and the Company, (iii) discussed the businesses, operations and prospects
of Parent and the  Company  with the  respective  managements  of Parent and the
Company,  (iv) reviewed the  historical  market prices and trading values of the
Shares,  (v) reviewed  publicly  available  financial and stock market data with
respect to other publicly-traded companies in lines of business Shattuck Hammond
believed to be  generally  comparable  to those of the  Company,  (vi)  reviewed
publicly available  financial  information and stock market data with respect to
proposed and completed merger and acquisition  transactions  involving companies
in lines of business  Shattuck  Hammond  believed to be generally  comparable to
those  of the  Company,  and  (vii)  conducted  such  other  studies,  analyses,
investigations  and inquiries,  and  considered  such other  information,  as it
deemed relevant.

     In rendering the Shattuck  Hammond  Opinion,  Shattuck  Hammond assumed and
relied  upon the  accuracy  and  completeness  of all  information  supplied  or
otherwise made available to it by Parent and the Company or obtained by Shattuck
Hammond from other  sources,  and relied upon the assurances of Parent's and the
Company's  respective  managements  that they were unaware of any information or
facts



                                       19

<PAGE>






that would make the  information  provided to  Shattuck  Hammond  incomplete  or
misleading.  Shattuck  Hammond did not  independently  verify such  information,
undertake an independent  appraisal of the assets or liabilities  (contingent or
otherwise) of Parent or the Company, nor was Shattuck Hammond furnished with any
such appraisals.  With respect to financial  forecasts  regarding Parent and the
Company  furnished to Shattuck Hammond by Parent and the Company,  respectively,
Shattuck  Hammond was advised by the  respective  managements  of Parent and the
Company,  and assumed,  that such  forecasts  had been  reasonably  prepared and
reflected the best currently  available estimates and judgment of the respective
managements  of Parent and the  Company  as to the  respective  expected  future
financial  performance of Parent and the Company. In addition,  Shattuck Hammond
assumed  that  certain of the  Company's  facilities  would be  disposed of at a
price,  and/or in a manner,  consistent  with  Parent's  estimates and that such
disposition(s)  would not have a material adverse impact on the net equity value
of the Company.  Shattuck  Hammond  also assumed that Parent would  complete the
Transaction  in  accordance  with  terms  and  conditions,  and upon  definitive
documents,  that are  standard  and  customary  for  similar  transactions.  The
Shattuck Hammond Opinion was necessarily  based upon market,  economic and other
conditions  that existed and could be evaluated as of the date of such  Opinion,
and on  information  available to Shattuck  Hammond as of the date  thereof.  No
limitations  were  imposed upon  Shattuck  Hammond by Parent with respect to the
investigations  to be made or  procedures  to be followed by it in rendering the
Shattuck Hammond Opinion.

     The following  paragraphs  summarize the most significant  quantitative and
qualitative  analyses  performed by Shattuck Hammond in arriving at the Shattuck
Hammond Opinion and do not purport to be a complete  description of the analyses
performed by Shattuck Hammond. The information presented below is based upon the
financial  condition  of Parent and the Company as of the date or dates  shortly
before the  delivery of the Shattuck  Hammond  Opinion on July 3, 1997 and share
price information through the close of the market on July 3, 1997. In the course
of  performing  its  analyses,  Shattuck  Hammond  noted that (i) Dr.  Robert N.
Elkins,  Chairman  and Chief  Executive  Officer  of Parent,  is a director  and
stockholder  of  the  Company  and  at  the  date  thereof   beneficially  owned
approximately  1.7 million Shares,  which  represented  approximately 23% of the
outstanding Shares;  (ii) John L. Silverman,  a director of Parent and executive
officer of a subsidiary of Parent, is a director and stockholder of the Company;
(iii)  Lawrence P.  Cirka,  a director  and  executive  officer of Parent,  is a
stockholder of the Company; and (iv) Timothy F. Nicholson, a director of Parent,
is a stockholder of the Company.

     In the preparation of its valuations,  Shattuck  Hammond utilized pro forma
projected results for 1997 on the assumption that the Company would successfully
sell or close down 12 of its leased  facilities  which  have been  operating  at
continuing losses (the "Assumed Discontinued  Facilities").  In this regard, the
financial impact on Shattuck  Hammond's  valuation analysis of the Company would
depend upon the prices (if any) for which the facilities  were sold, the outcome
of the negotiations with the lessor of 11 of the Assumed Discontinued Facilities
and the  accounting  treatment  of the sale or close  down.  In  addition to the
financial impact of the Assumed Discontinued  Facilities,  Shattuck Hammond also
believed  that pro forma 1997 results were a better  indicator of the  financial
value of the Company due to the Company's  discontinuation  of certain  business
operations in 1996 as well as other factors  which  occurred  during 1996 at the
Company.   Second,  Shattuck  Hammond  examined  the  financial  impact  of  the
Transaction  on Parent  under two  scenarios,  one  assuming no  synergies  were
realized and the other assuming realization of certain synergies (the |P`Assumed
Synergies|P')  which Parent  believed  would be realized in connection  with its
acquisition of the Company and would result in certain cost savings, namely: (i)
reductions  in certain  selling,  general  and  administrative  expenses  at the
Company,  which the Parent  estimated at  approximately  $1.2 million;  and (ii)
increased pre-tax profit at Parent,  which Parent estimated at $500,000,  due to
the provision of incremental  rehabilitation  services to Company  facilities by
Parent.

     Publicly-Traded Comparable Company Analysis.  Shattuck Hammond reviewed and
compared  certain  relevant  valuation  multiples of the Company and Parent to a
group of selected,  publicly-traded  companies considered by Shattuck Hammond to
be reasonably  comparable to the Company (the |P`Comparable  Companies|P') which
included: (i) Advocat, Inc.; (ii) Beverly Enterprises, Inc.; (iii) The Multicare
Companies  Inc.;  (iv) Regency  Health  Services,  Inc.;  and (v) Sun Healthcare
Group,  Inc. As discussed above,  the Company's pro forma projected  results for
1997  were  used for  valuation  purposes.  Based on a review  of a  variety  of
valuation multiples for the Comparable Companies, Shattuck Hammond be-



                                       20

<PAGE>






lieved that valuations  based on multiples of earnings before  interest,  taxes,
depreciation and amortization ("EBITDA") and price earnings ("P/E") multiples of
projected  1997  and 1998  net  income  provided  the  most  relevant  valuation
analyses. For valuations based on EBITDA,  information on projected 1997 results
for the Comparable Companies was not available and, therefore,  valuations based
on the most current twelve month EBITDA for the  Comparable  Companies were used
by Shattuck  Hammond,  discounted  by 10% and applied to the projected pro forma
1997  results of the  Company.  Shattuck  Hammond  calculated  a range of EBITDA
multiples for the Comparable  Companies,  Parent and the Company by dividing the
business  enterprise  value  ("BEV")  for each  company  (i.e.,  the  number  of
fully-diluted  shares outstanding  multiplied by the closing share price on June
6,  1997  plus  long-term  liabilities  less net  working  capital)  by  EBITDA.
(Long-term  liabilities and net working capital are hereafter referred to as the
Balance  Sheet  Adjustments.)  In  addition,  Shattuck  Hammond  calculated  the
projected 1997 and 1998 P/E multiples for the Comparable  Companies,  Parent and
the  Company  by  dividing  the share  price of each  company  by the  projected
earnings per share. The projected earnings per share estimates for all companies
except the Company were based on a mean  consensus  estimate by equity  research
analysts as reported through Bloomberg L.P. The Company's projected earnings per
Share were based on projections  prepared by the Company and reviewed by Parent.
For 1997,  the  Company's  projected  earnings per Share were  prepared on a pro
forma basis.

     This analysis indicated that the average EBITDA multiple for the Comparable
Companies was 8.2x, which Shattuck Hammond  discounted by 10% as described above
and created a high,  average  and low EBITDA  multiple  range of 8.4x,  7.4x and
6.4x.  Shattuck  Hammond then utilized these multiples to calculate Share values
for the Company adjusted for the estimated Balance Sheet Adjustments at December
31,  1997  (the  |P`Estimated  Balance  Sheet  Adjustments|P').  In the  Assumed
Synergies  scenario,  this analysis  produced per Share values of the Company of
from $5.67 to $2.63 per Share with a mean of $4.15 per  Share.  In the  scenario
which did not include the Assumed  Synergies,  this analysis  produced per Share
values of the  Company of from $3.88 to $1.27 per Share with a mean of $2.57 per
Share.  Furthermore,  the analysis  indicated that the average P/E multiples for
the  Comparable  Companies was 14.7x and 12.8x for 1997 and 1998,  respectively.
Shattuck  Hammond  then  utilized  high,  average  and low  projected  1997  P/E
multiples of 15.7x,  14.7x and 13.7x and projected  1998 P/E multiples of 13.8x,
12.8x and 11.8x. In the Assumed Synergies case, this analysis produced per Share
values of the  Company of from $5.74 to $5.01 with a mean of $5.38  based on the
Company's pro forma  projected  1997 net income and per Share values of $9.60 to
$8.20 with a mean of $8.90 based on the Company's  projected 1998 net income. In
the scenario which did not include the Assumed Synergies, this analysis produced
per Share  values  for the  Company  of from $3.83 to $3.34 with a mean of $3.59
based on the Company's pro forma  projected 1997 net income and per Share values
of from $7.91 to $6.77  with a mean of $7.34  based on the  Company's  projected
1998 net income.

     Discounted Cash Flow Analysis. Shattuck Hammond performed a discounted cash
flow  analysis of the Company to derive its value by computing the present value
of its future cash flow stream  utilizing  five year  projections of the Company
provided  to  Shattuck  Hammond  by  Parent  and the  Company,  terminal  EBITDA
valuation  multiples  of  6.0x,  7.0x  and 8.0x  determined  by the  methodology
described in |P`Publicly Traded Comparable Company Analysis|P'  described above,
and discount rates of 14%, 16% and 18%, which were approximately 25% higher than
the discount rates  generally  used by Parent.  Shattuck  Hammond  believed that
these discount rates were appropriate due to the Company's high leverage and the
uncertainty  regarding  the  sale of the  Assumed  Discounted  Facilities.  This
analysis  produced  per Share  values of the  Company  after  adjusting  for the
Estimated Balance Sheet Adjustments of from $12.01 to $6.34 with a mean of $8.97
in the Assumed  Synergies  scenario  and $10.54 to $5.28 with a mean of $7.72 in
the scenario which did not include the Assumed Synergies.

     Comparable Merger and Acquisition  Analysis.  Utilizing  publicly available
information, Shattuck Hammond analyzed the purchase prices and multiples paid or
proposed to be paid in three merger or acquisition transactions announced during
the previous  twelve months in which the target  companies were  publicly-traded
and  considered by Shattuck  Hammond to be reasonably  comparable to the Company
(the  |P`Comparable   Transactions|P').   These  transactions  (target/acquiror)
included Living Centers of America, Inc./GranCare, Inc./Apollo Management, L.P.;
Retirement Care Associates,  Inc./Sun  Healthcare  Group,  Inc.; and Geriatric &
Medical Companies, Inc./Genesis Health Ventures, Inc. Based



                                       21

<PAGE>






on a review of a variety of valuation multiples for the Comparable Transactions,
Shattuck Hammond believed that EBITDA multiples (BEV divided by EBITDA) provided
the most relevant valuation  analysis.  This analysis indicated that the average
EBITDA multiple for the Comparable Transactions was 8.5x, which Shattuck Hammond
discounted by 10%, and created high,  average and low EBITDA  multiples of 8.7x,
7.7x and 6.7x.  Shattuck  Hammond then utilized these multiples to calculate per
Share  values  of  the  Company   adjusted  for  the  Estimated   Balance  Sheet
Adjustments.  The per Share  values were based on the  Company's  projected  pro
forma 1997 EBITDA.  In the Assumed  Synergies case,  this analysis  produced per
Share values for the Company of from $6.12 to $3.09 with a mean of $4.61. In the
scenario which did not include the Assumed Synergies, this analysis produced per
Share values for the Company of from $4.27 to $1.66 with a mean of $2.96.

     Per Bed  Valuation  Analysis.  Based on  discussions  with  long-term  care
companies on per licensed bed valuations placed on facilities deemed by Shattuck
Hammond  to have  similar  characteristics  to those  operated  by the  Company,
Shattuck  Hammond  conducted  an  analysis  of the  value of the  number of beds
operated by the Company.  This analysis  differentiated  between beds which were
owned  and  those  which  were  leased   (excluding  the  Assumed   Discontinued
Facilities).  Shattuck  Hammond  estimated  a range of bed  values of $40,000 to
$30,000,  with a mean of $35,000 for owned beds, and $18,000 to $12,000,  with a
mean of $15,000 for leased beds.  Shattuck  Hammond then multiplied these values
by the respective  number of beds owned and leased by the Company,  adjusted for
the Estimated Balance Sheet Adjustments,  and derived a value per Share range of
$3.46  to  $0.44  with a mean of  $1.95.  Shattuck  Hammond  noted  in its  oral
presentation  to the Parent  Board that the per bed  valuation  analysis did not
take into account any synergies  that Parent  expected to derive in  conjunction
with the Transaction.

     Accretion/(Dilution)  Analysis.  Shattuck  Hammond  conducted  a per  share
accretion/(dilution)  analysis based on the projected  impact of the Transaction
on Parent's  projected  earnings per share.  This analysis  assumed (i) Parent's
estimate of transaction  costs,  (ii) a $4.5 million loss on the  disposition of
the Assumed  Discontinued  Facilities,  and (iii) a purchase  price per Share of
$3.50.  Shattuck  Hammond  created  a  high,  average  and low  analysis  of the
accretion/(dilution)  impact on Parent's  earnings per share by discounting both
the Company's 1997 pro forma projected pre-tax income and 1998 projected pre-tax
income by 0%, 20% and 30%, respectively. Through this analysis, Shattuck Hammond
derived a projected  accretion/(dilution)  impact on Parent's earnings per share
from $0.03 to $0.01 with a mean of $0.02 for 1997,  and from $0.09 to $0.05 with
a mean  of  $0.07  for  1998.  Shattuck  Hammond  noted  in  its  June  20  oral
presentation  to the  Parent  Board  that (i) based on due  diligence  conducted
subsequent  to June 11, 1997,  Parent  believed that the disposal of the Assumed
Discontinued  Facilities  would not result in a material  loss and (ii) that the
analysis did not take into  account any  synergies  related  either to potential
interest  savings due to  refinancing  of existing  debt and leases or potential
cost savings  resulting  from reduced  insurance  premiums  paid by the Company.
Shattuck  Hammond  further noted that such factors would  potentially  result in
additional accretion to Parent's projected earnings per share.

     The preparation of fairness opinions involves various  determinations as to
the most  appropriate  and  relevant  quantitative  and  qualitative  methods of
financial  analyses  and the  application  of those  methods  to the  particular
circumstances. Accordingly, such opinions are not readily susceptible to summary
description.  In arriving at the Shattuck Hammond Opinion,  Shattuck Hammond did
not attribute any particular  weight to any analysis or factor considered by it,
but rather made  qualitative  judgments as to the  significance and relevance of
each analysis and factor.  Shattuck  Hammond,  therefore,  believes its analyses
must be considered as a whole and that  considering any portion of such analyses
could create a  misleading  or  incomplete  view of the process  underlying  the
Shattuck Hammond Opinion.

     Shattuck  Hammond  was  retained  by the  Parent  Board on the basis of its
experience as financial  advisors in connection  with mergers and  acquisitions.
The Parent Board retained  Shattuck  Hammond to provide  financial  advisory and
investment  banking services to Parent,  and to provide an opinion to the Parent
Board as to the  fairness of the  Transaction  to Parent's  stockholders  from a
financial  point of view,  pursuant  to a letter  agreement  dated June 5, 1997.
Pursuant to that agreement,  Parent agreed to pay Shattuck  Hammond (i) a fee of
$100,000 payable upon the signing of such agreement,  and (ii) a fee of $200,000
payable on the date of delivery  of its  opinion as to the  fairness to Parent's
stockholders from a financial point of view of the proposed  transaction,  which
sum on the date hereof had not been paid.



                                       22

<PAGE>






Parent also agreed to reimburse Shattuck Hammond for expenses including fees and
expenses of its legal counsel  incurred by it and to indemnify  Shattuck Hammond
for certain  liabilities  that may arise out of the rendering of its services or
opinions.

     Shattuck  Hammond is a nationally  recognized  investment  banking firm. As
part of its investment banking business, Shattuck Hammond is continually engaged
in the valuation of businesses and their  securities in connection  with mergers
and  acquisitions,   negotiated   underwritings,   secondary   distributions  of
securities, private placements and other purposes. Shattuck Hammond had provided
certain  investment  banking  services  to Parent from time to time prior to its
engagement with respect to the Transaction, including (i) for a fee of $125,000,
the delivery of a commercial reasonableness opinion in January 1997 with respect
to  a  line  of  credit  made  available  to  the  Company  by  Parent,  partial
consideration  for which  included  issuance to Parent of certain Share purchase
warrants and the granting of a management contract by the Company to Parent; and
(ii) for a fee of $60,000,  which was paid in November  1996,  the delivery of a
valuation  report  and  fairness  opinion  in  connection  with  an  acquisition
unrelated to the Company.  Also, in March 1997,  Parent engaged Shattuck Hammond
pursuant to a written  agreement to perform  financial  advisory services and to
render oral and written  opinions  as to the  fairness to Parent's  stockholders
from a financial point of view of a proposed transaction. This engagement letter
provided for payment to Shattuck  Hammond of a fee of $100,000 upon execution of
the engagement letter, an additional  $100,000 fee upon the rendering of an oral
fairness  opinion and an  additional  fee of $150,000 upon delivery of a written
fairness opinion. The transaction was never consummated and Parent has agreed to
pay  Shattuck  Hammond  a total  of  $100,000  (plus  reimbursement  of  certain
expenses) in connection with such engagement.  In addition,  Shattuck Hammond is
serving  as Dealer  Manager  in this  Offer  for which it will  receive a fee of
$150,000 and  reimbursement  of expenses.  The management of Parent and Shattuck
Hammond are in the process of discussing  the  potential  engagement of Shattuck
Hammond to provide additional financial advisory services in the future.

     The Shattuck  Hammond  Opinion will be made  available for  inspection  and
copying at the principal executive offices of Parent during its regular business
hours by any  interested  equity  security  holder of  Parent  or such  person's
representative  who has been so  designated in writing.  In addition,  a copy of
Shattuck Hammond's written presentation has been filed as an exhibit to the Rule
13e-3 Transaction Statement on Schedule 13E-3 filed with the Commission and will
be available for  inspection and copying at the principal  executive  offices of
the Parent during regular  business  hours by any interested  stockholder of the
Company or  representatives  of such  stockholder  who has been so designated in
writing  and may be  inspected  and  copied,  and  obtained  by  mail,  from the
Commission  in  the  manner  specified  in  "THE  OFFER  -  Certain  Information
Concerning the Company."


6.  PURPOSE AND STRUCTURE OF THE OFFER AND THE MERGER; REASONS OF PARENT AND
    PURCHASER FOR THE OFFER AND THE MERGER


     Purpose and Structure. The purpose of the Offer is for Parent indirectly to
acquire the entire equity interest in the Company.  The purpose of the Merger is
for Parent to acquire all of the equity  interest  in the  Company not  acquired
pursuant to the Offer. Upon consummation of the Merger,  the Company will become
a  wholly-owned  subsidiary  of Parent.  The  acquisition  of the entire  equity
interest in the Company has been structured as a cash tender offer followed by a
cash merger in order to provide a prompt and orderly  transfer of  ownership  of
the equity  interest in the Company held by  stockholders  of the Company (other
than Parent and Purchaser)  from such  stockholders to Parent and to provide the
stockholders  of the Company (other than Parent and Purchaser) with cash for all
of their Shares.

     Under the Delaware GCL and the Company's certificate of incorporation,  the
approval of the Company Board and, under certain circumstances,  the affirmative
vote of the  holders of a majority  of the  outstanding  Shares are  required to
approve  and  adopt  the  Merger  Agreement  and the  transactions  contemplated
thereby, including the Merger. If the Offer is consummated, Parent and Purchaser
will have  sufficient  voting  power to cause the  approval  and adoption of the
Merger  Agreement  and  the  transactions   contemplated   thereby  without  the
affirmative vote of any other stockholder of the Company. Pursuant to the Merger
Agreement, the purchase by Purchaser of all Shares validly tendered in the Offer
and not withdrawn is a condition to the Merger.


                                       23

<PAGE>






     In the  Merger  Agreement,  the  Company  has  agreed  to take  all  action
necessary  to  convene a special  meeting of its  stockholders  as  promptly  as
practicable  after the  consummation of the Offer for the purpose of considering
and taking  action on the Merger  Agreement  and the  transactions  contemplated
thereby, if such action is required under the Delaware GCL. Parent and Purchaser
have agreed that all Shares owned by them and their subsidiaries,  including all
Shares  purchased in the Offer,  will be voted in favor of the Merger  Agreement
and the transactions contemplated thereby.

     Under the Delaware GCL, if, following  consummation of the Offer, Purchaser
owns at least 90% of the  Shares  then  outstanding,  Purchaser  will be able to
cause the Merger to occur without a vote of the Company's stockholders.  In such
event,  Parent,  Purchaser and the Company have agreed to take all necessary and
appropriate action to cause the Merger to become effective as soon as reasonably
practicable  after  consummation of the Offer without a meeting of the Company's
stockholders.  In the event all of the  conditions  to the Offer set forth under
"THE OFFER - Certain  Conditions  of the Offer"  shall have been  satisfied  but
there shall not have been  tendered to the Purchaser  sufficient  Shares so that
the Merger could be effected without a stockholders'  meeting in accordance with
Section 253 of the Delaware GCL,  Purchaser may extend the Offer for a period or
periods  aggregating  not more than 15 business  days after the later of (i) the
initial  expiration  date of the  Offer and (ii) the date on which all the other
conditions  to the Offer set forth under "THE OFFER  Certain  Conditions  of the
Offer" have been satisfied.  If, following  consummation of the Offer, Purchaser
owns less  than 90% of the  Shares  then  outstanding,  a vote of the  Company's
stockholders will be required under the Delaware GCL to approve the Merger,  and
a significantly longer period of time will be required to effect the Merger. See
"THE OFFER - Certain Conditions of the Offer."

     Parent's Reasons for the Offer and the Merger.  Parent determined to pursue
the acquisition of the Company because of its determination that the acquisition
of geriatric  care  facilities in rural areas will be an important  component in
the expansion of its post-acute care network.  Parent's  recent  acquisitions of
home  healthcare   companies  have  established  the  Parent's  home  healthcare
capabilities  in rural  areas,  particularly  in certain of the areas  where the
Company has facilities. Parent believes that operating geriatric care facilities
in the same area as its home  healthcare  operations is important to its ability
to realize the full value of its home healthcare  operations.  In addition,  the
Parent believes that owning the Company will provide it with additional  markets
for its  rehabilitation  and  other  ancillary  services,  which  are  currently
provided to the Company's  facilities in large part by other  companies.  Parent
determined to pursue the acquisition of the Company in its entirety at this time
because without the Parent's  ongoing  financial and operational  support and in
light of the ongoing  consolidation  in the healthcare  industry,  the Company's
ability to survive as an independent  company is questionable  and the Parent is
not willing to  continue to support the Company as it has over the past  several
months  without the  benefits  of full  ownership.  Accordingly,  Parent and the
Purchaser believe the Offer and the Merger are in the best interests not only of
the Company's stockholders, but all of the Company's constituents, including its
employees, patients and suppliers.

     As an inducement to Parent to enter into the Merger  Agreement,  Dr. Elkins
has  agreed  that to the  extent the  Company's  net income to Parent  (assuming
certain of the  Company's  existing  facilities  are sold or  closed)  after the
incorporation of the Company's assets into Parent's  operations for the one-year
period ending on the first anniversary of the Merger (the "Guaranty  Period") is
less  than  the  projected  net  income  for the  Company  as set  forth  in the
projections  prepared by the Company and reviewed by Parent in  connection  with
the  transactions  contemplated by the Merger Agreement for the Guaranty Period,
Dr.  Elkins will pay to Parent the amount of the  shortfall,  up to a maximum of
his  after-tax net proceeds from his sale of Shares in the Offer and the Merger.
Dr. Elkins  guaranty is  conditioned  on  reimbursement  rates for the Company's
services,  in general,  remaining stable or increasing.  If reimbursement  rates
decrease,  then Dr.  Elkins'  guaranty  shall be  reduced in  proportion  to the
decrease in the reimbursement rate.


7. PLANS FOR THE COMPANY AFTER THE OFFER AND THE MERGER; CERTAIN EFFECTS OF THE
   OFFER AND THE MERGER

     Pursuant to the Merger Agreement, promptly upon completion of the Offer,
Parent and Purchaser intend to effect the Merger in accordance with the terms
of the Merger Agreement. See "SPECIAL FACTORS - The Merger Agreement."


                                       24

<PAGE>






     Parent's  management  has begun,  and intends to continue,  a review of the
Company  and  its  assets,  corporate  structure,  capitalization,   operations,
properties,  policies,  management and personnel to determine  what changes,  if
any,  would be desirable in order best to organize and integrate the  activities
of the Company  and  Parent.  Parent  expressly  reserves  the right to make any
changes  that it deems  necessary  or  appropriate  in light of its review or in
light of future  developments  or that would be  desirable  to permit  Parent to
manage the  Company.  Except as  otherwise  disclosed in this Offer to Purchase,
Parent has no present plans or proposals  that would result in an  extraordinary
corporate transaction involving the Company or any of its subsidiaries,  such as
a merger,  reorganization,  liquidation,  relocation  of  operations  or sale or
transfer of a material  amount of assets.  Parent  currently  intends to sell or
close down 12 to 15 of the  Company's  facilities  by December  31,  1997.  Such
facilities  generated  revenue of  approximately  $18 million to $23 million and
pre-tax losses of approximately $4 million to $5 million.  Parent has determined
that these  facilities  are located in markets which do not fit within  Parent's
post-acute care network strategy.

     On July 28,  1997,  IHS  entered  into a letter of intent  with  Health and
Retirement  Properties Trust ("HRPT"),  the Company's  principal  landlord and a
significant  lender to the  Company,  relating to an  agreement-in-principle  to
restructure  the lease and loan  agreements  between the Company and HRPT if the
transactions contemplated by the Merger Agreement are consummated. In April 1997
Parent  had   guaranteed   the  Company's   obligations   to  HRPT.   Under  the
agreement-in-principle,  (i) Parent or a nominee  will  purchase 14  facilities,
aggregating 1,238 beds, currently owned by HRPT and leased to the Company,  (ii)
approximately  $12.2 million  principal amount of loans from HRPT to the Company
will be prepaid and the collateral  security  released,  (iii) three  facilities
mortgage  financed  by HRPT  will be sold to HRPT  and  leased  to  Parent  or a
nominee,  (iv)  approximately  $8.8  million of mortgage  indebtedness  due HRPT
secured by nine  facilities  owned by the Company will be assumed by Parent or a
nominee,  (v) leases of 16 facilities operated by the Company will be assumed by
Parent or a nominee,  and (vi) the leases and  mortgages  being  assumed will be
modified to reduce future rent  increases  and release cash  security  deposits.
Parent will  guarantee all lease and mortgage  obligations  to HRPT,  which will
receive a $3.7 million  modification  fee. The  restructuring  of the  Company's
lease and loan arrangements with HRPT is subject to the completion of definitive
documentation,  and  there  can be no  assurance  the  Company's  lease and loan
arrangements  with HRPT will be  restructured on these terms, on different terms
or at all.

     As a result of the Offer,  the interest of Parent in the Company's net book
value and net  earnings  will  increase  in  proportion  to the number of Shares
acquired in the Offer. If the Merger is consummated,  Parent's  interest in such
items and in the Company's equity generally will increase to 100% and Parent and
its subsidiaries will be entitled to all benefits  resulting from that interest,
including  all  income  generated  by the  Company's  operations  and any future
increase in the Company's  value.  Similarly,  Parent will also bear the risk of
losses  generated by the Company's  operations  and any decrease in the value of
the Company after the Merger.  Subsequent to the Merger, current stockholders of
the Company  (other than Parent)  will cease to have any equity  interest in the
Company, will not have the opportunity to participate in the earnings and growth
of the Company after the Merger and will not have any right to vote on corporate
matters.  Similarly,  stockholders will not face the risk of losses generated by
the  Company's  operations  or  decline  in the value of the  Company  after the
Merger.

     The Shares are currently traded on The Nasdaq Stock Market, Inc.'s National
Market  (the  "Nasdaq  National  Market").  See "THE OFFER - Price  Range of the
Shares;  Dividend  Information."  Following the consummation of the Merger,  the
Shares  will no longer be quoted on Nasdaq  and the  registration  of the Shares
under the Exchange Act will be terminated.  Accordingly,  after the Merger there
will be no publicly traded equity securities of the Company  outstanding and the
Company will no longer be required to file periodic reports with the Commission.
See "THE  OFFER - Effect  of the  Offer on the  Market  for the  Shares,  Margin
Regulations  and  Registration  under the Exchange  Act." It is expected that if
Shares are not accepted  for payment by Purchaser  pursuant to the Offer and the
Merger is not consummated,  the Company's current management,  under the general
direction  of the  Company  Board,  will  continue  to manage the  Company as an
ongoing business.



                                       25

<PAGE>


8. RIGHTS OF STOCKHOLDERS IN THE MERGER

     Holders  of Shares do not have  appraisal  rights as a result of the Offer.
However,  if the Merger is consummated,  holders of Shares at the Effective Time
will have  certain  rights  pursuant  to the  provisions  of Section  262 of the
Delaware GCL ("Section 262") to dissent and demand  appraisal of, and to receive
payment  in  cash of the  fair  value  of,  their  Shares.  Under  Section  262,
dissenting stockholders who comply with the applicable statutory procedures will
be  entitled  to  receive a  judicial  determination  of the fair value of their
Shares  (exclusive  of any element of value arising from the  accomplishment  or
expectation of the proposed Merger). In addition,  such dissenting  stockholders
would  be  entitled  to  receive  a fair  rate  of  interest  from  the  date of
consummation  of the  Merger on the  amount  determined  to be the fair value of
their Shares. In determining the fair value of the Shares, the court is required
to take into account all relevant factors. Accordingly, such determination could
be based upon considerations  other than, or in addition to, the market value of
the Shares, including, among other things, asset values and earning capacity. In
Weinberger v. UOP, Inc., the Delaware  Supreme Court stated that "proof of value
by any  techniques or methods which are generally  considered  acceptable in the
financial  community and otherwise  admissible in court" should be considered in
an appraisal proceeding. The Weinberger court also noted that under Section 262,
fair value is to be  determined  "exclusive of any element of value arising from
the  accomplishment or expectation of the merger." In Cede & Co. v. Technicolor,
Inc.,  however,  the Delaware  Supreme  Court  stated that,  in the context of a
two-step  cash  merger,  "to the extent  that value has been added  following  a
change in majority  control before cash-out,  it is still value  attributable to
the going concern," to be included in the appraisal process. As a consequence of
the foregoing,  the fair value  determined in any appraisal  proceeding could be
the same as or more or less than the Merger Consideration.

     Purchaser  does not intend to object,  assuming the proper  procedures  are
followed,  to the exercise of appraisal rights by any stockholder and the demand
for appraisal of, and payment in cash for the fair value of, the Shares.  Parent
intends,  however,  to cause the Surviving  Corporation to argue in an appraisal
proceeding that, for purposes of such  proceeding,  the fair value of each Share
is less than the Merger  Consideration.  In this regard,  stockholders should be
aware that  opinions  of  investment  banking  firms as to the  fairness  from a
financial  point of view (including the opinions of Smith Barney and Wheat First
described herein) are not necessarily  opinions as to "fair value" under Section
262.

     THE  FOREGOING  SUMMARY OF THE RIGHTS OF DISSENTING  STOCKHOLDERS  DOES NOT
PURPORT  TO  BE A  COMPLETE  STATEMENT  OF  THE  PROCEDURES  TO BE  FOLLOWED  BY
STOCKHOLDERS  DESIRING  TO  EXERCISE  ANY  AVAILABLE  APPRAISAL  RIGHTS  AND  IS
QUALIFIED  IN ITS ENTIRETY BY REFERENCE TO THE FULL TEXT OF SECTION 262 INCLUDED
HEREWITH  IN ANNEX C. THE  PRESERVATION  AND  EXERCISE OF  APPRAISAL  RIGHTS ARE
CONDITIONED  ON STRICT  ADHERENCE TO THE  APPLICABLE  PROVISIONS OF THE DELAWARE
GCL.

     Several   decisions  by  Delaware   courts  have  held  that,   in  certain
circumstances, a controlling stockholder of a company involved in a merger has a
fiduciary duty to other  stockholders that requires that the merger be "entirely
fair" to such other  stockholders.  In  determining  whether a merger is fair to
minority stockholders,  Delaware courts have considered, among other things, the
type and amount of  consideration to be received by the stockholders and whether
there was fair dealing among the parties.  The Delaware  Supreme Court stated in
Weinberger  and in Rabkin v. Philip A. Hunt  Chemical  Corp.  that  although the
remedy ordinarily  available to minority  stockholders is the right to appraisal
described above, monetary damages, injunctive relief or such other relief as the
court may  fashion  may be  available  if a merger is found to be the product of
procedural unfairness, including fraud, misrepresentation or other misconduct.

9. THE MERGER AGREEMENT

     The following is a summary of the material terms of the Merger Agreement, a
copy of which  appears as an Exhibit to the Tender  Offer  Statement on Schedule
14D-1 filed by Purchaser and Parent with the  Commission in connection  with the
Offer.  Such  summary is  qualified  in its  entirety by reference to the Merger
Agreement.

     The Offer. The Merger Agreement  provides for the commencement of the Offer
as promptly  as  practicable  after the date  thereof but in no event later than
five  business days after the date of public  announcement  of the execution and
delivery of the Merger Agreement. The obligation of the Purchaser


                                       26

<PAGE>






to  commence  the Offer and to accept for  payment  and pay for Shares  tendered
pursuant to the Offer is subject to the  satisfaction or waiver by the Purchaser
of the  conditions  described in "THE OFFER - Certain  Conditions of the Offer."
Under the Merger Agreement,  the Purchaser  expressly reserves the right, in its
sole discretion,  to waive any such condition (other than the Minimum Condition,
which may only be waived with the Company's  consent) and make any other changes
in the terms and conditions of the Offer; provided, that, without the consent of
the  Company,  no change  may be made  which (a)  reduces  the  number of Shares
subject to the Offer,  (b) reduces the price per Share payable in the Offer, (c)
adds to the  conditions  to the  Offer,  (d)  extends  the Offer  other  than as
described in the next sentence, (e) changes the form of consideration payable in
the Offer or (f)  amends  any other term of or adds any new term to the Offer in
any manner materially adverse to the Company's stockholders.  The Purchaser may,
without  the  consent of the  Company,  but  subject to the  Company's  right to
terminate  the Merger  Agreement if Shares have not been accepted for payment on
or before  November  30,  1997,  (i) extend the Offer,  if at the  scheduled  or
extended  expiration  date of the Offer any of the conditions to the Purchaser's
obligation to purchase Shares shall not be satisfied or waived,  until such time
as such conditions are satisfied or waived, (ii) extend the Offer for any period
required by any rule,  regulation,  interpretation or position of the Commission
or the staff thereof  applicable to the Offer,  (iii) extend the Offer from time
to time until two business days after expiration of the waiting period under the
HSR Act, and (iv) extend the Offer for an  aggregate  period of not more than 15
business  days  beyond  the  latest  expiration  date that  would  otherwise  be
permitted  under  clauses (i), (ii) or (iii) of this sentence if there shall not
have been tendered to the Purchaser  sufficient  Shares so that the Merger could
be effected  without a  stockholders'  meeting in accordance with Section 253 of
the Delaware GCL.


     The Merger.  The Merger Agreement provides that, upon the terms and subject
to the  conditions  thereof  and in  accordance  with the  Delaware  GCL, at the
Effective  Time,  the Purchaser  will be merged with and into the Company.  As a
result of the Merger,  the separate  corporate  existence of the Purchaser  will
cease  and the  Company  will  continue  as the  Surviving  Corporation.  At the
Parent's  election,  any direct or indirect  subsidiary of the Parent other than
the Purchaser may be merged with and into the Company instead of the Purchaser.


     At the Effective Time, each Share issued and outstanding  immediately prior
to the Effective Time (other than Shares owned by the Company, any subsidiary of
the Company,  the Parent,  the Purchaser or any other  subsidiary of the Parent,
which  Shares  shall  automatically  be canceled  and retired and shall cease to
exist, and no consideration  shall be delivered in exchange therefor,  or Shares
held by stockholders  who shall have properly  demanded and perfected  appraisal
rights under Section 262) will be cancelled, extinguished and converted into the
right to receive  $4.00 in cash or any higher price that may be paid pursuant to
the Offer,  payable to the holder thereof,  without interest,  upon surrender of
the certificate formerly  representing such Share in the manner described in the
Merger Agreement (the "Merger Consideration").  In addition, as of the Effective
Time,  each  share of capital  stock of the  Purchaser  issued  and  outstanding
immediately  prior to the Effective  Time shall be converted into and become one
thousand fully paid and nonassessable  shares of common stock, par value $0.0025
per share, of the Surviving Corporation.



     The Merger  Agreement  provides that Shares that are issued and outstanding
immediately  prior to the Effective Time and which are held by stockholders  who
have  complied  with all the  provisions of Section 262 of the Delaware GCL will
not be converted into the right to receive the Merger Consideration, but will be
entitled to receive the  consideration as determined  pursuant to Section 262 of
the Delaware GCL;  provided,  however,  that if, after the Effective  Time, such
stockholder  shall have failed to perfect or shall have  withdrawn  or otherwise
lost  his,  her  or  its  right  to  appraisal  under  the  Delaware  GCL,  such
stockholder's Shares shall thereupon be deemed to have been converted, as of the
Effective Time, into the right to receive the Merger  Consideration as described
above. The Merger Agreement  requires that the Company give Parent prompt notice
of any  demand  for  appraisal  of  Shares  received  by  the  Company  and  the
opportunity to participate in and direct all  negotiations  and proceedings with
respect to any demand for appraisal. In addition, the Merger Agreement prohibits
the Company  from making any payment  with  respect to,  settling or offering to
settle or otherwise negotiating any demands for appraisal without Parent's prior
consent.


                                       27

<PAGE>






     Purchaser  or the  designated  paying agent shall be entitled to deduct and
withhold  from  the  consideration  otherwise  payable  pursuant  to the  Merger
Agreement  to any holder of Shares such  amounts  that  Purchaser  or the paying
agent is  required  to deduct and  withhold  with  respect to the making of such
payment under the United States Internal  Revenue Code of 1986, as amended,  the
rules and regulations promulgated thereunder or any provision of state, local or
foreign tax law.

     The Merger  Agreement  also provides that at the Effective Time and without
any further  action on the part of the Company and the  Purchaser,  the Restated
Certificate  of  Incorporation  (the  "Certificate  of  Incorporation")  of  the
Company,  as in effect  immediately prior to the Effective Time, will be amended
to provide  that the total  number of shares of all  classes of stock  which the
Company has the  authority to issue will be 1,000 shares of Common Stock and, as
so amended,  the  Certificate  of  Incorporation  will be the  certification  of
incorporation of the Surviving  Corporation until thereafter  changed or amended
as  provided  therein and under the  Delaware  GCL.  At the  Effective  Time and
without any further  action on the part of the  Company and the  Purchaser,  the
By-Laws of the Company as in effect immediately prior to the Effective Time will
be the By-Laws of the Surviving  Corporation until thereafter changed or amended
as provided therein or by law. The Merger Agreement  provides that the directors
of the Purchaser  immediately  prior to the  Effective  Time will be the initial
directors of the Surviving  Corporation,  each to hold office in accordance with
the Certificate of Incorporation and By-Laws of the Surviving  Corporation,  and
the officers of the Company immediately prior to the Effective Time shall be the
initial  officers  of the  Surviving  Corporation,  in  each  case  until  their
respective   successors   are  duly  elected  and  qualified  or  their  earlier
resignation or removal.

     Pursuant to the Merger Agreement, following the purchase of Shares pursuant
to the Offer, if approval of the Merger Agreement by the Company's  stockholders
is  required by law,  the Company  will,  at Parent's  request,  take all action
necessary  in  accordance  with  applicable  law to  convene  a  meeting  of its
stockholders  as soon as  practicable  to  consider  and vote  upon  the  Merger
Agreement and the transactions  contemplated  thereby. The Company will, through
the Board of Directors,  recommend that the Company's stockholders vote in favor
of the  adoption  of the  Merger  Agreement  and the  transactions  contemplated
thereby,  including  preparing and filing with the Commission under the Exchange
Act a proxy  statement  (the "Proxy  Statement")  and using its best  efforts to
cause  the  Proxy  Statement  to be mailed to  stockholders  of the  Company  as
promptly as practicable after such filing.  The Company will,  through the Board
of Directors,  recommend  that the Company's  stockholders  vote in favor of the
adoption of the Merger  Agreement  and the  transactions  contemplated  thereby,
subject to the Board of Directors'  fiduciary duty under  applicable law. At the
meeting of the Company's stockholders, the Parent will cause all Shares owned by
the Parent,  the  Purchaser or any other  subsidiary  of Parent,  including  all
Shares  purchased  in the  Offer,  to be voted in favor of the  adoption  of the
Merger Agreement and the transactions contemplated thereby.


     The Delaware GCL also provides  that if a parent  company owns at least 90%
of each  class  of  stock of a  subsidiary,  the  parent  company  can  effect a
"short-form"   merger  with  that   subsidiary   without  a  stockholder   vote.
Accordingly,  if, as a result of the Offer, or otherwise, the Purchaser acquires
or controls  the voting  power of at least 90% of the  outstanding  Shares,  the
Purchaser will be able, and intends,  to effect the Merger without a stockholder
vote.



     Representations    and   Warranties.    The   Merger   Agreement   contains
representations  and  warranties  by the Company  with  respect to,  among other
things, its organization and the organization and ownership of its subsidiaries,
its capitalization,  its corporate power and governmental authorization to enter
into the Merger  Agreement,  its  filings  with the  Commission,  its  financial
statements,  and the absence of certain  changes in its business since March 31,
1997. The Company has also  represented  and warranted that  consummation of the
transactions  contemplated  by the Merger  Agreement  does not conflict  with or
result in any breach of any provision of the  Certificate of  Incorporation  and
By-Laws of the  Company,  require  any filing  with,  or permit,  authorization,
consent or approval of, any  governmental  entity other than those  described in
the Merger Agreement, violate any applicable laws or (except as set forth in the
disclosure  schedule  to  the  Merger  Agreement)  any  material  agreements  or
instruments binding on the Company.  Other representations and warranties in the
Merger  Agreement  pertain  to  the  information  supplied  by  the  Company  in
connection with the Offer, the absence of undisclosed liabilities, the Com-


                                       28

<PAGE>





pany's employee benefit plans and other compensation  arrangements,  the absence
of certain  litigation  with respect to the Company,  compliance  by the Company
with applicable law, including environmental and healthcare  reimbursement laws,
tax matters, the inapplicability of state anti-takeover  statutes (except as set
forth in the disclosure schedule to the Merger Agreement), including Section 203
of the Delaware  GCL,  the  Company's  material  contracts,  insurance  matters,
intellectual property matters,  labor matters, real estate matters, and the vote
required  to  approve   the  Merger.   The  Merger   Agreement   also   contains
representations  and  warranties  with  respect  to the  extent  of  its  equity
interests  in other  entities,  any  brokerage  fees  payable as a result of the
consummation  of the Offer and the  Merger  and the  opinions  of its  financial
advisors  with  respect to the  fairness  of the  consideration  to be  received
pursuant to the Offer and the Merger.



     The Merger  Agreement also contains  representations  and warranties by the
Parent and the Purchaser with respect to, among other things,  the  organization
of the  Purchaser  and the  Parent,  their  authority  to enter  into the Merger
Agreement,  the  information  supplied by them in connection  with the Offer and
their  financial  ability to purchase  the  Shares.  The Merger  Agreement  also
contains  representations  and  warranties by the Purchaser and the Parent which
address any required  consents under any  applicable  provisions of the HSR Act,
the Exchange Act, the Securities Act of 1933, as amended (the "Securities Act"),
and the  regulations  thereunder  and  applicable  state  takeover  laws.  Other
representations  and  warranties  by the  Purchaser  and the  Parent  state that
execution  of the Merger  Agreement  by the Parent  and the  Purchaser  will not
conflict  with or result in any breach of any  provision of the  certificate  of
incorporation  or  by-laws  of the  Parent  or the  Purchaser,  or  violate  any
applicable  laws or any agreements or  instruments  binding on the Parent or its
subsidiaries (except as provided in the Merger Agreement).


     Covenants of the Company. Pursuant to the Merger Agreement, until such time
as  Parent's  designees  constitute  a majority  of the  members of the Board of
Directors of the Company,  the Company shall and shall cause its subsidiaries to
carry on their respective  businesses in the usual,  regular and ordinary course
in substantially the same manner as conducted prior to execution and delivery of
the Merger  Agreement and use all  reasonable  efforts to preserve  intact their
present business  organizations and preserve their relationships with customers,
suppliers,  employees and others having  business  dealings with the Company and
its subsidiaries.  Without limiting the generality of the foregoing, the Company
shall not, and shall not permit any of its  subsidiaries to, without the written
consent  of Parent or as  expressly  contemplated  or  permitted  by the  Merger
Agreement,  among other things:  (i) (A) declare or pay any dividends on or make
any other  distributions  in respect of its capital stock,  other than dividends
and  distributions  by any direct or indirect  wholly-owned  subsidiaries of the
Company,  (B) split,  combine or reclassify any of its capital stock or issue or
authorize or propose the issuance of any other securities in respect of, in lieu
of or in substitution for shares of its capital stock or (C) repurchase,  redeem
or  otherwise  acquire any shares of capital  stock or other  securities  of the
Company or its subsidiaries, except pursuant to agreements referenced in Section
4.24 of the Merger Agreement or listed in the disclosure schedule thereto;  (ii)
issue, deliver,  sell, pledge or encumber any shares of its capital stock or any
securities convertible into, or any rights,  warrants,  calls,  subscriptions or
options to acquire,  any such  shares or  convertible  securities,  or any other
ownership  interest,  or authorize or propose to do any of the foregoing  (other
than the  issuance  of  Shares  upon  exercise  of stock  options  and  warrants
outstanding as of the date of the Merger  Agreement);  (iii) amend or propose to
amend  its  certificate  of  incorporation  or  by-laws;  (iv)  enter  into  any
management  agreement  for any of its assets or acquire or agree to acquire  (A)
any business or any  corporation,  partnership,  joint  venture,  association or
other  business  organization  or  division  thereof or (B) any assets  that are
material, individually or in the aggregate, to the Company and its subsidiaries,
taken as a whole,  except  purchases  of  inventory  in the  ordinary  course of
business consistent with past practice;  (v) sell, lease,  license,  encumber or
otherwise  dispose of or agree to sell,  lease,  license,  encumber or otherwise
dispose of any of its assets,  except for the  disposition  of  equipment in the
ordinary  course of business  consistent  with past practice;  (vi) (A) incur or
guarantee  any  indebtedness  for  borrowed  money,   issue  or  sell  any  debt
securities,   guarantee  any  debt  securities  of  others  or  enter  into  any
"keep-well" or other agreement to maintain any financial  statement condition of
another person or enter into any  arrangement  having the economic effect of any
of the foregoing,  except for borrowings for working capital purposes consistent
with past practices or (B) make any loans,



                                       29

<PAGE>






advances or capital  contributions  to, or investments in, any person other than
in the case of both clauses (A) and (B) any loan from the Company to a direct or
indirect wholly-owned subsidiary;  (vii) make any tax election that would have a
material  effect on the  Company  or  settle  or  compromise  any  material  tax
liabilities;  (viii) except as otherwise permitted by the Merger Agreement, pay,
discharge, settle or satisfy any claim, liability or obligation,  other than the
payment,  in the ordinary course of business consistent with past practice or in
accordance  with their  terms,  of  liabilities  recognized  or disclosed in the
Company's most recent  consolidated  financial  statements included in documents
filed  with the  Commission  and  liabilities  incurred  since  the date of such
financial  statements in the ordinary  course of business  consistent  with past
practice;  (ix)  except in the  ordinary  course  of  business  or as  otherwise
permitted  by the Merger  Agreement,  modify,  amend or  terminate  any material
agreement or waive any material  rights or claims;  or (x) except as provided in
the Merger Agreement or required by law,  increase the compensation of executive
officers or  directors,  enter into,  adopt,  amend or  terminate  any  employee
benefit plan or any plan,  agreement,  policy or arrangement  for the benefit of
any  director,  officer or current or former  employee,  or pay any  benefit not
required  by any plan or  arrangement  as in effect as of the date of the Merger
Agreement  (including the grant of, or acceleration of exercisability or vesting
of, stock options, stock appreciation rights and restricted stock). In addition,
the Company has agreed to (i) provide  Parent or its counsel  with copies of all
filings made by the Company with any governmental  entity in connection with the
Merger  Agreement;  and (ii) consult with Parent  before filing any material tax
return as to the  positions  and  elections  to be taken or made with respect to
such return,  and to take such  positions or make such  elections as the Company
and Parent shall jointly agree.

     Prohibition on Solicitation. The Merger Agreement provides that the Company
and  its  officers,  directors,  employees,   representatives  and  agents  will
immediately  cease any ongoing  discussions  or  negotiations,  if any, with any
parties  conducted prior to the date of the Merger Agreement with respect to any
Takeover  Proposal (as defined below);  provided that following the cessation of
any such discussions or negotiations,  future  discussions or negotiations  with
any such parties will be governed by the remaining provisions of this paragraph.
Except as set forth in the Merger  Agreement,  (a) neither the Company or any of
its  subsidiaries,  nor  any of its or  their  respective  officers,  directors,
employees or representatives  will encourage,  solicit or initiate (including by
way of  furnishing  information)  or take any  other  action to  facilitate  any
inquiries or the making of any proposal  which  constitutes or may reasonably be
expected to lead to any Takeover  Proposal or participate in any  discussions or
negotiations  regarding any Takeover  Proposal and (b) neither the Company Board
nor any committee  thereof shall (i) withdraw or modify,  or propose to withdraw
or modify, in a manner adverse to Parent, the approval or recommendation by such
Board of  Directors  or  committee  of the Offer,  the Merger  Agreement  or the
Merger,  (ii)  approve or  recommend,  or propose to approve or  recommend,  any
Takeover  Proposal or (iii) cause the Company to enter into any  agreement  with
respect to any Takeover  Proposal.  Notwithstanding  the foregoing,  at any time
prior to  acceptance  of the Shares  pursuant to the Offer (a) the Company Board
may take, and disclose to the Company's stockholders, a position contemplated by
Rule  14e-2(a)  promulgated  under the  Exchange  Act with respect to any tender
offer for shares of capital  stock of the  Company;  provided,  that the Company
Board will not  recommend  that the  stockholders  of the Company  tender  their
shares in  connection  with any such tender offer unless the Company Board shall
have determined in good faith,  after  consultation  with outside counsel,  that
failing to take such action would be  inconsistent  with the Board of Directors'
fiduciary duty under applicable law; (b) the Company may furnish information, in
response  to an  unsolicited  Takeover  Proposal,  to any person  pursuant  to a
confidentiality  agreement,  and may participate in negotiations concerning such
Takeover  Proposal,  if the Company Board determines in its good faith judgment,
after consultation with outside counsel,  that it is necessary to do so in order
to  comply  with  its  fiduciary  duties  to the  Company's  stockholders  under
applicable law; and (c) the Company may (subject to the provisions of the Merger
Agreement),   if  the  Board  of  Directors  determines  in  good  faith,  after
consultation  with  outside  counsel,  that it is necessary to do so in order to
comply with its fiduciary duties to the Company's  stockholders under applicable
law,  withdraw or modify its approval or recommendation of the Offer, the Merger
Agreement and the Merger,  approve or recommend a Superior  Proposal (as defined
below),  cause the Company to enter into an agreement with respect to a Superior
Proposal or terminate the Merger Agreement, but in each case only at a time that
is after the first  business day following  Parent's  receipt of written  notice
advising  Parent  that the  Company  Board has  received  a  Superior  Proposal,
specifying



                                       30

<PAGE>






the material terms and conditions of such Superior  Proposal and identifying the
person making such Superior  Proposal.  In addition,  if the Company proposes to
enter  into an  agreement  with  respect  to any  Takeover  Proposal,  it  shall
concurrently  with  entering  into such  agreement  pay, or cause to be paid, to
Parent  the  Termination  Fee (see  "-Fees  and  Expenses").  Under  the  Merger
Agreement,  the Company is  obligated  to notify the Parent  immediately  of any
request for  information  or of any Takeover  Proposal,  the material  terms and
conditions  of such request or Takeover  Proposal and the identity of the person
making such request or Takeover Proposal.  The Company has agreed to keep Parent
fully  informed  of the status  and  details  of any such  request  or  Takeover
Proposal.

     For  purposes  of the  Merger  Agreement,  "Takeover  Proposal"  means  any
inquiry,  proposal  or offer from any person  relating to any direct or indirect
acquisition  or  purchase  of 20% or more of the assets of the  Company  and its
subsidiaries or 20% or more of any class of equity  securities of the Company or
any of its subsidiaries,  any tender offer or exchange offer that if consummated
would  result  in any  person  beneficially  owning  20% or more of any class of
equity  securities  of the  Company  or any of  its  subsidiaries,  any  merger,
consolidation,  business  combination,  sale of  substantially  all the  assets,
recapitalization,  liquidation, dissolution or similar transaction involving the
Company or any of its subsidiaries,  other than the transactions contemplated by
the Merger  Agreement,  or any other transaction the consummation of which could
reasonably be expected to impede,  interfere with,  prevent or materially  delay
the Offer  and/or the Merger or which  would  reasonably  be  expected to dilute
materially the benefits to Parent of the transactions contemplated by the Merger
Agreement. For purposes of the Merger Agreement, a "Superior Proposal" means any
bona fide proposal made by a third party to acquire, directly or indirectly, for
consideration consisting of cash and/or securities,  more than 50% of the Shares
then  outstanding  or all or  substantially  all the assets of the  Company  and
otherwise on terms which the Company Board determines in its good faith judgment
(based on the advice of a financial advisor of nationally recognized reputation)
to be more  favorable  to the  Company's  stockholders  than the  Offer  and the
Merger.

     Reasonable Efforts.  The Merger Agreement provides that, upon the terms and
subject to the  conditions  thereof,  each of the parties  thereto shall use its
reasonable  efforts to take, or cause to be taken, all actions  necessary to (i)
comply promptly with all legal  requirements which may be imposed on itself with
respect to the Offer and the Merger (which actions shall include  furnishing all
information  required  under the HSR Act and in connection  with approvals of or
filings with any other governmental entity) and will promptly cooperate with and
furnish  information  to each  other in  connection  with any such  requirements
imposed upon any of them or any of their  subsidiaries  in  connection  with the
Offer and the  Merger and (ii)  obtain  (and will  cooperate  with each other in
obtaining)  any consent,  authorization,  order or approval of, or any exemption
by, any  governmental  entity or other public or private third party required to
be  obtained  or made by  Parent,  the  Purchaser,  the  Company or any of their
subsidiaries  in  connection  with the Offer and the Merger or the taking of any
action  contemplated  thereby or by the Merger  Agreement,  except that no party
need waive any substantial rights or agree to any substantial  limitation on its
operations or to dispose of any assets.


     Board of Directors.  The Merger Agreement provides that, subject to Section
14(f) of the Exchange Act and Rule 14f-1  thereunder,  promptly upon the payment
by the Purchaser for any Shares  pursuant to the Offer,  the Purchaser  shall be
entitled to designate  such number of directors of the Company as shall give the
Purchaser a majority of the directors; provided that until the Effective Time at
least two  persons  who are  directors  of the Company on the date of the Merger
Agreement  and who are not  officers of the Company  shall be  directors  of the
Company (the "Independent Directors"). Following the election of the Purchaser's
designees  to the  Board of  Directors  and  prior to the  Effective  Time,  the
affirmative vote of a majority of the Independent Directors shall be required by
the Company to (i) amend or terminate the Merger Agreement by the Company,  (ii)
exercise  or waive any of the  Company's  rights or  remedies  under the  Merger
Agreement,  or (iii)  extend  the  time  for  performance  of  Parent's  and the
Purchaser's respective obligations under the Merger Agreement.  The Company will
promptly,  at the  option  of the  Parent,  increase  the  size of the  Board of
Directors and/or obtain the resignations of such number of its current directors
as is  necessary  to enable the  Purchaser's  designees  to be elected to and to
constitute a majority of the Board of Directors,  and will cause the Purchaser's
designees to be so elected.


                                       31

<PAGE>





     Treatment of Stock Options and Warrants.  Pursuant to the Merger Agreement,
the Company has agreed to amend the  Company's  option  plans to provide that if
optionees do not exercise their  unexercised  options to purchase Shares granted
by the Company under such plans (the "Options")  within 30 days of a notice that
the Company proposes to merge into another  corporation,  then the optionee will
receive,  in  settlement of each Option,  a Cash Amount (as defined  below) with
respect to the number of Shares underlying the unexercised portion of the Option
immediately prior to the Effective Time. The Cash Amount payable for each Option
shall  equal  the  difference   between  (i)  the  product  of  (a)  the  Merger
Consideration  minus the  exercise  price per Share of each  Option  and (b) the
number of Shares covered by the  unexercised  portion of the Option and (ii) any
applicable  withholding taxes. The Company is obligated to give to each optionee
notice that the Company proposes to merge into another corporation following the
date of the Merger  Agreement.  The Company's  option plans will terminate as of
the Effective Time.

     The Merger  Agreement  provides that, at the Effective Time, each holder of
an outstanding  warrant to purchase Shares granted by the Company  ("Warrants"),
whether or not then exercisable,  shall, in settlement thereof, receive for each
Share  issuable  upon  exercise  of  such  Warrant  an  amount  (subject  to any
applicable  withholding tax) in cash equal to the difference  between the Merger
Consideration  and the per share  exercise  price of such  Warrant to the extent
such  difference  is a positive  number.  The Company has also agreed to use its
best  efforts  to obtain all  consents  or  releases  from  holders of  Warrants
necessary to give effect to the transactions contemplated by this paragraph.


     Indemnification  and  Insurance.  Under the Merger  Agreement the Purchaser
agrees  that all rights to  indemnification  existing in favor of the present or
former  directors  and  officers  of  the  Company  (as  such)  or  any  of  its
subsidiaries (collectively, the "Covered Persons"), as provided in the Company's
Certificate  of  Incorporation  or By-Laws,  or the  articles of  incorporation,
by-laws  or  similar  documents  of any of the  Company's  subsidiaries  and the
indemnification  agreements with such present and former  directors and officers
filed with the Commission and publicly available prior to the date of the Merger
Agreement,  with respect to matters  occurring  prior to the Effective Time will
survive  the Merger and  continue  in full force and effect in  accordance  with
their terms.  In addition,  for a period of six years from the  Effective  Time,
Parent shall (i) guarantee such indemnification obligations and (ii) maintain in
effect the Company's current officers' and directors' liability insurance policy
covering those persons who were covered at the time of the Merger Agreement.

     Conditions to Merger. The respective obligation of each party to the Merger
Agreement  to effect the Merger shall be subject to the  satisfaction,  prior to
the closing of the  transactions  contemplated by the Merger  Agreement,  of the
following  conditions:  (a) if necessary under  applicable law, the Merger shall
have been adopted by the requisite  vote of the  stockholders  of the Company in
accordance  with the  Delaware  GCL; (b) no legal  requirements  shall have been
enacted,  entered,  promulgated or enforced by any court or governmental  entity
which prohibit or prevent the  consummation of the Merger (provided that each of
the parties shall have used reasonable  efforts to prevent the entry of any such
injunction  or other order and to appeal as promptly as possible any  injunction
or other order that may be entered; (c) Purchaser shall have previously accepted
for payment and paid for Shares  pursuant to the Offer;  and (d) the  applicable
waiting period under the HSR Act shall have expired or been terminated.


     Termination.  The Merger  Agreement  may be terminated at any time prior to
the Effective Time of the Merger,  whether before or after approval of the terms
of the  Merger  Agreement  by the  stockholders  of the  Company,  (a) by mutual
consent  of the Parent and the  Company  (but only by action of the  Independent
Directors after the purchase of Shares pursuant to the Offer); (b) by either the
Company  or the  Parent  if (i) (x) as a  result  of the  failure  of any of the
conditions to the Offer the Offer shall have terminated or expired in accordance
with its terms  without the  Purchaser  having  accepted  for payment any Shares
pursuant to the Offer or (y) the  Purchaser  shall not have accepted for payment
any Shares pursuant to the Offer prior to November 30, 1997; provided,  however,
that the right to terminate the Merger  Agreement  shall not be available to any
party whose failure to perform any of its obligations under the Merger Agreement
results in the failure of any such condition or if the failure of such condition
results from facts or circumstances  that constitute a breach of  representation
or warranty under the Merger  Agreement by such party; or (ii) any  governmental
entity shall have issued an order,


                                       32

<PAGE>






decree or ruling or taken any other action permanently enjoining, restraining or
otherwise  prohibiting  the  acceptance  for payment of, or payment for,  Shares
pursuant  to the Offer or the Merger and such  order,  decree or ruling or other
action shall have become final and nonappealable; (c) by Parent or the Purchaser
(i)  prior to the  purchase  of Shares  pursuant  to the Offer in the event of a
breach  by the  Company  of any  representation,  warranty,  covenant  or  other
agreement  contained  in the Merger  Agreement  which (A) would give rise to the
failure  of  certain  conditions  to the Offer and (B) cannot be or has not been
cured within 20 days after the giving of written notice to the Company;  (ii) if
Parent or the  Purchaser is entitled to  terminate  the Offer as a result of the
Company Board or any committee  thereof having withdrawn or modified in a manner
adverse to Parent or the Purchaser its approval or  recommendation of the Offer,
the Merger or the Merger  Agreement,  or approved or  recommended  any  Takeover
Proposal,  or if the Company shall have entered into any agreement  with respect
to any Superior  Proposal in accordance with the Merger Agreement or the Company
Board or any committee  thereof has resolved to do any of the foregoing or (iii)
if, due to an  occurrence,  not  involving  a breach by Parent or the  Purchaser
under the Merger  Agreement,  which  makes it  impossible  to satisfy any of the
conditions set forth in "THE OFFER - Certain  Conditions of the Offer,"  Parent,
the Purchaser or any of their affiliates shall have failed to commence the Offer
on or prior to five  business  days  following  the date of the  initial  public
announcement  of the Offer;  (d) by the Company (i) in connection  with entering
into a definitive  agreement  relating to a Superior Proposal in accordance with
the Merger Agreement,  or (ii) if Parent or the Purchaser shall have breached in
any  material  respect  any of  their  respective  representations,  warranties,
covenants or other agreements contained in the Merger Agreement, which breach or
failure to perform is  incapable  of being cured or has not been cured within 20
days  after  the  giving of  written  notice  to  Parent  or the  Purchaser,  as
applicable,  except,  in any case,  such  breaches  and  failures  which are not
reasonably  likely to affect  adversely  Parent's or the Purchaser's  ability to
complete the Offer or the Merger,  or (iii) if Parent,  the  Purchaser or any of
their  affiliates  shall have failed to  commence  the Offer on or prior to five
business days following the date of the initial public announcement of the Offer
(provided  that the Company may not terminate the Merger  Agreement  pursuant to
this provision if the Company is at such time in breach of its obligations under
the Merger  Agreement such as to cause a material  adverse effect on the Company
and its subsidiaries, taken as a whole).


     In the  event  of the  termination  of the  Merger  Agreement,  the  Merger
Agreement  shall  forthwith  become  void and of no effect and there shall be no
liability on the part of any party thereto  except as described  under "Fees and
Expenses"  below and as otherwise  provided in the Merger  Agreement;  provided,
however,  that  nothing  in the Merger  Agreement  will  relieve  any party from
liability for any breach thereof before termination.

     Fees and Expenses.  The Merger Agreement  provides that, except as provided
in the following  paragraph,  all fees and expenses  incurred in connection with
the Offer, the Merger,  the Merger  Agreement and the transactions  contemplated
thereby will be paid by the party  incurring  such fees or expenses,  whether or
not the Offer or the Merger is consummated.


     Under the Merger  Agreement  the Company will pay, or cause to be paid,  in
same  day  funds,  to  the  Parent  (a) a  termination  fee of  $1,000,000  (the
"Termination  Fee") and (b) all  outstanding  loans between Parent or any of its
subsidiaries  and the Company if the Merger  Agreement is terminated  (w) by the
Company in accordance  with the provisions  described in clause (d)(i) under the
heading "Termination" above, (x) by the Parent in accordance with the provisions
described  in clause  (c)(ii)  under the heading  "Termination"  above or (y) by
either the Company or Parent in accordance  with the provisions of clause (b)(i)
above and (I) prior  thereto there shall have been  publicly  announced  another
Takeover Proposal or an event described in clause (d) under "THE OFFER - Certain
Conditions  of the Offer" shall have  occurred  and (II) a Takeover  Proposal is
consummated on or prior to March 31, 1998. Any amounts  payable  pursuant to the
Merger  Agreement shall be payable  concurrently  with termination of the Merger
Agreement in the case of  termination  pursuant to clauses (w) and (x) above and
at the time of  consummation  of a  Takeover  Proposal  as  described  in clause
(y)(II) above.


     Amendment;  Waiver. Any provision of the Merger Agreement may be amended or
waived prior to the Effective  Time (as set forth in the Merger  Agreement)  if,
and  only  if,  such  amendment  is in  writing  and  signed,  in the case of an
amendment, by the Company, the Parent and the Purchaser or, in the case


                                       33

<PAGE>





of a waiver,  by the party against whom the waiver is to be effective;  provided
that (i) any waiver or amendment shall be effective  against a party only if the
board of directors  of such party  approves  such waiver or  amendment  and (ii)
after the adoption of the Merger  Agreement by the  stockholders of the Company,
no such  amendment  or waiver  shall be made which by law  requires  the further
approval  of  such   stockholders   without  obtaining  such  further  approval.
Notwithstanding any provision included under this heading "Amendment; Waiver" to
the contrary, following the election or appointment of the Purchaser's designees
as directors of the Company and prior to the  Effective  Time,  the  affirmative
vote of a majority of the Independent Directors then in office shall be required
by the Company to (i) amend or  terminate  the Merger  Agreement by the Company,
(ii) exercise or waive any of the Company's  rights or remedies under the Merger
Agreement or (iii) extend the time for performance of Parent and the Purchaser's
respective obligations under the Merger Agreement.

     No  failure  by any  party to assert  any of its  rights  under the  Merger
Agreement or otherwise shall operate as a waiver thereof.

     Assignment.  The Merger  Agreement  shall be binding  upon and inure to the
benefit of the parties  thereto and their  respective  successors  and  assigns,
provided  that no party may assign any of its rights,  interests or  obligations
under the  Merger  Agreement  without  the prior  written  consent  of the other
parties thereto,  except that the Purchaser may assign any or all of its rights,
interests and obligations  under the Merger  Agreement to any direct or indirect
wholly-owned subsidiary of Parent.

10. INTERESTS OF CERTAIN PERSONS IN THE OFFER AND THE MERGER

     In  considering  the  recommendations  of the Company Board and the Special
Committee  with  respect  to the Offer and the Merger  and the  fairness  of the
consideration to be received in the Offer and the Merger, stockholders should be
aware that certain  officers and directors of the Company have  interests in the
Offer and the Merger which are  described  below and which may be in addition to
their  interests as  stockholders  of the Company.  Stockholders  also should be
aware that Parent and Purchaser  have certain  interests  that present actual or
potential  conflicts of interest in connection with the Offer and the Merger. As
a result of the  current  beneficial  ownership  of  approximately  21.0% of the
outstanding  Shares by Dr. Robert N. Elkins,  Parent's Chairman of the Board and
Chief  Executive  Officer,  Parent's  ownership  of warrants to purchase  Shares
representing approximately 13.5% of the outstanding Shares, the fact that two of
the Company's directors  (including Dr. Elkins) are directors of Parent, and the
management services and loans provided to the Company by the Parent,  Parent may
be deemed to control the Company.  The Special  Committee  and the Company Board
were  each  aware of these  actual  and  potential  conflicts  of  interest  and
considered them along with the other matters  described  under "SPECIAL  FACTORS
Recommendations of the Special Committee and the Company Board;  Fairness of the
Offer and the Merger."

     Dr.  Robert  N.  Elkins  and  Mr.  John  Silverman,  two of  the  Company's
directors,  are also stockholders,  directors and officers of Parent. Dr. Elkins
is a  stockholder  of Parent and the  Chairman of the Board and Chief  Executive
Officer of Parent,  and Mr.  Silverman is a stockholder  of Parent and the Chief
Executive Officer of a subsidiary of Parent.

     Michael S. Blass, Esq., a director of the Company,  is a partner of Blass &
Driggs,  which law firm has provided and continues to provide legal  services to
Parent as well as the Company on matters unrelated to the Merger Agreement. Fees
paid to Blass & Driggs by the Parent and the  Company in 1996 were $2.6  million
and $550,000, respectively.

     Ms. Deborah Lau is a member of the Special Committee.  Prior to joining the
Company as Chief  Operating  Officer in 1995, Ms. Lau was an employee of Parent.
She has no contractual arrangements,  commitments or understandings with Parent.
Ms. Lau is currently  President and Chief Executive Officer of the Company.  Ms.
Lau has an  employment  agreement  with the Company.  The  employment  agreement
provides for a term of three years  commencing  October 2, 1995,  with automatic
one-year  extensions on each anniversary  thereof unless either party elects not
to so extend by giving written notice at least 90 days prior to such anniversary
date.  Ms. Lau's current base salary is $237,659 per annum,  subject to increase
annually by a percentage equal to the percentage  increase in the Consumer Price
Index and such additional  amounts as may be determined at the discretion of the
Company's Chief Executive Officer. In addition, Ms. Lau may



                                       34

<PAGE>






also receive annual bonuses at the discretion of the Company's  Chief  Executive
Officer,  subject to a maximum amount equal to 35% of base salary per annum (and
a minimum of $56,250) for the year ended December 31, 1996).  Because Ms. Lau is
now  Chief  Executive  Officer  of the  Company,  the  Company  intends  to have
determinations  as to salary  increases  and  bonuses  made by either the entire
Company Board or the  Compensation  and Options  Committee of the Company Board.
Ms. Lau's  employment  agreement  provides  that the Company may  terminate  her
employment for, among other reasons, cause (as defined) by continuing to pay Ms.
Lau her then current base salary for a period of 18 months, provided that if, at
the time,  less than 18 months remains on the term of her employment  agreement,
such base salary  shall  continue  for the longer of the  remaining  term of her
employment  agreement or 12 months. In the event of a "change of control" of the
Company (as defined), Ms. Lau has the right, upon giving 30 days' written notice
to the Company  within 180 days  following  such event (or, if terminated by the
Company  during such 180 day period),  to  terminate  her  employment,  in which
event, Ms. Lau shall be entitled to receive her then base salary for a period of
36 months following the date of such termination and all stock options then held
by Ms. Lau shall  become fully  vested.  A "change of control" of the Company is
deemed to occur under Ms. Lau's employment  agreement:  (i) when a person, other
than Dr. Robert N. Elkins or an  institutional  investor becomes the "beneficial
owner" of more  than 20% or more of the  Shares,  (ii) in the  event of  certain
mergers or  consolidations  in which the  Company is not the  surviving  entity,
(iii) in the event of the sale,  lease or transfer of  substantially  all of the
Company's assets or the liquidation of the Company, or (iv) if Dr. Elkins ceases
to  be  a  director  of  the  Company.  The  consummation  of  the  transactions
contemplated by the Merger Agreement will constitute a "change of control" under
Ms. Lau's employment agreement.

     Mr.  Wallace Olson is a member of the Special  Committee.  Mr. Olson has no
contractual or other  relationship  with Parent or any of its affiliates  (other
than the  Company).  Mr.  Olson was a principal  shareholder  of  Southern  Care
Centers, Inc. ("Southern Care"), which was merged into a wholly-owned subsidiary
of the Company in May 1996. In connection with such transaction, the Company and
the selling shareholders of Southern Care (including Mr. Olson) are engaged in a
dispute  regarding  post-closing   settlement  matters.  The  Company  claims  a
receivable  due  from  the  selling   shareholders,   including  Mr.  Olson,  of
approximately  $1.4  million.  Such  claim  has  been  disputed  by the  selling
shareholders  of  Southern  Care,  who have also  asserted  claims  against  the
Company. See Note 2 to the Company's  Consolidated Financial Statements included
in Schedule III.

     Information  regarding the beneficial  ownership of Shares by the Company's
directors and executive  officers is set forth under "SPECIAL FACTORS Beneficial
Ownership of Shares." Messrs. Blass and Silverman, directors of the Company, and
Mr. William Krystopowicz,  an executive officer of the Company, are parties to a
voting  agreement  in favor of Dr.  Elkins  with  respect to their  Shares.  See
"SPECIAL FACTORS - Share Ownership by Parent, Purchaser and Their Affiliates."

11. SHARE OWNERSHIP BY PARENT, PURCHASER AND THEIR AFFILIATES

     As of July 31, 1997,  Parent owns warrants to acquire  1,189,274 Shares, of
which warrants to purchase 784,587 Shares have an exercise price below the Offer
Price. In addition,  the Shares beneficially owned by all executive officers and
directors  of Parent  (including  the Shares Dr.  Elkins has the right to vote),
represent  approximately  21.0% of the  outstanding  Shares  on a  fully-diluted
basis.  Robert N. Elkins,  Chairman of the Board and Chief Executive  Officer of
Parent  and a  director  of the  Company,  beneficially  owns  1,600,853  Shares
(including  10,989  Shares  issuable  upon the  exercise  of options and 737,392
Shares  which he has the  right to vote  pursuant  to a voting  agreement).  Mr.
Silverman, a director of Parent and the Company,  beneficially owns 8,083 Shares
(excluding  35,242 Shares  issuable upon the exercise of  outstanding  options),
which  Shares are subject to the voting  agreement in favor of Dr.  Elkins,  and
other executive  officers and directors of Parent  beneficially own an aggregate
of 187,674 Shares,  which Shares are subject to the voting agreement in favor of
Dr. Elkins. See "SPECIAL FACTORS - Background of the Offer and the Merger."

     Voting  Agreement and Stockholders  Agreement.  Stockholders of the Company
who, at April 25, 1996,  owned an  aggregate  of 737,392  shares of Common Stock
(including  287,602  shares  owned by a limited  partnership  in which a limited
partnership  controlled  by Dr.  Robert N.  Elkins is a general  partner  and is
afforded  sole voting power) are parties to a Voting  Agreement  with Dr. Elkins
(the "Voting Agreement"),



                                       35

<PAGE>






a director,  founder and  principal  stockholder  of the Company,  in which such
stockholders  have agreed that, during the ten-year term of the Voting Agreement
(which was effective  January 26, 1996), at all meetings of stockholders  and in
all written consents of  stockholders,  they will vote all Common Stock owned at
the time in the same manner as Common Stock owned by Dr. Elkins (840,472 shares)
is voted by him. Each such stockholder has also irrevocably appointed Dr. Elkins
as proxy to represent and vote all shares of Common Stock of such stockholder at
any meeting of  stockholders  of the Company and in all actions taken by written
consent of stockholders. The Voting Agreement prohibits the parties thereto from
transferring their Shares except (i) to an immediate family member who agrees to
be bound by the Voting Agreement, (ii) to an entity wholly-owned by such person,
which entity becomes a party to the Voting  Agreement,  (iii) in an underwritten
public  offering  or a sale  under  Rule 144  under the  Securities  Act or (iv)
pursuant  to a pledge to any NASD  member  firm.  Under the terms of the  Voting
Agreement, the Shares subject to the Voting Agreement cannot be tendered without
Dr. Elkins' consent.  Common Stock owned by such  stockholders  will cease to be
subject to the Voting  Agreement  following any sale thereof in an  underwritten
public  offering  pursuant  to the  Securities  Act, or in a sale under Rule 144
promulgated  under such Act. Parties to the Voting Agreement include Lawrence P.
Cirka and John L. Silverman,  both of whom are directors and executive  officers
of Parent and, in the case of Mr. Silverman, a director of the Company,  Deborah
Lau and Michael Blass,  who are directors of the Company,  as well as W. Bradley
Bennett,  Marshall  A.  Elkins  and Marc B.  Levin,  all of whom  are  executive
officers of Parent. In addition,  Equity-Linked  Investors,  L.P.  ("ELI-I") and
Equity-Linked  Investors-II,   L.P.  ("ELI-II")  entered  into  a  Stockholders'
Agreement, dated as of December 30, 1993 (the "Stockholders'  Agreement"),  with
Dr. Elkins and the Company,  pursuant to which ELI-I and ELI-II are collectively
entitled to designate  two nominees to the  Company's  Board of  Directors.  Dr.
Elkins has agreed,  pursuant to the Stockholders'  Agreement, to vote all shares
over which he has voting  control  for the  election  of such  nominees.  If the
collective  ownership  of ELI-I and  ELI-II  and their  affiliates  falls  below
665,907  shares,  they will be entitled to one board  nominee so long as they or
their  affiliates  own any  shares of Common  Stock.  ELI-I  and  ELI-II,  which
currently own an aggregate of 1,331,814  shares of the  Company's  Common Stock,
have had no designees sitting on the Company Board since June 1996. See "SPECIAL
FACTORS - Beneficial Ownership of Shares."

     Voting and Tender  Agreements.  As an  inducement  and a  condition  to the
Parent and the Purchaser  entering  into the Merger  Agreement and incurring the
obligations  set forth therein,  including the Offer and the Merger,  the Parent
required that each of Dr. Robert N. Elkins,  the Parent's  Chairman of the Board
and Chief Executive Officer,  and ELI-I and ELI-II (together with ELI-I,  "ELI")
(Dr.  Elkins and ELI, each a  "Stockholder"  and together,  the  "Stockholders")
enter into a Voting and Tender  Agreement  (the  "Tender  Agreements")  with the
Parent and the Purchaser.

     Pursuant  to the  Tender  Agreements,  each  Stockholder  has agreed (i) to
tender for sale to the Purchaser, pursuant to the terms of the Offer, the Shares
then owned of record or  beneficially  by such  Stockholder and (ii) that during
the time that the Tender Agreement is in effect, the Stockholder shall not give,
sell, assign,  hypothecate,  pledge,  encumber, grant a security in or otherwise
dispose of, any  Shares,  or any right,  title or  interest  therein or thereto,
except  to the  Purchaser  pursuant  to the  Voting  and  Tender  Agreement.  In
addition,  the  Stockholder  has  agreed  that  during  the time that the Tender
Agreement  is in effect,  at any  meeting of the  stockholders  of the  Company,
however called, and in any action by consent of the stockholders of the Company,
the Stockholder shall vote the Shares (i) in favor of the Merger pursuant to the
Merger Agreement and (ii) against any proposal for any recapitalization, merger,
sale of assets or other business  combination between the Company and any person
or entity  (other than the Merger) or any other action or  agreement  that would
result in a breach of any  covenant,  representation  or  warranty  or any other
obligation or agreement of the Company under the Merger Agreement or which could
result in any of the  conditions to the Company's  obligations  under the Merger
Agreement not being fulfilled.  In addition,  each Stockholder has agreed (i) to
grant to Parent,  if so requested by Parent,  an  irrevocable  proxy to vote the
Shares in a manner consistent with the preceding  sentence,  (ii) not to join in
any action that is inconsistent with, or designed or intended to have the effect
of  discouraging,  the  completion  of the Merger  pursuant  to the terms of the
Merger  Agreement  and (iii) not to enter into any agreement or grant a proxy or
power of attorney  with  respect to the Shares  which is  inconsistent  with the
Tender Agreement.  The Tender Agreements contain customary  representations  and
warranties by the parties. Under the Tender Agreements,  Dr. Elkins is obligated
to



                                       36

<PAGE>






tender in the Offer the 840,472  outstanding Shares owned by him, as well as the
287,602 Shares owned by a partnership in which a limited partnership  controlled
by Dr. Elkins is a general  partner and is afforded sole voting and  dispositive
power,  and ELI is  obligated  to tender  the  1,331,814  Shares  owned by them,
representing  in the aggregate  2,459,888  Shares,  or 32.4% of the  outstanding
Shares and 46.2% of the 5,329,119 Shares required to meet the Minimum Condition.
Under the Tender Agreements, Dr. Elkins will be obligated to vote, to the extent
not tendered with his consent,  in favor of the Merger the 449,790  Shares which
he has the right to vote pursuant to the Voting Agreement.

     The Tender  Agreements  provide  that the  Stockholders  entered  into such
agreements  solely as the owner of  Shares,  and that the  agreements  set forth
therein  shall  in no way  prohibit  the  Stockholder  or  any of its  officers,
directors,  employees,  representatives  or agents from  taking,  or omitting to
take, any action as a director, employee, representative or agent of the Company
permitted to be taken or omitted under the Merger Agreement.

     In order to induce the Parent,  the Purchaser and the Company to enter into
the Merger  Agreement,  the Tender  Agreement  executed by ELI provides that (i)
Parent and the  Purchaser  released  ELI from all debts,  obligations  and other
claims it ever had or now has against ELI, (ii) upon Purchaser  gaining  control
of the Company, Parent and Purchaser would cause the Company to release ELI from
all debts,  obligations and other claims it ever had or now has against ELI, and
(iii) upon ELI's  receipt  of the  foregoing  release  from the  Company,  ELI's
release of Parent, the Purchaser and the Company from all debts, obligations and
other claims it ever had or now has against the Parent,  the  Purchaser  and the
Company would become effective. In order to induce the Parent, the Purchaser and
the Company to enter into the Merger Agreement, the Tender Agreement executed by
Dr. Elkins provided that upon Purchaser gaining control of the Company,  (i) Dr.
Elkins would release the Company from all debts, obligations and other claims he
ever had or now has against the Company and (ii) the Company  would  release Dr.
Elkins  from all  debts,  obligations  and  other  claims it ever had or now has
against Dr. Elkins.

12. BENEFICIAL OWNERSHIP OF SHARES

     The  following  table sets forth certain  information,  as of July 31, 1997
(except as  otherwise  indicated),  regarding  the  ownership  of Shares by each
person  known by the Company to be the  beneficial  owner of more than 5% of the
outstanding Shares, as well as each director of the Company, the Chief Executive
Officer of the Company, certain other officers of the Company, and all executive
officers and directors of the Company as a group:



                                         AMOUNT AND NATURE OF       PERCENT OF
BENEFICIAL OWNER                        BENEFICIAL OWNERSHIP(1)     CLASS(2)
- -------------------------------------   -------------------------   -----------
Robert N. Elkins
 8889 Pelican Bay Boulevard
 Naples, Florida 33963   ............          1,600,853(3)            21.0%

Integrated Health Services
 10065 Red Run Boulevard
 Owing Mills, Maryland 21117   ......          1,189,274(4)            13.5

Equity-Linked Investors, L.P.
Desai Capital Management Incorporated
Rohit M. Desai
 540 Madison Avenue
 New York, New York 10022   .........            665,907(5)             8.8

Equity-Linked Investors-II, L.P.
Desai Capital Management Incorporated
Rohit M. Desai
 540 Madison Avenue
 New York, New York 10022   .........            665,907(5)             8.8

Putnam Investments, Inc.
Putnam Investment Mangement, Inc.
The Putnam Advisory Company, Inc.
 One Post Office Square
 Boston, Massachusetts 02109   ......            417,700(6)             5.5



                                       37

<PAGE>

<TABLE>
<CAPTION>
                                                           AMOUNT AND NATURE OF       PERCENT OF
BENEFICIAL OWNER                                          BENEFICIAL OWNERSHIP(1)     CLASS(2)
- -------------------------------------------------------   -------------------------   ------------
<S>                                                       <C>                         <C>
Deborah A. Lau  .......................................              26,190(7)               *
William J. Krystopowicz  ..............................              64,174(8)(9)            *
Wallace Olson, Esq.   .................................            264,444                 3.5
John L. Silverman  ....................................              43,325(8)(10)           *
Michael S. Blass   ....................................              35,238(8)(11)           *
All current directors and executive officers as a group
 (9 persons) ..........................................           1,969,546(4)(12)        25.6
</TABLE>
- ----------
 *  Less than 1%

(1)  The Company  has advised  Parent and  Purchaser  that it believes  that all
     beneficial  owners named in the table have sole voting and investment power
     with respect to the Shares they  beneficially  own. The Shares shown in the
     table to be  beneficially  owned include any Shares that the person has the
     right to acquire  within 60 days of July 31,  1997,  by the exercise of any
     Company option of which the Company has knowledge. Shares issuable upon the
     exercise of options are considered outstanding for the purpose of computing
     the percentage of  outstanding  Shares which would be owned by the optionee
     if the options held by such person and currently exercisable or exercisable
     within 60 days after July 31,  1997 were  exercised,  but  (except  for the
     calculation of beneficial ownership by all executive officers and directors
     as a group) are not considered outstanding for the purpose of computing the
     percentage of outstanding Shares owned by any other person.

(2)  Percent of 7,597,801  Shares  outstanding as of July 31, 1997,  counting as
     outstanding  for each named  person all Shares  issuable  to such person on
     exercise of Company options that are included in the first column.

(3)  Includes (a) 840,472 Shares owned  individually by Dr. Elkins,  (b) 287,602
     Shares  (3.8%)  owned  by a  partnership  in  which a  limited  partnership
     controlled by Dr.  Elkins is a general  partner and is afforded sole voting
     (subject to the Voting Agreement  described  above) and dispositive  power,
     (c)  449,790  additional  Shares  (5.9%)  subject to the  Voting  Agreement
     described  above as to which shares Dr. Elkins has sole voting power but no
     dispositive  power,  (d)  12,000  Shares  owned by his wife as to which Dr.
     Elkins  disclaims  beneficial  ownership and (e) 10,989  Shares  subject to
     options.  Excludes the 1,189,274  Shares issuable upon exercise of warrants
     held by Parent  (see  footnote  4), of which Dr.  Elkins is Chairman of the
     Board  and  Chief  Executive  Officer.   Dr.  Elkins  disclaims  beneficial
     ownership  of Shares  deemed  beneficially  owned by Parent.  See  "SPECIAL
     FACTORS - Share Ownership by Parent, the Purchaser and Their Affiliates."

(4)  Represents  Shares issuable upon exercise of warrants.  Excludes the Shares
     beneficially owned by Dr. Robert N. Elkins (see footnote 3) who is Chairman
     of the Board and Chief  Executive  Officer  of Parent,  as to which  Shares
     Parent disclaims  beneficial  ownership.  Dr. Elkins  disclaims  beneficial
     ownership of all warrants held by Parent.

(5)  ELI-I and ELI-II are limited  partnerships,  the general  partners of which
     are  Rohit  M.  Desai   Associates   and  Rohit  M.  Desai   Associates-II,
     respectively.  Mr. Rohit M. Desai is the managing  general partner of Rohit
     M. Desai Associates and Rohit M. Desai Associates-II. Mr. Desai is also the
     sole  stockholder,  Chairman of the Board and President of DCMI, which acts
     as an investment advisor to ELI-I and ELI-II. Under the investment advisory
     agreements between DCMI and each of ELI-I and ELI-II, DCMI has the power to
     vote and dispose of these Shares.  Accordingly,  each of DCMI and Mr. Desai
     may be deemed to be beneficial  owners of all 1,331,814 Shares owned in the
     aggregate  directly by ELI-I and ELI-II.  DCMI and Mr. Desai each  disclaim
     beneficial ownership of such Shares.

(6)  Based on a Schedule 13G filed with the  Commission  and the Company,  which
     provided information as at December 31, 1996, Putnam Investments,  Inc. and
     its subsidiaries, Putnam Investment Management Inc. and The Putnam Advisory
     Company,  Inc.,  registered  investment advisors,  have shared voting power
     with  respect  to  45,500  Shares,  no voting  power  with  respect  to the
     remaining  372,200  Shares and shared  dispositive  power as to all 417,700
     Shares.

(7)  Includes 16,190 Shares subject to options.

(8)  The Shares (and Shares subject to options) owned by such person are subject
     to the Voting Agreement described above and, accordingly,  each such person
     has no voting power, but has sole dispositive  power,  with respect to such
     Shares.

(9)  Includes 31,828 Shares subject to options.

(10) Includes 35,242 Shares subject to options.

(11) Includes 10,989 Shares subject to options.

(12) Includes 105,238 Shares subject to options.


                                       38

<PAGE>


                                   THE OFFER


1. TERMS OF THE OFFER; EXPIRATION DATE.

     Upon the terms and subject to the  conditions of the Offer  (including,  if
the Offer is extended or amended,  the terms and  conditions of any extension or
amendment),  the Purchaser  will accept for payment and pay for all Shares which
are validly  tendered on or prior to the  Expiration  Date and not  withdrawn as
provided in "THE OFFER - Withdrawal  Rights." The term  "Expiration  Date" shall
mean 12:00 midnight, New York City time, on Thursday,  September 4, 1997, unless
and until the Purchaser, in its sole discretion (but subject to the terms of the
Merger Agreement), shall have extended the period of time for which the Offer is
open,  in which event  "Expiration  Date" shall mean the latest time and date at
which the Offer, as so extended by the Purchaser, shall expire.

     The Offer is conditioned upon, among other things,  (i) the satisfaction of
the Minimum Condition,  (ii) the expiration or termination of any waiting period
under the HSR Act applicable to the purchase of Shares pursuant to the Offer and
(iii) the  satisfaction  of the other  conditions  set forth  under  "THE  OFFER
Certain Conditions of the Offer."

     Subject  to  the  applicable  rules  and  regulations  of  the  Commission,
Purchaser expressly reserves the right (but shall not be obligated), in its sole
discretion (but subject to the terms and conditions of the Merger Agreement), at
any time and from time to time,  upon the failure to be  satisfied of any of the
conditions to the Offer under "THE OFFER - Certain  Conditions of the Offer," to
(i) decline to purchase any of the Shares tendered and terminate the Offer, (ii)
waive  such  unsatisfied  condition  (other  than the  Minimum  Condition),  and
purchase all Shares validly tendered, (iii) extend the Offer and, subject to the
right of stockholders to withdraw Shares until the Expiration  Date,  retain the
Shares which have been tendered during the period or periods for which the Offer
is extended or (iv) amend the Offer.

     Subject to the  applicable  rules and  regulations of the  Commission,  the
Purchaser  expressly  reserves the right, in its sole discretion (but subject to
the terms and conditions of the Merger Agreement),  at any time and from time to
time,  and  regardless  of whether or not any of the events set forth under "THE
OFFER - Certain  Conditions of the Offer" have occurred,  to modify the terms of
the Offer, except that, without the consent of the Company,  the Purchaser shall
not (i) reduce the number of Shares to be  purchased  in the Offer,  (ii) reduce
the price for the Shares, (iii) add to the conditions set forth under "THE OFFER
- -  Certain  Conditions  of the  Offer,"  (iv)  except  as  provided  in the next
sentence,  extend the Offer, (v) change the form of consideration payable in the
Offer or (vi)  amend  any  other  term of or add any new term to the  Offer in a
manner materially  adverse to the stockholders.  Notwithstanding  the foregoing,
the  Purchaser  may,  without  the  consent of the  Company,  but subject to the
Company's  right to  terminate  the  Merger  Agreement  if Shares  have not been
accepted  for payment on or prior to  November  30,  1997,  (i) extend the Offer
beyond the Expiration  Date, if at the Expiration  Date any of the conditions to
the Purchaser's  obligation to accept for payment, and pay for, Shares shall not
be  satisfied or waived,  until such time as such  conditions  are  satisfied or
waived,  (ii) extend the Offer for any period required by any rule,  regulation,
interpretation or position of the Commission or the staff thereof  applicable to
the Offer or in order to obtain any regulatory approval or comply with any other
governmental  regulation  applicable  to the  transactions  contemplated  by the
Merger  Agreement,  (iii)  extend the Offer from time to time until two business
days after  expiration of the waiting  period under the HSR Act, and (iv) extend
the Offer for an aggregate  period of not more than 15 business  days beyond the
latest Expiration Date that would otherwise be permitted under clauses (i), (ii)
or (iii) of this sentence if there shall not have been tendered to the Purchaser
sufficient  Shares so that the Merger could be effected  without a stockholders'
meeting  in  accordance   with  Section  253  of  the  Delaware  GCL.  UNDER  NO
CIRCUMSTANCES  WILL INTEREST BE PAID ON THE PURCHASE PRICE FOR TENDERED  SHARES,
WHETHER OR NOT PURCHASER EXERCISES ITS RIGHT TO EXTEND THE OFFER.

     There can be no assurances  that the  Purchaser  will exercise its right to
extend the Offer.  Any extension,  amendment or termination  will be followed as
promptly as  practicable  by public  announcement.  In the case of an extension,
Rule 14e-1(d) under the Exchange Act requires that the announcement be issued no
later  than  9:00  a.m.,  Eastern  time,  on the next  business  day  after  the
previously  scheduled Expiration Date in accordance with the public announcement
requirements of Rule 14d-4(c)


                                       39

<PAGE>


under the Exchange Act.  Subject to applicable law (including Rules 14d-4(c) and
14d-6(d) under the Exchange Act,  which require that any material  change in the
information  published,  sent or given to  stockholders  in connection  with the
Offer be promptly  disseminated to stockholders in a manner reasonably  designed
to inform stockholders of such change), and without limiting the manner in which
the Purchaser may choose to make any public announcement, the Purchaser will not
have any  obligation  to publish,  advertise or otherwise  communicate  any such
public  announcement  other  than by  making a  release  to the Dow  Jones  News
Service.  As used in this Offer to Purchase,  "business day" means any day other
than a Saturday,  Sunday or federal holiday and consists of the time period from
12:01 a.m. through 12:00 midnight, New York City time.

     If the Purchaser  extends the Offer or if the Purchaser  (whether before or
after its  acceptance  for  payment of Shares) is delayed in its  purchase of or
payment  for  Shares  or is unable to pay for  Shares  pursuant  to the Offer in
accordance with the terms of the Merger  Agreement,  then,  without prejudice to
the  Purchaser's  rights under the Offer,  the  Depositary  may retain  tendered
Shares on behalf of the Purchaser,  and such Shares may not be withdrawn  except
to the extent  tendering  stockholders  are  entitled  to  withdrawal  rights as
described  under "THE OFFER - Withdrawal  Rights."  However,  the ability of the
Purchaser to delay the payment for Shares which the  Purchaser  has accepted for
payment is limited by Rule 14e-1(c)  under the Exchange Act, which requires that
a bidder pay the consideration  offered or return the securities deposited by or
on behalf of holders of securities  promptly after the termination or withdrawal
of such bidder's offer.

     If the Purchaser  makes a material  change in the terms of the Offer or the
information  concerning the Offer, or waives a material  condition of the Offer,
subject to the Merger  Agreement,  the  Purchaser  will  disseminate  additional
tender  offer  materials  and extend the Offer to the extent  required  by Rules
14d-4(c),  14d-6(d) and 14e-1 under the Exchange Act. The minimum  period during
which the Offer must remain open following  material changes in the terms of the
Offer or  information  concerning  the Offer,  other than a change in price or a
change in the  percentage  of  securities  sought  or a change  in the  dealer's
soliciting  fee,  will depend upon the facts and  circumstances,  including  the
relative  materiality of the terms or information.  In the Commission's view, an
offer  should  remain open for a minimum of five  business  days from the date a
material change is first published,  sent or given to  securityholders,  and, if
material  changes  are made with  respect to  information  that  approaches  the
significance  of price and share  levels,  a minimum of ten business days may be
required to allow for adequate dissemination and investor response. With respect
to a change in price or a change in percentage of securities  sought or a change
in the dealer's solicitation fee, a minimum ten business day period is generally
required under the applicable  rules and  regulations of the Commission to allow
for adequate dissemination to stockholders and for investor response.

     The Company has  provided to the  Purchaser  its list of  stockholders  and
security  position  listings  for the  purpose  of  disseminating  the  Offer to
stockholders.  This Offer to Purchase and the related Letter of Transmittal  and
other  relevant  materials are being mailed to record holders of Shares and will
be furnished to brokers, dealers,  commercial banks, trust companies and similar
persons whose names, or the names of whose  nominees,  appear on the stockholder
list or, if applicable,  who are listed as participants  in a clearing  agency's
security  position listing,  for subsequent  transmittal to beneficial owners of
Shares.

2. PROCEDURE FOR ACCEPTING THE OFFER AND TENDERING SHARES.

     Valid  Tender.  For Shares to be validly  tendered  pursuant  to the Offer,
either (i) a properly  completed and duly  executed  Letter of  Transmittal  (or
facsimile  thereof),  together  with any required  signature  guarantees,  or an
Agent's Message (as defined below) in connection  with a book-entry  delivery of
Shares, and any other required documents,  must be received by the Depositary at
one of its addresses set forth on the back cover page of this Offer to Purchase,
and Share Certificates for tendered Shares must be received by the Depositary at
one of such addresses or such Share  Certificates must be delivered  pursuant to
the  procedures  for  book-entry  transfer  set forth  below  (and a  Book-Entry
Confirmation  (as defined below)  received by the Depositary) in each case at or
prior to the Expiration Date, or (ii) the tendering stockholder must comply with
the guaranteed delivery procedures set forth below.



                                       40

<PAGE>


     Book-Entry Transfer. The Depositary will establish accounts with respect to
the  Shares  at The  Depository  Trust  Company  ("DTC")  and  the  Philadelphia
Depository Trust Company  ("PDTC") (DTC and PDTC,  each, a "Book-Entry  Transfer
Facility" and, collectively,  the "Book-Entry Transfer Facilities") for purposes
of the Offer within two business  days after the date of this Offer to Purchase.
Any  financial  institution  that  is a  participant  in any  of the  Book-Entry
Transfer  Facility  systems may make book-entry  delivery of Shares by causing a
Book-Entry  Transfer  Facility  to transfer  such  Shares into the  Depositary's
account at a Book-Entry  Transfer  Facility,  in accordance with such Book-Entry
Transfer  Facility's  procedures  for transfer.  However,  although  delivery of
Shares may be effected  through  book-entry  transfer at a  Book-Entry  Transfer
Facility, a Letter of Transmittal (or facsimile thereof), properly completed and
duly executed,  together with any required signature  guarantees,  or an Agent's
Message (as defined below),  and any other required documents must, in any case,
be  transmitted  to and received by the  Depositary  at one of its addresses set
forth on the back cover page of this Offer to Purchase  prior to the  Expiration
Date,  or the tendering  stockholder  must comply with the  guaranteed  delivery
procedures set forth below. The confirmation of a book-entry  transfer of Shares
into the  Depositary's  account at a Book-Entry  Transfer  Facility as described
above  is  referred  to  herein  as a  "Book-Entry  Confirmation."  DELIVERY  OF
DOCUMENTS TO A BOOK-ENTRY  TRANSFER  FACILITY IN ACCORDANCE WITH SUCH BOOK-ENTRY
TRANSFER FACILITY'S PROCEDURES DOES NOT CONSTITUTE DELIVERY TO THE DEPOSITARY.

     The term "Agent's Message" means a message  transmitted  through electronic
means  by  a  Book-Entry  Transfer  Facility,  in  accordance  with  the  normal
procedures of such  Book-Entry  Transfer  Facility and the  Depositary,  to, and
received by, the  Depositary  and forming a part of a  Book-Entry  Confirmation,
which  states that such  Book-Entry  Transfer  Facility  has received an express
acknowledgment  from  the  participant  in  such  Book-Entry  Transfer  Facility
tendering the Shares which are the subject of such Book-Entry  Confirmation that
such  participant has received and agrees to be bound by the terms of the Letter
of  Transmittal  and that the Purchaser may enforce such  agreement  against the
participant.  The term  "Agent's  Message"  shall  also  include  any hard  copy
printout  evidencing such message generated by a computer terminal maintained at
the Depositary's office.

     THE METHOD OF DELIVERY OF SHARES,  THE LETTER OF TRANSMITTAL  AND ALL OTHER
REQUIRED DOCUMENTS, INCLUDING DELIVERY THROUGH ANY BOOK-ENTRY TRANSFER FACILITY,
IS AT THE ELECTION AND RISK OF THE TENDERING STOCKHOLDER.  SHARES WILL BE DEEMED
DELIVERED ONLY WHEN ACTUALLY RECEIVED BY THE DEPOSITARY (INCLUDING,  IN THE CASE
OF A BOOK-ENTRY TRANSFER, BY BOOK-ENTRY  CONFIRMATION).  IF DELIVERY IS BY MAIL,
REGISTERED MAIL WITH RETURN RECEIPT REQUESTED, PROPERLY INSURED, IS RECOMMENDED.
IN ALL CASES, SUFFICIENT TIME SHOULD BE ALLOWED TO ENSURE TIMELY DELIVERY.

     Signature  Guarantees.  No signature guarantee is required on the Letter of
Transmittal  if (i) the  Letter  of  Transmittal  is  signed  by the  registered
holder(s) of the Shares (which term, for purposes of this section,  includes any
participant  in a Book-Entry  Transfer  Facility  system whose name appears on a
security  position  listing as the owner of the Shares)  tendered  therewith and
such  registered  holder(s) has not completed  either the box entitled  "Special
Delivery  Instructions" or the box entitled  "Special  Payment  Instructions" on
such Letter of Transmittal or (ii) such Shares are tendered for the account of a
bank, broker,  dealer, credit union, savings association or other entity that is
a member in good standing of the Securities  Transfer Agents  Medallion  Program
(an "Eligible Institution"). In all other cases, all signatures on the Letter of
Transmittal  must be guaranteed by an Eligible  Institution.  See Instructions 1
and 5 to the Letter of Transmittal.

     If the Share Certificates are registered in the name of a person other than
the signer of the Letter of  Transmittal,  or if payment is to be made, or Share
Certificates  not accepted for payment or not tendered are to be returned,  to a
person  other  than  the  registered   stockholder,   then  the  tendered  Share
Certificates  must be endorsed or accompanied by  appropriate  stock powers,  in
either  case  signed  exactly as the name or names of the  registered  holder or
holders  appear  on such  Share  Certificates,  with  the  signature(s)  on such
certificates or stock powers  guaranteed as described  above. See Instructions 1
and 5 of the Letter of Transmittal.

     If  Share   Certificates  are  forwarded  to  the  Depositary  in  multiple
deliveries,  a Letter of Transmittal  (or manually  signed  facsimile  thereof),
properly completed and duly executed, must accompany each such delivery.



                                       41

<PAGE>


     Guaranteed Delivery.  If a stockholder desires to tender Shares pursuant to
the  Offer  and  such  stockholder's  Share  Certificates  are  not  immediately
available or such  stockholder  cannot  deliver the Share  Certificates  and all
other required documents to the Depositary prior to the Expiration Date, or such
stockholder cannot complete the procedure for delivery by book-entry transfer on
a timely basis, such Shares may nevertheless be tendered if all of the following
conditions are satisfied:

          (i) such tender is made by or through an Eligible Institution;

          (ii) a  properly  completed  and duly  executed  Notice of  Guaranteed
     Delivery,  substantially in the form provided by the Purchaser herewith, is
     received  by  the  Depositary,  as  provided  below,  on or  prior  to  the
     Expiration Date; and

          (iii) the  Share  Certificates  representing  all  tendered  Shares in
     proper form for transfer (or a Book-Entry Confirmation with respect to such
     Shares) in each case together  with a properly  completed and duly executed
     Letter of Transmittal (or facsimile thereof) are received by the Depositary
     within three NASDAQ  trading days after the date of execution of the Notice
     of  Guaranteed  Delivery.  A "NASDAQ  trading  day" is any day on which the
     Nasdaq National Market is open for business.

     The Notice of Guaranteed  Delivery may be delivered by hand or  transmitted
by telegram,  telex,  facsimile  transmission or mail to the Depositary and must
include a  guarantee  by an Eligible  Institution  in the form set forth in such
Notice of Guaranteed Delivery.

     Notwithstanding  any other provisions  hereof,  payment for Shares accepted
for payment  pursuant  to the Offer will in all cases be made only after  timely
receipt by the Depositary of (a) Share  Certificates for (or a timely Book-Entry
Confirmation  with  respect to) such  Shares,  (b) a Letter of  Transmittal  (or
facsimile thereof) for such Shares,  properly completed and duly executed,  with
any required signature guarantees,  or, in the case of a book-entry transfer, an
Agent's  Message,  and  (c)  any  other  documents  required  by the  Letter  of
Transmittal.  Accordingly, tendering stockholders may be paid at different times
depending upon when Share Certificates,  Book-Entry Confirmations and such other
documents are actually received by the Depositary.  UNDER NO CIRCUMSTANCES  WILL
INTEREST  BE PAID BY  PURCHASER  ON THE  PURCHASE  PRICE  OF THE  SHARES  TO ANY
TENDERING STOCKHOLDERS, REGARDLESS OF ANY EXTENSION OF THE OFFER OR ANY DELAY IN
MAKING SUCH PAYMENT.

     Determination  of  Validity.  All  questions  as  to  the  validity,  form,
eligibility  (including  time of  receipt)  and  acceptance  for  payment of any
tendered  Shares  pursuant  to any of the  procedures  described  above  will be
determined by the Purchaser,  in its sole discretion,  which determination shall
be final and binding on all parties.  The Purchaser  reserves the absolute right
to reject any or all tenders of any Shares  determined by it not to be in proper
form or the  acceptance  of or  payment  for which  may,  in the  opinion of the
Purchaser's  counsel,  be unlawful.  The  Purchaser  also  reserves the absolute
right, in its sole discretion,  subject to the terms of the Merger Agreement, to
waive any of the  conditions of the Offer or any defect or  irregularity  in any
tender  with  respect to Shares of any  particular  stockholder,  whether or not
similar  conditions,  defects or irregularities  are waived in the case of other
Shares.  No tender of Shares will be deemed to have been  validly made until all
defects and irregularities have been cured or waived. None of the Purchaser, the
Parent,  any of their  affiliates or assigns,  the  Depositary,  the Information
Agent,  the Dealer  Manager or any other  person  will be under any duty to give
notification of any defects or  irregularities in tenders or incur any liability
for failure to give any such  notification.  Purchaser's  interpretation  of the
terms and conditions of the Offer  (including the Letter of Transmittal  and the
Instructions thereto) will be final and binding.

     Appointment  as Proxy.  By executing the Letter of Transmittal as set forth
above, a tendering  stockholder  irrevocably appoints designees of the Purchaser
and each of them as the stockholder's  attorneys-in-fact  and proxies, each with
full  power  of  substitution,  in  the  manner  set  forth  in  the  Letter  of
Transmittal,  to the fullest extent of such stockholder's rights with respect to
the  Shares  tendered  by such  stockholder  and  accepted  for  payment  by the
Purchaser  (and with  respect  to any and all other  Shares or other  securities
issued or issuable in respect of such Shares on or after the date thereof).  All
such powers of attorneys and proxies shall be considered irrevocable and coupled
with an interest in the



                                       42

<PAGE>


tendered Shares. This appointment will be effective when, and only to the extent
that,  the  Purchaser  accepts  such Shares for  payment.  Upon  acceptance  for
payment, all prior powers of attorneys and proxies given by the stockholder with
respect to the Shares  (and such other  Shares  and  securities)  will,  without
further action, be revoked and no subsequent powers of attorneys and proxies may
be given by or any subsequent written consent executed by such stockholder (and,
if given or executed,  will not be deemed  effective) with respect thereto.  The
designees  of the  Purchaser  will,  with  respect to the Shares (and such other
Shares and securities) for which such appointment is effective,  be empowered to
exercise all voting and other rights of such  stockholder  as they in their sole
discretion  may deem proper at any annual,  special or adjourned  meeting of the
Company's  stockholders,  by  written  consent  in lieu of any such  meeting  or
otherwise. The Purchaser reserves the right to require that, in order for Shares
to be validly  tendered,  immediately  upon the  acceptance  for payment of such
Shares the  Purchaser  is able to  exercise  full  voting and other  rights of a
record  and  beneficial  stockholder,  including  rights in respect of acting by
written consent, with respect to such Shares and other securities.

     Other  Requirements.  A tender of Shares  pursuant to one of the procedures
described  above will constitute the tendering  stockholder's  acceptance of the
terms and  conditions of the Offer.  The  Purchaser's  acceptance for payment of
Shares  tendered  pursuant  to the Offer  will  constitute  a binding  agreement
between the tendering  stockholder  and the Purchaser upon the terms and subject
to the conditions of the Offer.

     Backup Federal Income Tax  Withholding  and Substitute  Form W-9. Under the
"backup withholding" provisions of federal income tax law, the Depositary may be
required to withhold 31% of the amount of any  payments of cash  pursuant to the
Offer. In order to avoid backup withholding,  a stockholder  tendering Shares in
the Offer must,  unless an exemption  applies,  provide the Depositary with such
stockholder's  correct  taxpayer  identification  number ("TIN") on a substitute
Form W-9 and certify,  under penalties of perjury,  that such TIN is correct and
that such  stockholder  is not subject to backup  withholding.  If a stockholder
does  not  provide  its  correct  TIN or  fails to  provide  the  certifications
described  above,  the Internal  Revenue Service ("IRS") may impose a penalty on
such stockholder and payment of cash to such  stockholder  pursuant to the Offer
may be subject to backup  withholding of 31%. All stockholders  tendering Shares
pursuant to the Offer should  complete and sign the substitute Form W-9 included
in the  Letter of  Transmittal  to provide  the  information  and  certification
necessary to avoid backup withholding (unless an applicable exemption exists and
is proved in a manner  satisfactory  to the  Depositary).  Certain  stockholders
(including  among others all  corporations  and certain foreign  individuals and
entities)  are  not  subject  to  backup   withholding.   Noncorporate   foreign
stockholders should complete and sign a Form W-8, Certificate of Foreign Status,
a copy of which may be obtained  from the  Depositary,  in order to avoid backup
withholding. See Instruction 9 of the Letter of Transmittal.

3. WITHDRAWAL RIGHTS.

     Tenders of Shares made pursuant to the Offer are  irrevocable,  except that
Shares  tendered  pursuant  to  the  Offer  may  be  withdrawn  pursuant  to the
procedures set forth below at any time prior to the Expiration  Date and, unless
theretofore  accepted for payment as provided  herein,  may also be withdrawn at
any time after October 6, 1997. If the Purchaser  extends the Offer,  is delayed
in its  acceptance  for  payment of Shares or is unable to  purchase  or pay for
Shares  validly  tendered  for  any  reason,  then,  without  prejudice  to  the
Purchaser's rights hereunder,  tendered Shares may be retained by the Depositary
on behalf of the  Purchaser  and may not be withdrawn  except to the extent that
tendering  stockholders  are entitled to withdrawal  rights as set forth in this
section.  Any such delay in  acceptance  for payment will be  accompanied  by an
extension of the Offer to the extent required by law.

     For  a  withdrawal  to be  effective,  a  written,  telegraphic,  telex  or
facsimile  transmission  notice of  withdrawal  must be timely  received  by the
Depositary  at one of its  addresses  set forth on the back  cover  page of this
Offer to Purchase.  Any such notice of  withdrawal  must specify the name of the
person  who  tendered  the  Shares to be  withdrawn,  the number of Shares to be
withdrawn and the name of the registered stockholder,  if different from that of
the person who tendered such Shares.  If Share  Certificates have been delivered
or otherwise identified to the Depositary, then prior to the physical release of
such certificates, the serial numbers shown on the particular Share Certificates
to be withdrawn, and a signed notice of withdrawal with



                                       43

<PAGE>


signatures  guaranteed by an Eligible  Institution (except in the case of Shares
tendered for the account of the Eligible Institution), must also be furnished to
the Depositary as described above. If Shares have been tendered  pursuant to the
procedure  for  book-entry  transfer set forth under "THE OFFER - Procedure  for
Accepting  the Offer and Tendering  Shares," any notice of withdrawal  must also
specify the name and number of the account at the applicable Book-Entry Transfer
Facility to be credited with the withdrawn Shares and otherwise comply with such
Book-Entry Transfer Facility's  procedures for such withdrawal,  in which case a
notice of  withdrawal  will be effective if delivered to the  Depositary  by any
method of delivery described in the first sentence of this paragraph.

     Withdrawals  of  tenders  of Shares  may not be  rescinded,  and any Shares
properly  withdrawn will thereafter be deemed not validly  tendered for purposes
of the Offer.  Withdrawn  Shares may be retendered by again following one of the
procedures  described above under "THE OFFER - Procedure for Accepting the Offer
and Tendering Shares" at any time on or prior to the Expiration Date.

     All  questions as to the form and validity  (including  time of receipt) of
notices  of  withdrawal  will  be  determined  by the  Purchaser,  in  its  sole
discretion,  which  determination  shall  be  final  and  binding.  None  of the
Purchaser,  the Parent, any of their affiliates or agents,  the Depositary,  the
Information Agent, the Dealer Manager or any other person will be under any duty
to  give  notification  for any  defects  or  irregularities  in any  notice  of
withdrawal or incur any liability for failure to give any such notification.

4. ACCEPTANCE FOR PAYMENT AND PAYMENT FOR SHARES.

     Upon the terms and subject to the  conditions of the Offer  (including,  if
the Offer is extended or amended, the terms and conditions of any such extension
or  amendment),  the  Purchaser  will accept for payment,  and will pay for, all
Shares  validly  tendered  prior  to  the  Expiration  Date  (and  not  properly
withdrawn)  as soon as  practicable  after the  Expiration  Date.  In all cases,
payment for Shares purchased pursuant to the Offer will be made only upon timely
receipt by the  Depositary  of (i)  certificates  for such Shares or  Book-Entry
Confirmation  of a  book-entry  transfer of such  Shares  into the  Depositary's
account at a Book-Entry  Transfer  Facility pursuant to the procedures set forth
under "THE OFFER - Procedure for Accepting the Offer and Tendering Shares," (ii)
the Letter of Transmittal (or facsimile  thereof),  properly  completed and duly
executed, together with any required signature guarantees, or an Agent's Message
in connection with a book-entry transfer, and (iii) any other documents required
by the Letter of Transmittal.

     For purposes of the Offer,  the  Purchaser  will be deemed to have accepted
for payment,  and thereby  purchased,  Shares validly tendered and not withdrawn
as, if and when the Purchaser  gives oral or written notice to the Depositary of
the Purchaser's  acceptance for payment of such Shares pursuant to the Offer. In
all cases,  upon the terms and subject to the  conditions of the Offer,  payment
for Shares accepted for payment pursuant to the Offer will be made by deposit of
the purchase  price with the  Depositary,  which will act as agent for tendering
stockholders  for the  purpose  of  receiving  payment  from the  Purchaser  and
transmitting  payment  to  stockholders  whose  Shares  have been  accepted  for
payment. UNDER NO CIRCUMSTANCES WILL INTEREST ON THE PURCHASE PRICE FOR TENDERED
SHARES BE PAID,  REGARDLESS OF ANY EXTENSION OF THE OFFER OR ANY DELAY IN MAKING
PAYMENT AFTER THE EXPIRATION DATE. Upon the deposit of funds with the Depositary
for the  purpose  of making  payments  to  tendering  stockholders,  Purchaser's
obligation to make such payments  shall be satisfied and tendering  stockholders
must  thereafter  look solely to the  Depositary  for payment of amounts owed to
them by reason of the  acceptance  for payment of Shares  pursuant to the Offer.
Purchaser  will pay any stock  transfer  taxes with  respect to the transfer and
sale to it or its order pursuant to the Offer,  except as otherwise  provided in
Instruction 6 of the Letter of Transmittal,  as well as any charges and expenses
of the Depositary and the Information Agent.

     If Purchaser is delayed in its  acceptance  for payment of, or payment for,
tendered  Shares  or is  unable to accept  for  payment  or pay for such  Shares
pursuant to the Offer for any reason,  then,  without  prejudice to  Purchaser's
rights  under the Offer  (but  subject  to  Purchaser's  obligations  under Rule
14e-1(c)  under  the  Exchange  Act to pay for or  return  the  tendered  Shares
promptly after the termination or withdrawal of the Offer),  the Depositary may,
nevertheless, retain tendered Shares on behalf of Purchaser, and such Shares may
not be withdrawn  except to the extent  tendering  stockholders  are entitled to
exercise,  and duly exercise,  withdrawal rights as described under "THE OFFER -
Withdrawal Rights."


                                       44

<PAGE>


     If any tendered  Shares are not accepted for payment for any reason,  or if
certificates  are  submitted  for more  Shares than are  tendered,  certificates
evidencing  such  unpurchased  or  untendered  Shares will be returned,  without
expense,  to the tendering  stockholder  (or, in the case of Shares delivered by
book-entry transfer to a Book-Entry Transfer Facility pursuant to the procedures
set forth under "THE OFFER - Procedure  for  Accepting  the Offer and  Tendering
Shares,"  such  Shares will be  credited  to an account  maintained  within such
Book-Entry  Transfer  Facility),   as  promptly  as  practicable  following  the
expiration, termination or withdrawal of the Offer.

     Purchaser  reserves the right to transfer or assign,  in whole or from time
to time in part, to one or more of Purchaser's  subsidiaries or affiliates,  the
right to  purchase  all or any  portion of the Shares  tendered  pursuant to the
Offer,  but any such  transfer or assignment  will not relieve  Purchaser of its
obligations under the Offer or prejudice the rights of tendering stockholders to
receive payment for Shares validly tendered and accepted for purchase.

     If  the  Purchaser  varies  the  terms  of  the  Offer  by  increasing  the
consideration  to be paid per  Share,  the  Purchaser  shall pay such  increased
consideration for all Shares purchased pursuant to the Offer whether or not such
Shares have been tendered prior to such increase.

5. CERTAIN FEDERAL INCOME TAX CONSEQUENCES OF THE OFFER.

     The following is a summary of certain of the material United States federal
income tax  consequences of the receipt of cash for Shares pursuant to the Offer
or the Merger. This summary is for general information only, is based on the law
as currently in effect and does not address all aspects of income  taxation that
may be relevant to stockholders.  For example,  this discussion does not address
tax consequences under any applicable  foreign,  state, local or other tax laws.
In  addition,   this   discussion  does  not  address  the  federal  income  tax
consequences  of the  receipt  of cash for Shares  pursuant  to the Offer or the
Merger to particular  categories of taxpayers subject to special treatment under
the  United  States  federal  income  tax  laws,   such  as  trusts,   financial
institutions,  broker-dealers,  persons who are not citizens or residents of the
United States, tax-exempt organizations, life insurance companies, employees who
acquire  their  Shares  through  the  exercise of an  employee  stock  option or
otherwise  as  compensation,  and  persons  who  receive  payments in respect of
options to acquire Shares.  STOCKHOLDERS ARE URGED TO CONSULT THEIR TAX ADVISORS
WITH  RESPECT TO THE SPECIFIC  TAX  CONSEQUENCES  OF THE OFFER AND THE MERGER TO
THEM, INCLUDING THE CONSEQUENCES UNDER FEDERAL,  STATE, LOCAL, FOREIGN AND OTHER
TAX LAWS AND AS A RESULT OF CHANGES IN SUCH TAX LAWS,  INCLUDING  RECENT CHANGES
TO APPLICABLE FEDERAL CAPITAL GAINS RATES AND HOLDING PERIODS.

     The receipt of cash for Shares  pursuant to the Offer or the Merger will be
a taxable transaction for federal income tax purposes. In general, a stockholder
who receives cash for Shares  pursuant to the Offer or the Merger will recognize
gain or loss for federal income tax purposes equal to the difference between the
amount of cash  received in exchange for the Shares sold and such  stockholder's
adjusted tax basis in such Shares.  Provided that the Shares constitute  capital
assets in the hands of the  stockholder,  such gain or loss will be  treated  as
capital gain or loss.  Under the Taxpayer Relief Act of 1997, which was recently
enacted into law, the  effective  tax rates and holding  periods  applicable  to
capital  gains have been  modified.  The new Act  provides  that  capital  gains
recognized  on the  receipt of cash  pursuant to the Offer or the Merger will be
subject to a 20% maximum  rate if the  stockholder  has held the Shares for more
than 18 months at the time of sale.  However,  a 28% maximum rate would apply if
at the time of sale a stockholder has held the Shares for more than one year but
not more than 18 months.  Gain or loss will be  calculated  separately  for each
block of Shares  (i.e.,  a group of Shares  with the same tax basis and  holding
period).

     A stockholder  (other than certain  exempt  stockholders  including,  among
others,  all  corporations  and certain  foreign  individuals and entities) that
tenders Shares may be subject to 31% backup  withholding  unless the stockholder
provides its TIN and certifies that such number is correct or properly certifies
that it is awaiting a TIN, or unless an exemption  applies.  A  stockholder  who
does not  furnish  its TIN may be subject to a penalty  imposed by the IRS.  See
"THE OFFER - Procedure for Accepting the Offer and Tendering Shares."


                                       45

<PAGE>

     If backup withholding applies to a stockholder,  the Depositary is required
to withhold 31% from payments to such stockholder.  Backup withholding is not an
additional  tax.  Rather,  the amount of the backup  withholding can be credited
against the Federal  income tax  liability  of the person  subject to the backup
withholding,  provided  that the  required  information  is given to the IRS. If
backup withholding results in an overpayment of tax, a refund can be obtained by
the stockholder upon filing an appropriate income tax return.

6. PRICE RANGE OF SHARES; DIVIDEND INFORMATION.

     The Shares, which were initially offered to the public on August 9, 1995 at
a price of $9.50 per Share,  are traded in the  over-the-counter  market and are
quoted on the Nasdaq National Market under the symbol "CCAI".

     The following table sets forth,  for the quarters  indicated,  the high and
low sale  prices  for the  Shares on the  Nasdaq  National  Market  based on the
Company's  1996 Annual Report on Form 10-K (the  "Company's  1996 Form 10-K") by
the Dow Jones  Historical  Stock Quote  Reporter  and other  publicly  available
sources.

                                                  High              Low
                                                -------           ------
     Fiscal 1995:
       Third Quarter (from August 9)  ......     $  14           $ 9 3/4
       Fourth Quarter  .....................        14 5/8         9 3/4


                                                 High               Low     
                                                -------            -----   
     Fiscal 1996:                                                        
       First Quarter   ......................   $  15  1/2       $ 9     
       Second Quarter  .....................       13  5/8         9  1/4   
       Third Quarter   .....................       12  3/8         6        
       Fourth Quarter  .....................        8  1/8         3  1/2  


                                                 High              Low
                                                ------            -----
     Fiscal 1997:
       First Quarter   ........................  $  4 5/8        $ 2 3/8
       Second Quarter  ........................     3 7/8          1 3/8
       Third Quarter (through August 6)  ......     4              2 7/8


     On July 31, 1997,  the last full trading day prior to the  announcement  of
the execution of the Merger Agreement and the Purchaser's  intention to commence
the Offer,  the closing  price of the Shares as reported on the Nasdaq  National
Market was  $3.1875.  As of August 6, 1997,  the last full  trading day prior to
commencement  of the Offer,  such closing  price was $3.8125.  Stockholders  are
urged to obtain current market quotations for the Shares.

     The  Purchaser  has been  advised by the Company  that since the  Company's
initial  public  offering in August  1995,  the  Company  has  neither  paid nor
declared any dividends on the Shares, and that it does not intend to declare any
dividends  in the  foreseeable  future.  The  Company's  bank  revolving  credit
facility  prohibits the payment of cash dividends on the Shares, and each of the
Company's leases for its long-term care facilities  contains provisions that may
limit the amount of cash dividends that the Company may pay.

     Under the terms of the Merger  Agreement,  the  Company  has agreed that it
will  not (i)  declare  or pay any  dividends  on or make any  distributions  in
respect of its capital  stock,  (ii)  split,  combine or  reclassify  any of its
capital  stock or issue or  authorize  or  propose  the  issuance  of any  other
securities  in  respect  of, in lieu of or in  substitution  for such  shares of
capital stock,  (iii) except as permitted by the Merger  Agreement,  repurchase,
redeem or  otherwise  acquire  any shares of its  capital  stock or (iv)  issue,
deliver,  sell,  pledge or  encumber,  or  authorize  or propose  the  issuance,
delivery, sale, pledge or encumbrance of, any shares of its capital stock of any
class or any securities convertible into, or any rights,



                                       46

<PAGE>


warrants,  calls,  subscriptions  or  options  to  acquire,  any such  shares or
convertible securities,  or other ownership interest (other than the issuance of
shares of Common  Stock  upon the  exercise  of  certain  options  and  warrants
described in the Merger Agreement).

7. EFFECT OF THE OFFER ON THE MARKET FOR SHARES, MARGIN REGULATIONS AND
   REGISTRATION UNDER THE EXCHANGE ACT.

     Market for the Shares.  The purchase of Shares by Purchaser pursuant to the
Offer will reduce the number of Shares that might  otherwise  trade publicly and
the number of holders of Shares and could  adversely  affect the  liquidity  and
market value of the remaining Shares held by the public.

     Depending  on the number of Shares  purchased  pursuant  to the Offer,  the
Shares  may no longer  meet the  requirements  of the  National  Association  of
Securities  Dealers,  Inc.  (the "NASD") for  continued  inclusion in the Nasdaq
National  Market,  which require the issuer have (i) at least  200,000  publicly
held shares with a market  value of  $1,000,000,  (ii) 400  stockholders  or 300
stockholders of round lots, (iii) net tangible assets of $1,000,000, $2,000,000,
or $4,000,000, depending on the profitability of the issuer during the four most
recent  fiscal  years and (iv) a minimum bid price per share of $1.00 or, in the
alternative,  market value of public float of $3,000,000  and  $4,000,000 of net
tangible  assets.  The NASD has filed with the Commission  proposed rule changes
which would materially increase the foregoing maintenance criteria. In the event
that  Shares  were no longer  eligible  for Nasdaq  National  Market  quotation,
quotations might still be available from other sources. The extent of the public
market for the Shares and the  availability of such quotations  would,  however,
depend upon the number of holders of Shares remaining at such time, the interest
in  maintaining  a market in the  Shares on the part of  securities  firms,  the
possible termination of registration under the Exchange Act, as described below,
and other  factors.  The Company has informed the Purchaser that as of August 1,
1997 there were  approximately  80  stockholders  of record of the Shares and in
excess of 2,000  beneficial  owners of Shares.  If as a result of the Offer, the
Shares no longer meet the requirements of the NASD for continued trading and the
trading of Shares on the Nasdaq National Market is discontinued,  the market and
prices for the Shares could be adversely affected.

     Margin Regulations.  The Shares are currently "margin securities" under the
regulations  of the  Board of  Governors  of the  Federal  Reserve  System  (the
"Federal Reserve Board"),  which has the effect, among other things, of allowing
brokers to extend credit on the collateral of the Shares. Depending upon factors
similar to those  described  above  regarding  listing  and  market  quotations,
following  the Offer it is possible  that the Shares would no longer  constitute
"margin  securities"  for the purposes of the margin  regulations of the Federal
Reserve Board and therefore could no longer be used as collateral for loans made
by brokers.

     Registration  Under the Exchange Act. The Shares are  currently  registered
under the Exchange Act. Registration of the Shares under the Exchange Act may be
terminated  upon  application of the Company to the Commission if the Shares are
not listed on a national securities exchange and there are fewer than 300 record
holders of the  Shares.  Termination  of  registration  of the Shares  under the
Exchange Act would reduce substantially the information required to be furnished
by the Company to the  stockholders and to the Commission and would make certain
provisions  of the  Exchange  Act,  such  as  the  short-swing  profit  recovery
provisions of Section 16(b),  the requirement of furnishing a proxy statement in
connection  with  stockholders'  meetings  pursuant  to  Section  14(a)  and the
requirements  of Rule  13e-3  under  the  Exchange  Act with  respect  to "going
private" transactions no longer applicable to the Company.  Furthermore,  if the
Purchaser  acquires a substantial  number of Shares or the  registration  of the
Shares under the Exchange Act were to be terminated, the ability of "affiliates"
of the Company and persons  holding  "restricted  securities"  of the Company to
dispose of such securities  pursuant to Rule 144 under the Securities Act may be
impaired or  eliminated.  If  registration  of the Shares under the Exchange Act
were terminated  prior to the  consummation  of the Merger,  the Shares would no
longer  be  "margin  securities"  or be  eligible  for  Nasdaq  National  Market
reporting.

     The Purchaser  currently  intends to seek to cause the Company to terminate
the registration of the Shares under the Exchange Act as soon after consummation
of the Offer as the  requirements  for termination of  registration  are met. If
registration of the Shares is not terminated prior to the Merger, trading of the
Shares on the Nasdaq National Market will be discontinued,  and the registration
of the Shares under the Exchange Act will be terminated,  following consummation
of the Merger.



                                       47

<PAGE>

8. CERTAIN INFORMATION CONCERNING THE COMPANY.

     The information concerning the Company contained in this Offer to Purchase,
including  financial  information,  has been  furnished  by the Company or taken
from, or based upon,  publicly available  documents and records on file with the
Commission  and other public  sources.  The summary  information  concerning the
Company in this section and  elsewhere in this Offer to Purchase is derived from
the Company's 1996 Form 10-K and the Company's Quarterly Report on Form 10-Q for
the quarter ended March 31, 1997 (the "Company's  1997 Form 10-Q").  The summary
information  set forth below is  qualified  in its entirety by reference to such
documents  (which  may be  obtained  and  inspected  as  described  below  under
"Available  Information")  and should be considered in conjunction with the more
comprehensive  financial  and  other  information  in such  documents  and other
publicly  available  reports  and  documents  filed  by  the  Company  with  the
Commission.  Neither Parent nor the Purchaser assumes any responsibility for the
accuracy or  completeness  of the  information  contained in such  documents and
records,  or for any  failure by the  Company to  disclose  events that may have
occurred and may affect the significance or accuracy of any such information but
which are not known to the Purchaser.

     General.  The Company was  incorporated  on December 28, 1992 as a Delaware
corporation  under the name  ElderCare of America,  Inc. and changed its name to
Community  Care of America,  Inc. on October 13, 1993.  The Company's  principal
executive offices are located at 3050 North Horseshoe Drive,  Suite 260, Naples,
Florida 34104, and its telephone number is (941) 435-0085.

     According  to the  Company's  1996 Form  10-K,  the  Company  develops  and
operates skilled nursing facilities in medically  underserved rural communities.
The  Company's  strategy  is to enter rural areas  through  the  acquisition  of
long-term  care  facilities  which  serve as  platforms  from  which to  develop
networks that provide an array of healthcare and related  services.  The Company
believes that long-term care facilities in rural communities generally represent
underutilized  assets  to which  other  services  can be added  to  extend  high
quality,  cost-effective  solutions to address unmet basic  healthcare needs for
those  who live in rural  locations.  The  Company's  strategy  is  designed  to
coordinate flexible,  community-based  healthcare services,  including long-term
care,  rehabilitation,  adult day care,  home  healthcare,  assisted  living and
transportation  services.  The Company  also  affiliates  with other  healthcare
providers  whose  patients  can  benefit  from  utilizing  the  Company's  other
services.  During  1996,  the  Company  achieved  a growth of 37.4% in  revenues
(before a $1.9 million  revenue  adjustment in 1996) above 1995 levels which was
largely attributable to the acquisition or management of eight facilities in the
Southeast.

     As of August 7, 1997,  the  Company  operated 54  licensed  long-term  care
facilities with 4,450 licensed beds, one rural healthcare clinic, two outpatient
rehabilitation  centers, one child day care center and 115 assisted living units
within six of the communities  which the Company serves.  The Company  currently
operates in Alabama, Colorado, Florida, Georgia, Iowa, Kansas, Louisiana, Maine,
Missouri, Nebraska, Texas and Wyoming.

     Directors  and  Officers.  The  name,  address,   principal  occupation  or
employment,  five-year  employment  history and citizenship of each director and
executive officer of the Company is set forth on Schedule II hereto.

     Summary Historical Financial Data. The selected consolidated financial data
with  respect  to the  Company  and its  subsidiaries  set  forth  below and the
information  set forth in Schedule III hereto has been excerpted or derived from
information  contained in the Company's  1996 Form 10-K and the  Company's  1997
Form 10-Q. More comprehensive  financial information is included in such reports
(including  management's  discussion  and  analysis of financial  condition  and
results of  operations)  and in other  documents  filed by the Company  with the
Commission,  and the following summary is qualified in its entirety by reference
to such  reports and other  documents  and all of the  financial  data and notes
contained  therein.  Such reports and other documents may be examined and copies
may be obtained  from the offices of the  Commission  and the NASD in the manner
set  forth  below  under  "Available  Information."  A  copy  of  the  financial
statements  set forth in the Company's  1996 Form 10-K is reproduced as Schedule
III hereto.


                                       48

<PAGE>

                        COMMUNITY CARE OF AMERICA, INC.
                  SELECTED SUMMARY CONSOLIDATED FINANCIAL DATA
                    (IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)

<TABLE>
<CAPTION>
                                                                                                       THREE MONTHS
                                                                 YEARS ENDED DEC. 31,                 ENDED MARCH 31,
                                                        ---------------------------------------   -----------------------
                                                         1994         1995           1996          1996         1997
                                                        ----------   ----------   -------------   ---------   -----------
<S>                                                     <C>          <C>          <C>             <C>         <C>
Statement of Operations Data:
Total revenues   ....................................   $ 57,492      $94,178      $ 127,512      $28,945      $32,694
Operating expenses  .................................    57,098        90,690        133,754       26,766       33,333
Loss on impairment of investments and other
 non-recurring charges ..............................         -             -         22,128            -            -
Operating income (loss)   ...........................       394         3,488        (28,370)       2,179         (639)
Earnings (loss) before extraordinary charge .........       394         2,441        (18,905)       2,179         (639)
Net earnings (loss) .................................       394         1,449        (18,905)       1,352         (477)
Dividends-preferred stock ...........................      (653)         (408)             -            -            -
Net earnings (loss) applicable to common stock          $  (259)      $ 1,041      $ (18,905)     $ 1,352      $  (477)
                                                        ========      =======      =========      ========     =======
Net earnings (loss) per share   .....................   $ (0.13)      $  0.22      $   (2.56)     $  0.19      $ (0.06)
                                                        ========      =======      =========      ========     =======
Weighted average number of common and com-
 mon equivalent shares outstanding                        2,041         4,840          7,385        7,198        7,598
                                                        ========      =======      =========      ========     =======
<CAPTION>
                                                                December 31,
                                                    -------------------------------------   March 31,
                                                        1994        1995        1996         1997
                                                    ---------   ---------   -------------   ----------
<S>                                                 <C>         <C>         <C>             <C>
Balance Sheet Data:
Working capital (deficit)   .....................   $ 2,276     $ 4,488      $ (10,952)     $(9,801)
Total assets ....................................    62,375      93,290        102,119      102,686
Long-term debt, including current portion  ......    33,086      35,665         60,371       60,172
Redeemable preferred stock and common stock
 subject to repurchase   ........................     5,908       2,181              -            -
Stockholders' equity  ...........................     4,745      31,241         16,003       15,526
</TABLE>

     Certain  Company  Projections.  In  connection  with the  Parent's  and the
Purchaser's  due  diligence  review  of the  Company  and in the  course  of the
negotiations  between  the  Company,  the  Parent  and the  Purchaser  and their
respective  advisors described in "SPECIAL FACTORS - Background of the Offer and
the Merger"  which led to the  execution  of the Merger  Agreement,  the Company
provided  the  Parent  and the  Purchaser  with  certain  projections  of future
operating  performance of the Company which the Parent and the Purchaser believe
are not publicly available. Such projections, which were prepared as part of the
effort to sell the Company,  cover the six-year  period  beginning with 1997 and
assumed  that 12  facilities  would be sold or closed  by the end of 1997.  Such
projections  did not take  into  account  any of the  potential  effects  of the
transactions contemplated by the Offer or the Merger.


             COMMUNITY CARE OF AMERICA, INC. MANAGEMENT PROJECTIONS
                                 (in thousands)
<TABLE>
<CAPTION>
                                             YEAR ENDED DECEMBER 31,
                         ----------------------------------------------------------------
                           1997       1998       1999       2000       2001       2002
                         ---------- ---------- ---------- ---------- ---------- ---------
<S>                      <C>        <C>        <C>        <C>        <C>        <C>
Total revenue  .........   $107,475   $117,423   $129,166   $142,082   $156,290   $171,91
Operating income  ......     20,289     25,549     28,104     30,914     34,005     37,40
Net income  ............      1,967      4,734      6,332      8,229     10,466     12,78
</TABLE>

     THE COMPANY DOES NOT AS A MATTER OF COURSE MAKE PUBLIC ANY  PROJECTIONS  AS
TO FUTURE  PERFORMANCE  OR  EARNINGS,  AND THE  PROJECTIONS  SET FORTH ABOVE ARE
INCLUDED  IN THIS  OFFER TO  PURCHASE  ONLY  BECAUSE  THE  INFORMATION  WAS MADE
AVAILABLE  TO THE PARENT AND THE  PURCHASER  BY THE  COMPANY.  THE  COMPANY  HAS
INFORMED



                                       49

<PAGE>


THE PARENT AND THE  PURCHASER  THAT THESE  PROJECTIONS  WERE NOT PREPARED WITH A
VIEW TO PUBLIC  DISCLOSURE  OR COMPLIANCE  WITH THE PUBLISHED  GUIDELINES OF THE
COMMISSION OR THE GUIDELINES  ESTABLISHED BY THE AMERICAN INSTITUTE OF CERTIFIED
PUBLIC  ACCOUNTANTS  REGARDING  PROJECTIONS AND FORECASTS.  THE COMPANY HAS ALSO
INFORMED  THE PARENT AND THE  PURCHASER  THAT ITS INTERNAL  FINANCIAL  FORECASTS
(UPON WHICH THE PROJECTIONS  PROVIDED TO THE PARENT AND THE PURCHASER WERE BASED
IN PART) ARE, IN GENERAL, PREPARED SOLELY FOR INTERNAL USE AND CAPITAL BUDGETING
AND  OTHER  MANAGEMENT  DECISION-MAKING  PURPOSES  AND  ARE  SUBJECTIVE  IN MANY
RESPECTS AND THUS SUSCEPTIBLE TO VARIOUS  INTERPRETATIONS  AND PERIODIC REVISION
BASED ON ACTUAL EXPERIENCE AND BUSINESS  DEVELOPMENTS.  PROJECTED INFORMATION OF
THIS TYPE IS BASED ON ESTIMATES AND  ASSUMPTIONS  WHICH  THEMSELVES ARE BASED ON
EVENTS AND CIRCUMSTANCES THAT HAVE NOT TAKEN PLACE AND ARE INHERENTLY SUBJECT TO
SIGNIFICANT  FINANCIAL,  MARKET,  ECONOMIC  AND  COMPETITIVE  UNCERTAINTIES  AND
CONTINGENCIES,  ALL OF WHICH  ARE  DIFFICULT  TO  PREDICT  AND MANY OF WHICH ARE
BEYOND  THE  CONTROL  OF THE  COMPANY,  THE  PURCHASER  OR THE  PARENT  OR THEIR
RESPECTIVE FINANCIAL ADVISORS.  MANY OF THE ASSUMPTIONS UPON WHICH THE FOREGOING
PROJECTIONS  WERE  BASED,  NONE OF WHICH  WERE  APPROVED  BY THE  PARENT  OR THE
PURCHASER, ARE DEPENDENT UPON ECONOMIC FORECASTING (BOTH GENERAL AND SPECIFIC TO
THE  COMPANY'S  BUSINESSES),  WHICH  IS  INHERENTLY  UNCERTAIN  AND  SUBJECTIVE.
THEREFORE,  IT IS EXPECTED THAT THERE WILL BE DIFFERENCES BETWEEN THE ACTUAL AND
PROJECTED  RESULTS AND THAT THE ACTUAL RESULTS MAY BE MATERIALLY HIGHER OR LOWER
THAN THOSE PROJECTED.  NONE OF THE PARENT,  THE PURCHASER,  THE COMPANY OR THEIR
RESPECTIVE  FINANCIAL  ADVISORS ASSUMES ANY  RESPONSIBILITY  FOR THE ACCURACY OR
VALIDITY OF ANY OF SUCH  PROJECTIONS.  INCLUSION  OF THE  FOREGOING  PROJECTIONS
SHOULD NOT BE REGARDED AS AN INDICATION THAT PARENT, THE PURCHASER,  THE COMPANY
OR ANY OTHER  PERSON WHO  RECEIVED  SUCH  INFORMATION  CONSIDERS  IT AN ACCURATE
PREDICTION OF FUTURE EVENTS, AND NEITHER THE PURCHASER NOR THE PARENT HAS RELIED
ON THEM AS SUCH.  NONE OF THE PARENT,  THE  PURCHASER OR THE  COMPANY,  OR THEIR
RESPECTIVE FINANCIAL ADVISORS, OR ANY OTHER PARTY, INTENDS TO PUBLICLY UPDATE OR
OTHERWISE  PUBLICLY  REVISE THE  PROJECTIONS  SET FORTH ABOVE.  THE  INDEPENDENT
ACCOUNTANTS  FOR THE COMPANY,  THE PARENT AND THE  PURCHASER  HAVE NOT EXAMINED,
REVIEWED OR COMPILED THESE PROJECTIONS AND ACCORDINGLY DO NOT EXPRESS AN OPINION
OR ANY OTHER FORM OF ASSURANCE WITH RESPECT TO THEM.

     Available  Information.  The Company is subject to the  information  filing
requirements of the Exchange Act and, in accordance therewith, the Company files
periodic  reports,  proxy  statements and other  information with the Commission
under the Exchange Act relating to its business,  financial  condition and other
matters.  The Company is required to disclose in such proxy  statements  certain
information,  as of particular  dates,  concerning  the Company's  directors and
officers,  the  remuneration,  options granted to them, the principal holders of
the  Company's   securities  and  any  material  interest  of  such  persons  in
transactions  with  the  Company.  Such  reports,  proxy  statements  and  other
information  may be inspected at the  Commission's  office at 450 Fifth  Street,
N.W.,  Washington,  D.C. 20549,  and should also be available for inspection and
copying at the regional  offices of the Commission  located at Seven World Trade
Center,  13th Floor,  New York,  New York 10048 and  Citicorp  Center,  500 West
Madison Street (Suite 1400),  Chicago, IL 60661. Copies may be obtained by mail,
upon  payment of the  Commission's  customary  fees,  from the Public  Reference
Section of the  Commission's  principal  office at  Judiciary  Plaza,  450 Fifth
Street, N.W.,  Washington,  D.C. 20549. In addition,  the Commission maintains a
Web site that  contains  reports,  proxy and  information  statements  and other
information   regarding   the   Company   (and  other   registrants   that  file
electronically   with  the  Commission).   The  address  of  such  Web  site  is
(http://www.sec.gov).  Such material  should also be available for inspection at
The Nasdaq Stock Market, Inc., 1735 K Street, N.W., Washington, D.C. 20006.

9. CERTAIN INFORMATION CONCERNING THE PURCHASER AND THE PARENT.

     Purchaser.   The  Purchaser,   a  Delaware  corporation  and  wholly  owned
subsidiary of the Parent,  was  incorporated on July 31, 1997 for the purpose of
acquiring the Company and has not engaged in any other business  activity except
in connection with the Offer and the Merger. The Purchaser  maintains  executive
offices c/o Parent, 10065 Red Run Boulevard,  Owings Mills,  Maryland 21117, and
its telephone number at such address is 410-998-8400.

     Parent.  Parent  (NYSE:IHS)  is one of the  nation's  leading  providers of
post-acute healthcare services.  Post-acute care is the provision of a continuum
of care to patients  following  discharge from an acute care hospital.  Parent's
post-acute  care services  include  subacute  care,  home care and inpatient and
outpatient rehabilitation,  hospice and diagnostic services. Parent's post-acute
care network is designed to address the fact that the cost containment  measures
implemented by private insurers and managed


                                       50

<PAGE>


care organizations and limitations on government reimbursement of hospital costs
have resulted in the discharge  from  hospitals of many patients who continue to
require medical and rehabilitative  care. Parent's post-acute  healthcare system
is intended to provide  cost-effective  continuity  of care for its  patients in
multiple settings and enable payors to contract with one provider to provide all
of a patient's  needs  following  discharge  from acute care  hospitals.  Parent
believes that its post-acute care network can be extended beyond post-acute care
to also provide  "pre-acute"  care, i.e.,  services to patients which reduce the
likelihood of a need for a hospital stay. The Parent's  post-acute  care network
currently consists of approximately 1,100 service locations in 41 states.

     Parent  presently  operates 172  geriatric  care  facilities  (116 owned or
leased and 56  managed)  and 158 medical  specialty  units  ("MSUs"),  which are
typically 20 to 75 bed  specialty  units with physical  identities,  specialized
medical  technology and staffs  separate from the geriatric  care  facilities in
which they are located within 84 of these facilities. Parent offers a wide range
of basic  medical  services  as well as a  comprehensive  array of  respiratory,
physical, speech,  occupational and physiatric therapy in all its geriatric care
facilities.  Parent has  recently  expanded  significantly  its home  healthcare
services, and now offers home nursing, infusion,  respiratory and rehabilitation
services.

     Parent was  incorporated  in March 1986 as a Pennsylvania  corporation  and
reorganized  as a Delaware  corporation  in November  1986.  Parent's  principal
executive offices are located at 10065 Red Run Boulevard, Owings Mills, Maryland
21117 and its telephone number is (410) 998-8400.

     Directors and  Officers.  The name,  business  address,  present  principal
occupation or employment,  five-year  employment history and citizenship of each
director and of each  executive  officer of the Parent and the Purchaser are set
forth in Schedule I hereto.

     Available  Information.  Parent  is  subject  to the  informational  filing
requirements  of the Exchange  Act and, in  accordance  therewith,  Parent files
periodic  reports,  proxy  statements and other  information with the Commission
under the Exchange Act relating to its business,  financial  condition and other
matters.  Parent is  required  to  disclose  in such  proxy  statements  certain
information,  as of particular  dates,  concerning the directors and officers of
Parent,  the  remuneration  and stock  options  granted to them,  the  principal
holders of its securities and material interests of such persons in transactions
with Parent.  Such reports,  proxy  statements and other  information  should be
available for inspection and copying at the Commission in the same manner as set
forth with respect to information concerning the Company in "THE OFFER - Certain
Information  Concerning the Company." Such material should also be available for
inspection at the offices of the New York Stock Exchange, Inc., 20 Broad Street,
New York,  NY 10005.  The financial  statements  set forth in Part I of Parent's
Quarterly Report on 10-Q for the quarter ended March 31, 1997 and pages 55-92 of
Parent's  Annual Report on Form 10-K for the fiscal year ended December 31, 1996
are incorporated herein by reference.

     Except for the 1,600,853 Shares beneficially owned by Dr. Robert N. Elkins,
Chairman  of the Board and Chief  Executive  Officer of Parent and a director of
the Company  (including  737,392  Shares which Mr.  Elkins has the right to vote
pursuant to the Voting Agreement and 10,939 Shares issuable upon the exercise of
outstanding  options),  the 8,083 Shares and options to purchase  35,242  Shares
owned by Mr.  John L.  Silverman,  an  employee  and  director  of Parent  and a
director of the Company (which Shares are subject to the Voting Agreement),  the
187,674 Shares owned by certain other executive officers and directors of Parent
(which  Shares are  subject to the Voting  Agreement)  and  warrants to purchase
1,189,274 Shares owned by Parent (see "SPECIAL  FACTORS  Background of the Offer
and the Merger"),  none of Purchaser,  Parent nor, to the best  knowledge of the
Purchaser  and  Parent,  any of the  persons  listed on Schedule I hereto or any
associate  of the  Purchaser  or the  Parent,  or any of the  persons so listed,
beneficially  owns  or  has a  right  to  acquire  directly  or  indirectly  any
securities of the Company.  Neither the Purchaser,  the Parent,  nor to the best
knowledge of the Purchaser, any of the persons or entities referred to above, or
any of the respective  executive  officers,  directors or subsidiaries of any of
the foregoing,  has effected any  transactions  in the securities of the Company
during the past 60 days.

     Except as described in this Offer to Purchase,  and except for the warrants
to purchase Shares issued by the Company to the Parent and the Voting  Agreement
to which Dr. Elkins is a party (see  "SPECIAL  FACTORS - Background of the Offer
and the Merger" and "SPECIAL FACTORS - Share Owner-



                                       51

<PAGE>


ship by Parent,  Purchaser  and Their  Affiliates"),  neither the  Purchaser nor
Parent,  nor to the best  knowledge  of the  Purchaser  and  Parent,  any of the
persons   listed  on  Schedule  I  hereto,   has  any   contract,   arrangement,
understanding  or  relationship  with  any  other  person  with  respect  to any
securities  of  the  Company,   including,   but  not  limited  to,   contracts,
arrangements,  understandings or relationships concerning the transfer or voting
of such securities, joint ventures, loan or option arrangements,  puts or calls,
guaranties of loans,  guaranties  against loss or the giving or  withholding  of
proxies.  Except as described in this Offer to Purchase,  neither the Purchaser,
the Parent,  nor to the best  knowledge of the Purchaser and Parent,  any of the
persons listed on Schedule I hereto,  has had since the formation of the Company
any  business  relationships  or  transactions  with the  Company  or any of its
executive  officers,  directors or  affiliates  that are required to be reported
under the rules and  regulations  of the  Commission  applicable  to the  Offer.
Except as  described  in this  Offer to  Purchase,  since the  formation  of the
Company,  there have been no contacts,  negotiations or transactions between the
Purchaser, the Parent or, to the best knowledge of the Purchaser and the Parent,
any of the persons listed in Schedule I hereto, on the one hand, and the Company
or its  affiliates,  on the other hand,  concerning a merger,  consolidation  or
acquisition,  a tender offer or other acquisition of securities,  an election of
directors, or a sale or other transfer of a material amount of assets.

10. SOURCE AND AMOUNT OF FUNDS.

     The Purchaser  estimates that approximately  $36.4 million will be required
to (i)  purchase  Shares  pursuant  to the  Offer and the  Merger,  (ii) pay the
holders of outstanding  stock options an amount equal to the excess of the price
per Share  pursuant to the Offer over the exercise  price of such stock  option,
multiplied by the number of Shares  subject to such stock option,  (iii) pay the
holders of  outstanding  warrants an amount equal to the excess of the price per
Share pursuant to the Offer over the exercise price of such warrant,  multiplied
by the  number  of Shares  subject  to such  warrant,  and (iv) pay the fees and
expenses related to the Offer.

     The  Purchaser  will  obtain  the  necessary  funds for the Offer  from the
Parent.  The Parent will obtain such funds from (i) its working capital and (ii)
borrowings  under its  revolving  credit  facility.  The Parent  has  sufficient
availability under the revolving credit facility to provide the required funds.

     On May 15, 1996,  the Parent entered into a $700 million  revolving  credit
facility, including a $100 million letter of credit subfacility,  with Citibank,
N.A.,  as   Administrative   Agent,  and  certain  other  lenders  (the  "Credit
Facility").  The Credit Facility consists of a $700 million revolving loan which
reduces to $560 million on June 30, 2000 and $315 million on June 30, 2001, with
a final maturity on June 30, 2002. The $100 million subcommitment for letters of
credit will remain at $100 million until final maturity.  The Credit Facility is
guaranteed  by the Parent's  subsidiaries  and secured by a pledge of all of the
stock of substantially  all of the Parent's  subsidiaries.  At the option of the
Parent,  loans under the Credit Facility bear interest at a rate equal to either
(i) the sum of (a) the  higher of (1) the  bank's  base rate or (2) one  percent
plus the latest  overnight  federal funds rate plus (b) a margin of between zero
percent and one and one-quarter percent (depending on certain financial ratios);
or (ii) in the case of Eurodollar  loans,  the sum of between three  quarters of
one percent and two and one-half percent (depending on certain financial ratios)
and the  interest  rate in the  London  interbank  market for loans in an amount
substantially  equal  to the  amount  of  borrowing  and for the  period  of the
borrowing  selected  by the  Parent.  The Credit  Facility  limits the  Parent's
ability to incur  indebtedness  or contingent  obligations,  to make  additional
acquisitions,  to create  or incur  liens on  assets,  to pay  dividends  and to
purchase or redeem the Parent's stock. In addition, the Credit Facility requires
that the Parent meet certain  financial  tests,  and provides the banks with the
right to require the payment of all of the amounts  outstanding under the Credit
Facility  if there is a change in control  of the Parent or if any person  other
than Dr. Robert N. Elkins,  Parent's Chairman and Chief Executive Officer,  or a
group  managed by Dr. Elkins owns more than 40% of the Parent's  capital  stock.
Amounts repaid under the Credit Facility may be reborrowed  until June 30, 2002.
Citibank, N.A. is acting as the Depositary for the Offer.

     Parent anticipates that borrowings under the Credit Facility will be repaid
from  operating  cash flow of the Parent,  the Company and its  subsidiaries  or
other  sources,  which may include the proceeds of debt or equity  financings of
Parent. No decisions have been made concerning these matters and such



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decisions  will be made based on the  Parent's  review of its  business  and the
advisability of particular transactions, as well as on prevailing interest rates
and other financial and market conditions.

     A copy of the Parent's  revolving  credit  facility has been filed with the
Commission. Reference is made to such exhibit for a more complete description of
the terms and conditions of such document.

11. CERTAIN CONDITIONS OF THE OFFER.

     Notwithstanding  any other provision of the Offer or the Merger  Agreement,
the  Purchaser  shall not be required  to accept for payment or,  subject to any
applicable  rules and  regulations  of the  Commission,  including Rule 14e-1(c)
under the Exchange Act  (relating to the  Purchaser's  obligation  to pay for or
return tendered Shares after the termination or withdrawal of the Offer), to pay
for any Shares  tendered  pursuant to the Offer unless (i) there shall have been
validly  tendered and not  withdrawn  prior to the  expiration of the Offer such
number of Shares which would constitute a majority of the outstanding  shares of
Common  Stock of the  Company on a  fully-diluted  basis on the date of purchase
("on a  fully-diluted  basis"  means,  as of the date of the  purchase of Shares
pursuant  to the Offer,  the  number of Shares  outstanding,  together  with all
Shares of the Company  issuable  pursuant to options and  warrants) and (ii) any
waiting period under the HSR Act  applicable to the purchase of Shares  pursuant
to the Offer shall have expired or been terminated. Furthermore, notwithstanding
any other term of the Offer or the Merger  Agreement,  the Purchaser will not be
required to accept for payment or,  subject as aforesaid,  to pay for any Shares
not  theretofore  accepted for payment or paid for, and may  terminate the Offer
if, at any time on or after the date of the  Merger  Agreement  and  before  the
acceptance  of such  Shares for  payment  or the  payment  therefor,  any of the
following conditions exists (other than as a result of any action or inaction of
the Parent or any of its subsidiaries  which  constitutes a breach of the Merger
Agreement):

       (a) there shall be threatened, instituted or pending by any person or any
    Federal,  state or local government or any court,  administrative  agency or
    commission or other governmental authority or agency,  domestic,  foreign or
    supranational (a "Governmental  Entity") any suit,  action or proceeding (i)
    challenging  the  acquisition by Parent or the Purchaser of any Shares under
    the Offer, seeking to restrain or prohibit the making or consummation of the
    Offer or the  Merger or the  performance  of any of the  other  transactions
    contemplated by the Merger  Agreement or seeking to obtain from the Company,
    Parent or the  Purchaser  any damages not covered by insurance  which in the
    reasonable  judgment  of Parent are  material in relation to the Company and
    its  subsidiaries  taken as whole,  (ii)  seeking to  prohibit or impose any
    limitations on Parent's or the  Purchaser's  ownership or operation (or that
    of any of their  respective  subsidiaries  or  affiliates)  of the Company's
    businesses  or  assets,  or to  compel  Parent  or the  Purchaser  or  their
    respective  subsidiaries  and  affiliates to dispose of or hold separate any
    portion  of the  business  or assets  of the  Company  or  Parent  and their
    respective subsidiaries,  (iii) seeking to impose limitations on the ability
    of the Purchaser, or render the Purchaser unable, to accept for payment, pay
    for or  purchase  some or all of the  Shares  pursuant  to the Offer and the
    Merger,  (iv) seeking to impose  limitations on the ability of Parent or the
    Purchaser  effectively  to exercise  full rights of  ownership of any Shares
    including,  without limitation, the right to vote such Shares on all matters
    properly  presented  to the  stockholders  of  the  Company,  or  (v)  which
    otherwise  in the  reasonable  judgment  of  Purchaser  are likely to have a
    material adverse effect on the Company;

       (b) there shall be any  statute,  rule,  regulation,  judgment,  order or
    injunction enacted, entered,  enforced,  promulgated or deemed applicable to
    the  Offer  or the  Merger,  or any  other  action  shall  be  taken  by any
    Governmental  Entity,  other than the application to the Offer or the Merger
    of applicable  waiting  periods  under the HSR Act,  that in the  reasonable
    judgment of Parent is likely to result,  directly or  indirectly,  in any of
    the  consequences  referred to in clauses (i) through (v) of  paragraph  (a)
    above;

       (c) there shall have occurred any events that, either  individually or in
    the aggregate,  have caused or in the reasonable  judgment of the Parent are
    likely to cause a material adverse change with respect to the Company;


                                       53

<PAGE>





       (d) (i) the Board of  Directors of the Company or any  committee  thereof
    shall  have  withdrawn  or  modified  in a manner  adverse  to Parent or the
    Purchaser  its approval or  recommendation  of the Offer,  the Merger or the
    Merger Agreement, or approved or recommended any Takeover Proposal, (ii) the
    Company shall have entered into any  agreement  with respect to any Superior
    Proposal  in  accordance  with the  Merger  Agreement  or (iii) the Board of
    Directors of the Company or any  committee  thereof  shall have  resolved to
    take any of the foregoing actions;

       (e) any of the representations and warranties of the Company set forth in
    the Merger Agreement that are qualified as to materiality  shall not be true
    and  correct and any such  representations  and  warranties  that are not so
    qualified  shall not be true and correct in any  material  respect,  in each
    case as of the date of the Merger Agreement and at the scheduled or extended
    expiration of the Offer;

       (f)  the  Company  shall  have  failed  to  perform  or cure  within  the
    applicable cure period any material  obligation or to comply in any material
    respect  with any  material  agreement  or  covenant  of the  Company  to be
    performed or complied with by it under the Merger Agreement;

       (g) the Merger Agreement shall have been terminated in accordance with
    its terms;

       (h)  there  shall  have  occurred  (i)  any  general  suspension  of,  or
    limitation  of prices  for,  trading  in  securities  on the New York  Stock
    Exchange  or  NASDAQ,  (ii) a  declaration  of a banking  moratorium  or any
    suspension  of  payments in respect of banks in the United  States,  (iii) a
    commencement of war, armed  hostilities or other  international  or national
    calamity directly involving the Armed Forces of the United States,  (iv) any
    general limitation (whether or not mandatory) by any governmental  authority
    on the extension of credit by banks or other lending institutions and (v) in
    the case of any of the foregoing existing at time of the commencement of the
    Offer, a material acceleration or worsening thereof; or

       (i) the  Parent,  Purchaser  and the  Company  shall  not  have  procured
    consents  (i) to transfer of  healthcare  licenses in the States of Alabama,
    Colorado,  Florida,  Georgia,  Iowa,  Kansas,  Louisiana,  Maine,  Missouri,
    Nebraska,  Texas and Wyoming,  (ii) to transfers of the Certificates of Need
    in the States of Alabama and Maine and (iii) from  Healthcare and Retirement
    Properties Trust and Daiwa Healthco 2, L.L.C., the Company's lenders.

     The foregoing  conditions are for the sole benefit of the Purchaser and the
Parent, may be asserted by the Purchaser and the Parent, in whole or in part, at
any time and from time to time, in the reasonable  judgment of the Purchaser and
Parent regardless of the circumstances  giving rise to any such condition (other
than a  breach  by the  Parent  or the  Purchaser),  and  may be  waived  by the
Purchaser  and  Parent  in whole or in part at any time and from time to time in
their sole  discretion.  The failure by Parent or the  Purchaser  at any time to
exercise any of the  foregoing  rights will not be deemed a waiver of any right,
the waiver of such right with respect to any particular  facts or  circumstances
shall not be deemed a waiver with  respect to any other facts or  circumstances,
and each right will be deemed an ongoing  right that may be asserted at any time
and from time to time. Should the Offer be terminated  pursuant to the foregoing
provisions,  all tendered Shares not  theretofore  accepted for payment shall be
returned forthwith by the Depositary to the tendering stockholders.

12. CERTAIN LEGAL MATTERS.

     General.  Except  as  described  in this  section,  based on its  review of
publicly  available  filings by the Company with the Commission,  other publicly
available  information  concerning  the  Company and  materials  which have been
provided to the Parent or the  Purchaser  by the Company,  the  Purchaser is not
aware of any license or  regulatory  permit  that  appears to be material to the
business of the Company and its subsidiaries  taken as a whole that is likely to
be adversely affected by the Purchaser's acquisition of Shares (and the indirect
acquisition  of the stock of the Company's  subsidiaries)  pursuant to the Offer
or, except as set forth below,  of any filings,  approval or any other action by
any domestic or foreign  governmental or administrative  authority that would be
required prior to the acquisition of Shares (or the indirect  acquisition of the
stock of the Company's  subsidiaries)  by the  Purchaser  pursuant to the Offer.
However,  should any such approval or other action be required,  it is currently
contemplated that


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<PAGE>

such  approval  or action  would be sought  except  as  described  below in this
section  under "State  Takeover  Laws."  Except as  permitted  by the  condition
described  under  "THE OFFER - Certain  Conditions  of the  Offer,"  there is no
current  intent to delay the purchase of Shares  tendered  pursuant to the Offer
pending the outcome of any such matter.  There can be no assurance that any such
approval  or other  action,  if needed,  would be obtained  without  substantial
conditions or that adverse  consequences might not result to the business of the
Company,  the Parent or the Purchaser or that certain parts of the businesses of
the  Company,  the Parent or the  Purchaser  might not have to be disposed of or
held separate or other substantial  conditions  complied with in order to obtain
such  approval or take such other action or in the event that such  approval was
not  obtained or such other  action was not taken,  any of which could cause the
Purchaser to elect  (subject to the terms of the Merger  Agreement) to terminate
the Offer  without  the  purchase  of the  Shares  thereunder.  The  Purchaser's
obligation  under the Offer to accept for  payment and pay for Shares is subject
to  certain  conditions,  including  conditions  relating  to the legal  matters
discussed in this section.

     State  Takeover  Laws.  The Company is  incorporated  under the laws of the
State  of  Delaware.  Section  203 of the  Delaware  GCL  prohibits  a  Delaware
corporation  such as the  Company  from  engaging  in a  "Business  Combination"
(defined as a variety of  transactions,  including  mergers) with an "Interested
Stockholder"  (defined generally as a person that is the beneficial owner of 15%
or more of a corporation's outstanding voting stock) for a period of three years
following the date that such person became an Interested  Stockholder unless (a)
prior to the date such person  became an  Interested  Stockholder,  the board of
directors of the  corporation  approved  either the Business  Combination or the
transaction that resulted in the stockholder becoming an Interested Stockholder,
(b) upon  consummation  of the  transaction  that  resulted  in the  stockholder
becoming an Interested  Stockholder,  the Interested  Stockholder owned at least
85% of the  voting  stock  of  the  corporation  outstanding  at  the  time  the
transaction  commenced,  excluding stock held by directors who are also officers
of the  corporation  and  employee  stock  ownership  plans that do not  provide
employees with the right to determine confidentially whether shares held subject
to the  plan  will be  tendered  in a  tender  or  exchange  offer  or (c) on or
subsequent  to the date  such  person  became  an  Interested  Stockholder,  the
Business  Combination  is approved by the board of directors of the  corporation
and authorized at a meeting of stockholders,  and not by written consent, by the
affirmative  vote of the holders of at least 662|M/3% of the outstanding  voting
stock of the  corporation  not owned by the Interested  Stockholder.  Parent has
been an  Interested  Stockholder  of the  Company for more than three years as a
result of the ownership of Shares by Dr. Robert N. Elkins,  Parent's Chairman of
the Board and Chief Executive  Officer.  The Purchaser was formed after approval
of the  Offer,  the  Merger  and the  Merger  Agreement  by the  Company  Board.
Accordingly,  the  Company,  Parent and the  Purchaser  believe  Section  203 is
inapplicable to the Offer and the Merger.

     A number of other states throughout the United States have enacted takeover
statutes  that  purport,  in varying  degrees,  to be  applicable to attempts to
acquire  securities  of  corporations  that  are  incorporated  or have  assets,
stockholders,  executive  offices  or  places  of  business,  or whose  business
operations  otherwise have substantial  effect, in such states. In Edgar v. MITE
Corp.,  the Supreme Court of the United  States held that the Illinois  Business
Takeover Act,  which involved  state  securities  laws that made the takeover of
certain corporations more difficult,  imposed a substantial burden on interstate
commerce and therefore was  unconstitutional.  In CTS Corp. v. Dynamics Corp. of
America,  however, the Supreme Court of the United States held that a state may,
as a matter of corporate law and, in particular, those laws concerning corporate
governance,  constitutionally disqualify a potential acquiror from voting on the
affairs  of a  target  corporation  without  prior  approval  of  the  remaining
stockholders,  provided  that such  laws  were  applicable  only  under  certain
conditions.  The state law before the Supreme Court was by its terms  applicable
only to corporations that had a substantial  number of stockholders in the state
and were incorporated there.

     The  Company,  directly  or through  subsidiaries,  conducts  business in a
number of states  throughout  the  United  States,  some of which  have  enacted
takeover  statutes.  Purchaser does not know whether any of these statutes will,
by their terms, apply to the Offer, and has not complied with any such statutes.
To the extent that certain  provisions of these statutes purport to apply to the
Offer,  Purchaser  believes that there are reasonable  bases for contesting such
statutes.  If any  person  should  seek to apply  any  state  takeover  statute,
Purchaser  would take such action as then  appears  desirable,  which action may
include  challenging  the  validity  or  applicability  of any such  statute  in
appropriate court proceedings. If it is asserted that one or more



                                       55

<PAGE>


takeover  statutes apply to the Offer and it is not determined by an appropriate
court that such  statute or  statutes  do not apply or are invalid as applied to
the Offer,  Purchaser  might be required to file certain  information  with,  or
receive approvals from, the relevant state  authorities,  and Purchaser might be
unable to  purchase  or pay for Shares  tendered  pursuant  to the Offer,  or be
delayed in continuing or consummating the Offer. In such case, Purchaser may not
be  obligated to accept for payment or pay for Shares  tendered  pursuant to the
Offer.

     Antitrust Laws.  Under the HSR Act and the rules that have been promulgated
thereunder  by  the  Federal  Trade  Commission  ("FTC"),   certain  acquisition
transactions  may  not  be  consummated  unless  certain  information  has  been
furnished to the Antitrust Division of the Department of Justice (the "Antitrust
Division")  and  the FTC and  certain  waiting  period  requirements  have  been
satisfied.  The  acquisition of Shares  pursuant to the Offer is subject to such
requirements. See "THE OFFER - Certain Conditions of the Offer."

     Purchaser  expects to file a  Notification  and Report Form with respect to
the Offer under the HSR Act as soon as practicable following commencement of the
Offer.  The  waiting  period  under the HSR Act with  respect  to the Offer will
expire at 11:59  p.m.  New York City  time,  on the 15th day after the date such
form is filed,  unless early  termination of the waiting  period is granted.  In
addition,  the Antitrust  Division or the FTC may extend such waiting  period by
requesting  additional  information or documentary  material from Purchaser.  If
such a request is made with respect to the Offer,  the waiting period related to
the Offer  will  expire at 11:59  p.m.  New York City time on the 10th day after
substantial  compliance  by Purchaser  with such  request.  With respect to each
acquisition,  the  Antitrust  Division or the FTC may issue only one request for
additional  information.  In practice,  complying  with a request for additional
information or material can take a significant  amount of time. In addition,  if
the Antitrust Division or the FTC raises substantive issues in connection with a
proposed  transaction,  the parties may engage in negotiations with the relevant
governmental agency concerning possible means of addressing those issues and may
agree to delay consummation of the transaction while such negotiations continue.
Expiration or termination of applicable  waiting  periods under the HSR Act is a
condition  to  Purchaser's  obligation  to accept for payment and pay for Shares
tendered pursuant to the Offer.

     The Antitrust Division and the FTC frequently scrutinize the legality under
the  antitrust  laws of  transactions  such as the proposed  acquisition  of the
Company  by  the  Purchaser.  At  any  time  before  or  after  the  Purchaser's
acquisition of Shares pursuant to the Offer,  the Antitrust  Division or the FTC
could  take  such  action  under the  antitrust  laws as it deems  necessary  or
desirable in the public  interest,  including  seeking to enjoin the purchase of
Shares  pursuant  to the Offer or the  consummation  of the  proposed  Merger or
seeking the  divestiture of Shares  acquired by the Purchaser or the divestiture
of substantial  assets of the Company or its  subsidiaries  or the Parent or its
subsidiaries.  Private  parties may also bring legal action under the  antitrust
laws under certain circumstances.

     Based upon the examination of publicly  available  information  relating to
the business in which the Parent and the Company are engaged, the Parent and the
Purchaser  believe  that the  acquisition  of Shares by the  Purchaser  will not
violate the antitrust  laws.  There can be no assurance  that a challenge to the
Offer on  antitrust  grounds  will not be made or, if such a challenge  is made,
what the outcome will be. See "THE OFFER - Certain  Conditions of the Offer" for
certain conditions to the Offer, including conditions with respect to litigation
and certain government actions.

     Federal and State  Healthcare  Regulatory  Authorities.  The Company  owns,
operates  and/or manages  long-term  care and assisted  living  facilities.  The
facilities are operated in Alabama,  Colorado,  Florida,  Georgia, Iowa, Kansas,
Louisiana, Maine, Missouri, Nebraska, Texas and Wyoming.

     The regulatory  requirements  of these  jurisdictions  require notice of or
approval  prior to any  direct or  indirect  change  in  ownership,  control  or
management of any of the facilities or services.  These regulatory  requirements
include, without limitation, those providing for licensure,  certificate of need
or similar laws restricting  development and/or expansion activities ("CON laws"
or "CON"),  participation  in the  Medicaid  program,  as well as  federal  laws
regarding participation in the Medicare and the Medicaid programs. To the extent
that  the  consummation  of the  Offer  or the  consummation  of the  Merger  is
determined to constitute any such change in ownership,  control or management of
facilities under the



                                       56

<PAGE>


applicable   regulatory   requirements,   consummation  of  the  Offer  and  the
consummation  of the Merger would be subject to compliance  with the  regulatory
requirements of the applicable state, as well as any applicable federal laws and
receipt,  to  the  extent  applicable,   of  any  required  approvals  or  other
authorization.  The state and federal requirements are subject to interpretation
by the various agencies and may, in certain instances, be subject to waiver.

     Pursuant to federal Medicare program  standards,  providers must notify the
Medicare  program as promptly as possible  upon  initiating  negotiations  for a
change  of  ownership  but in no event  later  than 15  working  days  after the
transaction  causing the change in ownership occurs. When a provider undergoes a
change in  ownership,  the provider  must also file a final cost report no later
than 45 days  following the change in ownership.  According to Medicare  program
standards,  the merger of the provider corporation into another corporation,  or
the  consolidation of two or more  corporations,  resulting in the creation of a
new  corporation  constitutes  a  change  in  ownership.  However,  transfer  of
corporate  stock  or  the  merger  of  another  corporation  into  the  provider
corporation does not constitute a change in ownership.

     Alabama.  The  Alabama  CON  standards  exempt  from  review a transfer  of
ownership interest in a long term care facility; however, licensure requirements
include  a letter  of  non-reviewability  from the  State  Health  Planning  and
Development Agency. The licensure regulatory  requirements provide the notice of
any  change  of  ownership  of a long  term  care  facility  be  filed  with the
Department  of  Public   Health,   Division  of  Licensure   and   Certification
approximately 30 days prior to the change of ownership.

     Colorado.  The  Colorado  licensure  requirements  provide that a letter of
intent must be  submitted to the  Department  of Public  Health and  Environment
("DPHE") at least 30 days prior to any change of  ownership or control of a long
term care  facility.  Such  notification  must  explicitly  detail  the  pending
transaction.  DPHE will  evaluate the letter of intent and if deemed a change of
ownership,  DPHE will forward an application,  which must be completed and filed
with DPHE at least 30 days prior to the change occurring.  Additionally,  Health
Care Policy and Financing  ("HCPF") must be notified at least 60 days prior to a
transfer of ownership or control of a long term care facility  participating  in
the Colorado Medicaid program. Notification of HCPF must sufficiently detail the
transaction,  including any Purchase Agreement,  for evaluation of the necessity
of issuing new provider numbers.

     Florida.  The  Florida CON  standards  exempt from CON review a transfer of
ownership in a long term care facility. The regulatory requirements provide that
a  transfer  of  corporate  stock  does not  constitute  a change in  ownership;
however, the Florida Agency for Health Care Administration requires notification
prior to the final transfer.

     Georgia.  The  Georgia CON  standards  exempt from CON review a transfer of
ownership  in a long term care  facility.  The Georgia  regulatory  requirements
provide  that  notification  of a change in  ownership or control of a long term
care nursing  facility be provided to the Georgia Office of Regulatory  Services
at least 30 days prior to the final transfer.

     Iowa. The Iowa CON standards exempt from CON review a transfer of ownership
in a long term care  facility.  The Iowa  regulatory  requirements  provide that
notification  of a change in  ownership  or control of a long term care  nursing
facility be provided  to the Iowa  Health  Facilities  Division at least 30 days
prior to the final transfer.

     Kansas. The Kansas regulatory  requirements  provide that notification of a
change in ownership or control of a long term care nursing  facility be provided
to the State of Kansas  Department of Health and Environment,  Bureau of Adult &
Child Care at least 30 days prior to the final transfer.

     Louisiana. The Louisiana CON standards exempt from CON review a transfer of
ownership in a long term care facility.  The Louisiana  regulatory  requirements
provide  that  notification  of a change in  ownership or control of a long term
care  nursing  facility be provided to the  Louisiana  Department  of Health and
Hospitals,  Bureau of Health Services  Financing,  Health  Standards  Section at
least 30 days prior to the final transfer.

     Maine. The Offer and the Merger will not require any licensing notification
in the State of Maine.


                                       57

<PAGE>

     Missouri.  The Missouri CON standards  exempt from CON review a transfer of
ownership in a long term care  facility.  The Missouri  regulatory  requirements
provide  that  notification  of a change in  ownership or control of a long term
care nursing facility be provided to the Missouri Department of Social Services,
Division of Aging at least 30 days prior to the final transfer.

     Nebraska.  The Nebraska CON standards  exempt from CON review a transfer of
ownership in a long term care  facility.  The Nebraska  regulatory  requirements
provide that  notification  to the Nebraska  Department  of Health,  Division of
Licensing  of a change in  ownership  or  control  of a long  term care  nursing
facility  must  occur  within  48  hours  of  such  change.   Completed  license
applications,  for information  purposes,  including  applicable fees, are to be
provided to the NDOH at least 30 days prior to the final transfer.

     Texas. The Texas  regulatory  requirements  provide that  notification of a
change in ownership or control of a long term care nursing  facility be provided
to the Texas  Department of Human Services,  Licensing  Section at least 30 days
prior to the final transfer.

     Wyoming. The Wyoming regulatory requirements provide that notification of a
change in ownership or control of a long term care nursing  facility be provided
to the  Wyoming  Office of Health  Quality  at least 30 days  prior to the final
transfer.

     Federal Reserve Board Regulations.  The margin  regulations  promulgated by
the Federal Reserve Board place restrictions on the amount of credit that may be
extended for the purpose of purchasing  margin stock  (including  the Shares) if
such credit is secured by directly or indirectly by margin stock.  The Purchaser
and the Parent believe that the financing of the  acquisition of the Shares will
not be subject to the margin regulations.

13. FEES AND EXPENSES.

     Shattuck  Hammond is acting as Dealer Manager in connection  with the Offer
and has provided  certain  financial  advisory  services in connection  with the
acquisition of the Shares.  Parent has agreed to compensate Shattuck Hammond for
its  services  as Dealer  Manager and its  financial  advisory  services  and to
reimburse  Shattuck  Hammond for reasonable  out-of-pocket  expenses,  including
reasonable  attorneys'  fees, and has also agreed to indemnify  Shattuck Hammond
against certain liabilities and expenses in connection with the Offer, including
liabilities under the federal securities laws.

     The Purchaser has retained Citibank N.A. to act as Depositary and MacKenzie
Partners,  Inc. to serve as Information  Agent in connection with the Offer. The
Information  Agent may contact holders of Shares by mail,  telephone,  telecopy,
telegraph and personal  interview and may request  banks,  brokers,  dealers and
nominee  stockholders to forward  materials  relating to the Offer to beneficial
owners.  The  Purchaser  has  agreed  to pay  each  of the  Depositary  and  the
Information  Agent  reasonable and customary  compensation for their services in
connection with the Offer, plus  reimbursement for out-of-pocket  expenses,  and
has agreed to indemnify each of them against certain liabilities and expenses in
connection therewith, including certain liabilities under the federal securities
laws.

     Neither the  Purchaser nor the Parent will pay any fees or  commissions  to
any  broker  or dealer or other  person  (other  than the  Dealer  Manager,  the
Information  Agent and the  Depositary) in connection  with the  solicitation of
tenders of Shares pursuant to the Offer. Brokers, dealers,  commercial banks and
trust  companies  will be reimbursed by the Purchaser for customary  mailing and
handling expenses incurred by them in forwarding materials to their customers.



                                       58

<PAGE>

     The following is an estimate of expenses to be incurred in connection  with
the Offer and the Merger:

     Expenses To Be Paid By Purchaser And Its Affiliates:
       Financial Advisor/Dealer Manager   ...............   $  450,00
       Legal Fees .......................................      225,00
       Printing and Mailing   ...........................      110,00
       Filing Fees   ....................................       75,00
       Depositary Fees  .................................       50,00
       Information Agent Fees ...........................        7,50
       Miscellaneous ....................................       82,50
                                                           ----------
        Total  ..........................................   $1,000,00
                                                           ==========
     Expenses To Be Paid By The Company:
       Financial Advisors  ..............................   $2,050,00
       Legal Fees .......................................      200,00
       Printing and Mailing   ...........................       50,00
       Miscellaneous ....................................       50,00
                                                           ----------
        Total  ..........................................   $2,350,00
                                                           ==========

14. MISCELLANEOUS.

     The Offer is not being  made to (nor will  tenders be  accepted  from or on
behalf  of)  holders  of Shares in any  jurisdiction  in which the making of the
Offer or the acceptance  thereof would not be in compliance with the securities,
blue sky or other laws of such jurisdiction.  However, the Purchaser may, in its
sole discretion,  take such action as it may deem necessary to make the Offer in
any such  jurisdiction  and  extend  the  Offer to  holders  of  Shares  in such
jurisdiction.  In any jurisdiction where the securities,  blue sky or other laws
require the Offer to be made by a licensed broker or dealer,  the Offer shall be
deemed to be made on behalf of the  Purchaser  by the  Dealer  Manager or one or
more  registered  brokers or dealers  that are  licensed  under the laws of such
jurisdiction.

     NO  PERSON  HAS  BEEN  AUTHORIZED  TO GIVE ANY  INFORMATION  OR TO MAKE ANY
REPRESENTATION  ON BEHALF OF THE PURCHASER OR THE PARENT NOT CONTAINED HEREIN OR
IN THE  LETTER  OF  TRANSMITTAL  AND,  IF  GIVEN OR MADE,  SUCH  INFORMATION  OR
REPRESENTATION  MUST NOT BE RELIED UPON AS HAVING BEEN  AUTHORIZED.  NEITHER THE
DELIVERY OF THIS OFFER TO PURCHASE NOR ANY PURCHASE PURSUANT TO THE OFFER SHALL,
UNDER ANY CIRCUMSTANCES, CREATE ANY IMPLICATION THAT THERE HAS BEEN NO CHANGE IN
THE AFFAIRS OF PURCHASER OR THE COMPANY  SINCE THE DATE AS OF WHICH  INFORMATION
IS FURNISHED OR THE DATE OF THIS OFFER TO PURCHASE.

     Parent  and  Purchaser  have  filed  with the  Commission  a  Tender  Offer
Statement on Schedule  14D-1,  together  with  exhibits,  pursuant to Rule 14d-3
under the Exchange  Act, and Parent,  Purchaser  and the Company have filed with
the Commission a Rule 13e-3  Transaction  Statement on Schedule 13E-3,  together
with exhibits, pursuant to Rule 13e-3 under the Exchange Act, furnishing certain
additional  information with respect to the Offer. In addition,  the Company has
filed with the  Commission a  Solicitation/Recommendation  Statement on Schedule
14D-9,  together with  exhibits,  pursuant to Rule 14d-9 under the Exchange Act,
setting forth the  recommendation of the Company Board and the Special Committee
with  respect  to the  Offer  and  the  reasons  for  such  recommendations  and
furnishing  certain  additional  related  information.  Such  Schedules  and any
amendments  thereto,  including  exhibits,  may be  inspected  and copies may be
obtained from the  Commission in the manner set forth under "THE OFFER - Certain
Information  Concerning the Company"  (except that they will not be available at
the regional offices of the Commission).




                                        IHS ACQUISITION XXVI, INC.


August 7, 1997



                                       59

<PAGE>






                                                                      SCHEDULE I

                        DIRECTORS AND EXECUTIVE OFFICERS
                            OF PARENT AND PURCHASER

     Directors and Executive  Officers of Parent.  The name of each director and
each executive officer of Integrated  Health Services,  Inc. is set forth below.
The  business  address of each  executive  officer  is 10065 Red Run  Boulevard,
Owings Mills, Maryland 21117, telephone:  410-998-8400, except that the business
address  for each of Messrs.  Cirka and  Robert N.  Elkins is 8889  Pelican  Bay
Boulevard,  Naples, Florida 34108. Each person is a citizen of the United States
of America. The present principal occupation of employment of each person listed
below and such person's five-year employment history is set forth next to his or
her name.







<TABLE>
<CAPTION>
   NAME, ADDRESS AND PRESENT               PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
     POSITION WITH PARENT               MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- ----------------------------------   -----------------------------------------------------------
<S>                                  <C>
ROBERT N. ELKINS, M.D                Robert N. Elkins,  M.D. has been  Chairman of the Board and 
 CHAIRMAN OF THE BOARD AND CHIEF     Chief Executive Officer of Parent since March 1986 and also 
 EXECUTIVE OFFICER                   served as President from March 1986 to July 1994. From 1980 
                                     until  co-founding  Parent  with  Timothy F.  Nicholson,  a 
                                     director of Parent,  in 1986,  Dr.  Elkins was a co-founder 
                                     and Vice  President of Continental  Care Centers,  Inc., an 
                                     owner and operator of long-term healthcare facilities. From 
                                     1976 through 1980,  Dr. Elkins was a practicing  physician. 
                                     Dr. Elkins is a graduate of the University of Pennsylvania, 
                                     received his M.D.  degree from the Upstate  Medical Center, 
                                     State  University of New York,  and completed his residency 
                                     at Harvard University Medical Center.                       

LAWRENCE P. CIRKA                    Lawrence  P. Cirka has been  President  and a  director  of 
 PRESIDENT AND DIRECTOR              Parent  since July 1994,  and served as Chief  Operat-  ing 
                                     Officer  of  Parent  from  October  1987 to April  1997 and 
                                     Senior Vice  President  of Parent from October 1987 to July 
                                     1994. Prior to joining Parent,  Mr. Cirka served in various 
                                     operational capacities with Unicare Healthcare Corporation, 
                                     a long-term healthcare company, for 15 years, most recently 
                                     as   Vice   President-Western   Division,   where   he  had 
                                     operational and financial  responsibility  for 46 long-term 
                                     healthcare  facilities exceeding 5,000 beds. Mr. Cirka is a 
                                     graduate of Clarion  University and a Licensed Nursing Home 
                                     Administrator in Pennsylvania, Florida and Washington.      
                                     
EDWIN M. CRAWFORD                    Edwin M. Crawford has been a director of Parent since 1995. 
 DIRECTOR                            Since 1993 he has been  Chairman of the Board of Directors, 
 Magellan Health Services, Inc.      President and Chief  Executive  Officer of Magellan  Health 
 3414 Peachtree Road                 Services, Inc. (formerly Charter Medical Corporation),  and 
 Atlanta, Georgia 30326              served as President and Chief Operating  Officer of Charter 
                                     Medical  from  1992  to  1993.  From  1990  to  1992 he was 
                                     Executive Vice  President - Hospital  Operations of Charter 
                                     Medical.                                                    
</TABLE>                             


                                      I-1

<PAGE>







<TABLE>
<CAPTION>
  NAME, ADDRESS AND PRESENT               PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
POSITION WITH PARENT                  MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- --------------------------------   ------------------------------------------------------------
<S>                                <C>
KENNETH M. MAZIK                   Kenneth M. Mazik has been a director of Parent  since 1995.  
 DIRECTOR                          For the past  five  years he has  been a  private  investor  
 Jovius Foundation                 involved in numerous enterprises.  He serves as Chairman of  
 699 E. Fifth Avenue               the Jovius Foundation and as President of Au Clair Programs  
 Mt. Dora, Florida 32757           and  Orlando   Financial   Corporation,   specializing   in  
                                   investments in long-term care of the disabled.               
                                   
ROBERT A. MITCHELL                 Robert A.  Mitchell  has been a  director  of Parent  since
 Director                          1995.  From 1986 to the present he has  practiced  law with
 162 E. 64th Street                the Law Offices of Robert A. Mitchell,  with an emphasis on
 New York, NY 10021                corporate  and  entertainment  law,  as well as finance and
                                   public  relations  matters  concerning   healthcare  acqui-
                                   sitions.  Since  1992 he has  been  founder,  director  and
                                   treasurer of the Bone Marrow Foundation.                   

CHARLES W. NEWHALL III             Charles W.  Newhall III has been a director of Parent since
 DIRECTOR                          1986.  For over five years he has been General Part- ner of
 New Enterprise Associates         New  Enterprise  Associates,  a group  of  venture  capital
 1119 St. Paul Street              partnerships.                                              
 Baltimore, Maryland 24202         

TIMOTHY F. NICHOLSON               Timothy F.  Nicholson  has been a director of Parent  since  
 DIRECTOR                          1986. Since May 1993 he has served as Chairman and Managing  
 Speciality Care PLC               Director  of  Speciality  Care PLC.  From March 1986 to May  
 Hamilton House                    1993 he was  Executive  Vice  President  of Parent and from  
 1 Temple Avenue                   November 1986 to May 1993 he was Secretary of Parent.  From  
 London, EC4Y OHA, England         1980 to 1986 he served as Ex-  ecutive  Vice  President  of  
                                   Continental  Care Centers,  Inc.,  and from 1973 to 1980 he  
                                   was a practicing attorney.                                   
                                   

JOHN L. SILVERMAN                  John L.  Silverman has been a director of Parent since 1986  
 DIRECTOR AND CHIEF EXECUTIVE      and Chief  Executive  Officer and  President  of Asia Care,  
 OFFICER AND PRESIDENT OF ASIA     Inc., a subsidiary of Parent, since June 1995. From 1985 to  
 CARE, INC.                        1995 he was  President  of  VentureCorp,  Inc.,  a  venture  
 Asia Care, Inc.                   capital and investment management company, and from 1990 to  
 Suite 28(B), 28th Floor           1996 he was  President and Chief Finan- cial Officer of Chi  
 Wisma Denmark                     Systems,  Inc. (formerly the Chi Group, Inc.), a healthcare  
 86 Jalan Ampang                   consulting company.                                          
 50450 Kuala Lumpur, Malaysia      

GEORGE H. STRONG                   George H. Strong has been a director  of Parent  since 1994 
 DIRECTOR                          and is currently a director of several  corporations.  From 
 946 Navesink River Road           1978 until 1993, he served as a director and senior officer 
 Locust, New Jersey 07760          of  Universal  Health  Services,  Inc.,  a  publicly  owned 
                                   hospital management corporation.                            
</TABLE>                           


                                      I-2

<PAGE>

<TABLE>
<CAPTION>
NAME, ADDRESS AND PRESENT              PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
POSITION WITH PARENT                   MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- ----------------------------------   ---------------------------------------------------------
<S>                                  <C>
W. BRADLEY BENNETT                   W.  Bradley  Bennett has been  Executive  Vice  President - 
 EXECUTIVE VICE PRESIDENT -          Chief  Accounting  Officer of Parent since  September 1996. 
 CHIEF ACCOUNTING OFFICER            From April 1996 to September 1996, he served as Senior Vice 
                                     President - Chief Accounting  Officer of Parent,  as Senior 
                                     Vice President - Corporate Controller from November 1995 to 
                                     April 1996,  and as Vice  President - Corporate  Controller 
                                     from  December  1992 to November  1995.  From October 1991, 
                                     when he  joined  Parent,  to  December  1992,  he served as 
                                     Assistant  Corporate  Controller.  For five years  prior to 
                                     joining Parent, Mr. Bennett was with KPMG Peat Marwick LLP, 
                                     Certified  Public  Accountants.  Mr. Bennett is a Certified 
                                     Public  Accountant and a Summa Cum Laude graduate of Loyola 
                                     College, receiving a B.A. in Accounting.                    
                                     

BRIAN K. DAVIDSON                    Brian K.  Davidson  has been  Executive  Vice  President  - 
 EXECUTIVE VICE PRESIDENT -          Development  of Parent since  November  1995.  From January 
 DEVELOPMENT                         1993 to November 1995 he served as Senior Vice  President - 
                                     Development.  From January 1991, when he joined Parent,  to 
                                     January  1993 he served as Senior Vice  President - Managed 
                                     Operations  of Parent.  For more than five  years  prior to 
                                     joining  Parent,  Mr.  Davidson  served as Chief  Operating 
                                     Officer of the Tutera Group, a management company operating 
                                     skilled nursing beds and retirement  apartment  units.  Mr. 
                                     Davidson  received  B.S.  and  M.S.  degrees  from  Central 
                                     Missouri State University.                                  
                                     

VIRGINIA M. DOLLARD                  Virginia M.  Dollard has been  Executive  Vice  President - 
 EXECUTIVE VICE PRESIDENT - POST     Post Acute  Network  Operations of Parent since April 1997. 
 ACUTE NETWORK OPERATIONS            From  January  1997 to April 1997 she served as Senior Vice 
                                     President  - Post Acute  Network  Operations  of Parent and 
                                     from May 1995 to  January  1997 as Senior  Vice  President, 
                                     Southeast  Division of Parent.  For several  years prior to 
                                     joining  Parent,  Ms. Dollard was Executive  Vice-President 
                                     and Chief  Operating  Officer of  HealthPlus-New  York Life 
                                     Health plan, a 350,000  member  HMO/PPO  subsidiary  of New 
                                     York Life Insurance  Company.  Ms. Dollard  graduated Magna 
                                     Cum Laude from Roger Williams College with a B.S. in Health 
                                     and Social  Services  Administration.  She also received an 
                                     M.A.  in  Management  with   Distinction   from  Pepperdine 
                                     University.                                                 
                                    
</TABLE>


                                      I-3

<PAGE>







<TABLE>
<CAPTION>
NAME, ADDRESS AND PRESENT              PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
POSITION WITH PARENT                MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- -------------------------------   ----------------------------------------------------------
<S>                               <C>
MARSHALL A. ELKINS                Marshall A. Elkins has been  Executive  Vice  President and 
 EXECUTIVE VICE PRESIDENT AND     General  Counsel of Parent since November  1995.  From July 
 GENERAL COUNSEL                  1992 to November  1995 he served as Senior  Vice  President 
                                  and General Counsel of Parent and from January 1990 to July 
                                  1992 he served as General  Counsel  and Vice  President  of 
                                  Parent.  From July 1987 until joining  Parent in 1990,  Mr. 
                                  Elkins was in private practice in New York City. Mr. Elkins 
                                  served as General  Counsel to US West  Capital  Corporation 
                                  and later as Assistant General Counsel of US West Financial 
                                  Services  Corporation  from July 1985 to July  1987.  Prior 
                                  thereto,  Mr.  Elkins  was  associate  counsel  at CIT Cor- 
                                  poration  from 1980 to 1985.  Mr.  Elkins  received  a B.A. 
                                  degree from the University of Wisconsin and a J.D. from New 
                                  York Law School.                                            
                                  
ELEANOR C. HARDING                Eleanor C.  Harding  has been  Executive  Vice  President - 
 EXECUTIVE VICE PRESIDENT -       Finance of Parent since  September 1996. From November 1995 
 FINANCE                          to  September  1996 she served as Senior  Vice  President - 
                                  Finance and Treasurer and from August 1993 to November 1995 
                                  she served as Vice  President  - Finance and  Treasurer  of 
                                  Parent. From January 1990 until she joined Parent in August 
                                  1993, Ms. Harding  served as Senior Vice  President,  Chief 
                                  Financial  Officer  and  Treasurer  of the Marcor  Company. 
                                  Prior to  January  1990,  Ms.  Harding  served  in  similar 
                                  positions for Jiffy Lube International,  Inc. and The Black 
                                  and Decker  Corporation.  Ms.  Harding  received a B.A.  in 
                                  Economics from Mount Holyoke College and an M.S. in Finance 
                                  from Loyola College.                                        
                                  

MARC B. LEVIN                     Marc B. Levin has been  Executive Vice President - Investor  
 EXECUTIVE VICE PRESIDENT -       Relations  since November 1995. From March 1993 to November  
 INVESTOR RELATIONS               1995  he  served  as  Senior  Vice   President  -  Investor  
                                  Relations and from May 1991 to March 1993 he served as Vice  
                                  President - Investor  Relations of Parent.  From March 1989  
                                  until May  1991,  Mr.  Levin  served  as Vice  President  -  
                                  Corporate  Controller/Administration  of  Parent.  Prior to  
                                  joining  Parent  in  1989,  Mr.  Levin  served  in  various  
                                  capacities  with Beverly  Enterprises  for six years,  most  
                                  recently as Assistant to the President - Eastern  Division.  
                                  Mr.  Levin is a Certified  Public  Accountant  and received  
                                  B.S. and M.B.A. degrees from the University of Maryland.     
                                  
                                  
</TABLE>


                                      I-4

<PAGE>







<TABLE>
<CAPTION>
NAME, ADDRESS AND PRESENT            PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
POSITION WITH PARENT              MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- -----------------------------   ---------------------------------------------------------
<S>                             <C>
ANTHONY R. MASSO                Anthony  R.  Masso  has been  Executive  Vice  President  - 
 EXECUTIVE VICE PRESIDENT -     Managed Care since June 1994. Prior to joining Parent,  Mr. 
 MANAGED CARE                   Masso  served in several  managed care  operating  roles as 
                                Senior  Vice  President  of  American  MedCenters,  an  HMO 
                                company in  Minneapolis  and as Regional Vice  President of 
                                Aetna Health  Plans for the Midwest and Eastern  Divisions. 
                                He  had  operational   responsibility  for  thirteen  HMOs, 
                                serving on the boards of ten. For twelve  years,  Mr. Masso 
                                served as a senior  executive  in the federal HMO office of 
                                the Department of Health and Human Services. Mr. Masso is a 
                                graduate  of the  University  of Rhode  Island  and holds a 
                                master's degree from Syracuse University.                   

C. CHRISTIAN WINKLE             C.  Christian  Winkle has been Chief  Operating  Officer of 
 CHIEF OPERATING OFFICER        Parent since April 1997.  From November 1995 to April 1997, 
                                he served as Executive Vice President - Field Operations of 
                                Parent's owned and leased  facilities,  and from March 1994 
                                to  November  1995 he  served as Senior  Vice  President  - 
                                Operations.  Mr. Winkle joined Parent in September  1990 as 
                                Regional Vice  President of Operations  and President - MSU 
                                Prod- uct Development.  Prior to joining Parent, Mr. Winkle 
                                was  the  Executive   Director  of  the  Renaissance  Reha- 
                                bilitation  &  Diagnostic  Hospital  in  Chattanooga,  Ten- 
                                nessee.  Mr.  Winkle is a graduate of Case Western  Reserve 
                                University in Cleveland, Ohio.                              
                                
</TABLE>


     DIRECTORS AND EXECUTIVE  OFFICERS OF PURCHASER.  The directors of Purchaser
are Lawrence P. Cirka,  Eleanor C. Harding and Marc B. Levin, each of whom is an
executive officer of Parent.  The executive  officers of Purchaser are Robert N.
Elkins,  Lawrence P. Cirka, W. Bradley Bennett,  Brian K. Davidson,  Virginia M.
Dollard, Marshall A. Elkins, Eleanor C. Harding, Marc B. Levin, Anthony R. Masso
and C.  Christian  Winkle,  each of whom is an  executive  officer of Parent and
holds the same  office as that in Parent,  except  that  Robert N. Elkins is not
Chairman  of the  Board.  Each  of the  directors  and  executive  officers  was
appointed  or elected to office on July 31,  1997.  Unless  otherwise  indicated
above,  the  business  address of each such  person is 10065 Red Run  Boulevard,
Owings Mills, Maryland 21117, telephone:  410-998-8400. Each person is a citizen
of the United States of America.  The present principal occupation or employment
of each such person and such person's five-year  employment history is set forth
next to his or her name.



                                      I-5

<PAGE>







                                                                     SCHEDULE II

                        DIRCTORS AND EXECUTIVE OFFICERS
                                 OF THE COMPANY



     Directors and Executive Officers of the Company.  The name of each director
and each  executive  officer of  Community  Care of  America,  Inc. is set forth
below.  The business  address of each executive  officer is 3050 North Horseshoe
Drive, Suite 260, Naples, Florida, 34104, telephone:  941-435-0085.  Each person
is a citizen of the United States of America.  The present principal  occupation
of employment of each person listed below and such person's five-year employment
history is set forth next to his or her name.

<TABLE>
<CAPTION>
 NAME, ADDRESS AND PRESENT              PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
 POSITION WITH THE COMPANY          MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- -------------------------------   ----------------------------------------------------------
<S>                               <C>
MICHAEL S. BLASS                  Michael S. Blass,  41, has been a director since July 1995. 
 DIRECTOR                         Mr.  Blass  has been a  partner  in the law firm of Blass & 
 c/o Blass & Driggs               Driggs  for more  than  the  past  five  years.  Mr.  Blass 
 461 Fifth Avenue                 received a B.A.  degree from  Georgetown  University  and a 
 New York, New York 10017         J.D. Degree from Fordham University.                        
                                  
ROBERT N. ELKINS, M.D.            Robert N. Elkins,  M.D., 53, co-founder of the Company, has
 DIRECTOR                         served as a director since  December  1992.  Since March of
 8889 Pelican Bay Boulevard       1986,  Dr.  Elkins has also served as Chairman of the Board
 Naples, Florida 34108            and Chief Executive  Officer of Parent,  and he also served
                                  as President from March 1986 to July 1994.  From 1980 until
                                  co-founding Parent with Timothy F. Nicholson, a director of
                                  Parent,  Dr. Elkins was a co-founder  and Vice President of
                                  Continental  Care  Centers,  Inc., an owner and operator of
                                  long-term  healthcare  facilities.  From 1976 through 1980,
                                  Dr.  Elkins was a  practicing  physician.  Dr.  Elkins is a
                                  graduate of the  University of  Pennsylvania,  received his
                                  M.D.  degree  from  the  Upstate   Medical  Center,   State
                                  University  of New York,  and  completed  his  residency at
                                  Harvard  University  Medical  Center.  Dr. Elkins is also a
                                  director  of  Capstone  Capital  Corpora-  tion and Davstar
                                  Industries, Inc.                                           
                                  

WILLIAM J. KRYSTOPOWICZ          William  J.  Krystopowicz,  45,  has  been  Executive  Vice 
 EXECUTIVE VICE PRESIDENT AND    President   since  February  1994.  From  July  1993  until 
 DIRECTOR OF MERGERS AND         February  1994,  Mr.  Krystopowicz  served  as the  Interim 
 ACQUISITIONS                    President.  He  also  served  as the  Company's  Chief  Fi- 
                                 nancial  Officer  from  February  1994 until June 1995,  at 
                                 which  time  he  became  the   Director   of  Mergers   and 
                                 Acquisitions.  Prior to joining  the  Company in July 1993, 
                                 Mr.  Krystopowicz  served as Parent's Senior Vice President 
                                 of Financial  Services since August 1988. Mr.  Krystopowicz 
                                 received  a  B.S.   degree  in   accounting   from  LaSalle 
                                 University.                                                 
</TABLE>                         


                                      II-1

<PAGE>







<TABLE>
<CAPTION>
NAME, ADDRESS AND PRESENT                   PRESENT PRINCIPAL OCCUPATION OR EMPLOYMENT;
POSITION WITH THE COMPANY                   MATERIAL POSITIONS HELD DURING THE PAST FIVE YEARS
- ---------------------------------------   ----------------------------------------------------------
<S>                                       <C>
DEBORAH A. LAU                            Deborah  A.  Lau,  37,  has  served  as  President,   Chief 
 PRESIDENT, CHIEF EXECUTIVE               Executive  Officer,  Chief  Financial  Officer and director 
 OFFICER, CHIEF FINANCIAL OFFICER         (while retaining the post of Chief Operating Officer) since 
 AND DIRECTOR                             April 4, 1997. Prior to that time, since October 1995, when 
                                          she joined the Company,  Ms. Lau served as  Executive  Vice 
                                          President  and Chief  Operating  Officer.  From  March 1989 
                                          until she joined the Company, Ms. Lau served with Parent as 
                                          its  Regional  Vice  President  from March 1989 to November 
                                          1993,  Vice President  Healthcare  Controller from November 
                                          1993 to December 1994 and Vice President of Financial Oper- 
                                          ations from  January  1995.  Prior to March  1989,  Ms. Lau 
                                          served as Assistant Controller at Continental Care Centers, 
                                          Inc.  Ms. Lau  received  a B.S.  degree in  accounting  and 
                                          business administration at Towson State University.         

WALLACE OLSON                             Wallace  Olson,  50, has  served as a  director  since June 
 DIRECTOR                                 1997. Mr. Olson has been involved in long-term  health care 
 207 Krystal Building                     since 1985.  From 1990 to 1996,  Mr.  Olson was a principal 
 1 Union Square                           and chief  executive  officer for  Southern  Care  Centers, 
 Chattanooga, Tennessee 37404             Inc., a long-term  health care  company,  which in 1996 was 
                                          sold to the  Company.  Prior  thereto,  Mr.  Olson was Vice 
                                          President  -  Acquisitions  for  Nursing  Care  Centers  of 
                                          America,  Inc., Vice President - Acquisitions of Harborside 
                                          Healthcare  and  Director  of  Acquisitions  for Life  Care 
                                          Centers of America,  Inc. Mr.  Olson  practiced as a public 
                                          accountant from 1971 to 1984.                               
                                          

JOHN L. SILVERMAN                         John L. Silverman,  55, has served as Chairman of the Board
 CHAIRMAN OF THE BOARD AND                and director since  December 1993.  Since July 1995, he has
 DIRECTOR                                 been  President and Chief  Executive  Officer of Asia Care,
 c/o Integrated Health Services, Inc.     Inc., a  subsidiary  of Parent.  From 1985 to 1995,  he was
 10065 Red Run Boulevard                  also President and Chief Executive  Officer of Venturecorp,
 Owings Mills, Maryland 21117             Inc., a venture capital and investment  management company.
                                          From 1990 to 1996,  he was  President of Chi Systems,  Inc.
                                          (formerly  the Chi Group,  Inc.),  a healthcare  consulting
                                          company.  Mr.  Silverman has also been a director of Parent
                                          since 1986.                                                
</TABLE>                                  


                                      II-2

<PAGE>

                                                                    SCHEDULE III


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                          CONSOLIDATED BALANCE SHEETS
                            (dollars in thousands)





<TABLE>
<CAPTION>
                                                                                 DECEMBER 31,
                                                                            -----------------------   MARCH 31,
                                                                             1995         1996          1997
                                                                            ---------   -----------   ------------
                                                                                                      (unaudited)
<S>                                                                         <C>         <C>           <C>            
Assets
Current Assets:
 Cash and cash equivalents  .............................................    $ 2,485    $  1,709       $     611
 Accounts receivable (note 3)  ..........................................     12,934      16,407          17,934
 Inventories ............................................................      1,534       1,761           1,754
 Prepaid expenses and other current assets ..............................      3,662       1,095           1,295
                                                                             -------    ---------      ---------
   Total current assets  ................................................     20,615      20,972          21,594
Property, plant and equipment, net of accumulated depreciation (notes
 4 and 6) ...............................................................     54,327      58,424          58,209
Notes receivable (note 16)  .............................................      2,533           -               -
Deposits  ...............................................................     10,244       6,637           6,637
Excess of cost over fair value of net assets acquired, net of accumulated
 amortization of $139 in 1995, $710 in 1996 and $899 in 1997 (note 2).         3,299      13,666          13,496
Deferred financing costs ................................................        948       1,066           1,326
Other assets ............................................................      1,324       1,354           1,424
                                                                             -------    ---------      ---------
                                                                             $93,290    $102,119       $ 102,686
                                                                             =======    =========      =========
Liabilities and Shareholders' Equity
Current Liabilities:
 Current maturities of long-term debt (note 6)   ........................    $ 1,258    $  6,341       $   4,407
 Accounts payable and accrued expenses (note 5)  ........................     14,869      23,402          24,807
 Put option contracts payable (219,798 shares) (note 16)  ...............          -       2,181           2,181
                                                                             -------    ---------      ---------
   Total current liabilities   ..........................................     16,127      31,924          31,395
                                                                             -------    ---------      ---------
Long-term debt, less current maturities (note 6) ........................     34,407      54,030          55,765
Deferred income taxes (note 8) ..........................................      9,334         162               -
Commitments and contingencies (notes 2, 7, 12, 13 and 16) ...............
Common stock subject to repurchase (219,798 shares) (notes 2 and 16).          2,181           -               -
Shareholders' equity (notes 10 and 15):
 Common  stock,  $.0025  par value;  authorized  15,000,000  shares;  
   issued and outstanding 6,982,789 shares in 1995 and 7,597,801 shares
   in 1996 (including 219,798 shares subject to repurchase)  ............         17          19              19
 Additional paid-in capital .............................................     31,356      36,465          36,465
 Deficit  ...............................................................       (132)    (19,037)        (19,514)
 Receivable from shareholders (note 2)  .................................          -      (1,444)         (1,444)
                                                                             -------    ---------      ---------
   Net shareholders' equity .............................................     31,241      16,003          15,526
                                                                             -------    ---------      ---------
                                                                             $93,290    $102,119       $ 102,686
                                                                             =======    =========      =========
</TABLE>


          See accompanying notes to consolidated financial statements.

                                      F-1

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     CONSOLIDATED STATEMENTS OF OPERATIONS
               (dollars in thousands, except per share amounts)





<TABLE>
<CAPTION>
                                                                                                      THREE MONTHS
                                                                                                          ENDED
                                                               YEARS ENDED DECEMBER 31,                 MARCH 31,
                                                       ---------------------------------------- -------------------------
                                                          1994         1995          1996          1996         1997
                                                       ------------ ------------ -------------- ------------ ------------
                                                                                                       (unaudited)
<S>                                                    <C>          <C>          <C>            <C>          <C>
Operating revenues:
 Net patient service revenues ........................ $  56,699    $  92,259     $  123,143      $   26,144 $  32,449
 Other operating revenues  ...........................       793        1,919          4,369           2,801       245
                                                       ----------   ----------    ----------     ----------- ----------
   Total operating revenues   ........................    57,492       94,178        127,512          28,945    32,694
                                                       ----------   ----------    ----------     ----------- ----------
Operating expenses:
 Facility operating expenses  ........................    46,035       73,693        111,171          22,106    27,239
 Corporate administrative and general  ...............     2,935        4,765          5,226           1,434     1,039
 Rent (note 7) .......................................     3,806        6,404          8,999           1,763     2,632
 Depreciation and amortization   .....................     1,465        2,033          3,021             645       857
 Interest, net of interest income (note 6)   .........     2,857        3,795          5,337             818     1,566
 Loss on impairment of investments and other
   non-recurring charges (note 12)  ..................         -            -         22,128               -         -
                                                       ----------   ----------    ----------     ----------- ----------
   Total operating expenses   ........................    57,098       90,690        155,882          26,766    33,333
                                                       ----------   ----------    ----------     ----------- ----------
   Earnings (loss) before income taxes and ex-
    traordinary charge                                       394        3,488        (28,370)          2,179      (639)
Federal and state income taxes (note 8)   ............         -        1,047         (9,465)            827      (162)
                                                       ----------   ----------    ----------     ----------- ----------
   Earnings (loss) before extraordinary charge  ......       394        2,441        (18,905)          1,352      (477)
Extraordinary charge, net of income taxes
 (note 15)  ..........................................         -         (992)             -               -         -
                                                       ----------   ----------    ----------     ----------- ----------
   Net earnings (loss)  ..............................       394        1,449        (18,905)          1,352      (477)
Dividends-preferred stock  ...........................      (653)        (408)             -               -         -
                                                       ----------   ----------    ----------     ----------- ----------
   Net earnings (loss) applicable to common
    stock   .......................................... $    (259)   $   1,041     $  (18,905)     $    1,352 $    (477)
                                                       ==========   ==========    ==========     =========== ==========
Per common share:
 Earnings (loss) before extraordinary charge ......... $   (0.13)   $    0.42     $    (2.56)     $     0.19 $   (0.06)
 Extraordinary charge   ..............................         -        (0.20)             -               -         -
                                                       ----------   ----------    ----------     ----------- ----------
 Net earnings (loss) ................................. $   (0.13)   $    0.22     $    (2.56)     $     0.19 $   (0.06)
                                                       ==========   ==========    ==========     =========== ==========
Weighted average number of common and com-
 mon equivalent shares outstanding                     2,041,154    4,840,457      7,384,697       7,197,905 7,597,801
                                                       ==========   ==========    ==========     =========== ==========
</TABLE>


          See accompanying notes to consolidated financial statements.

                                      F-2

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY


                            (dollars in thousands)





<TABLE>
<CAPTION>
                                                                   ADDITIONAL                  RECEIVABLE
                                                          COMMON     PAID IN    ACCUMULATED       FROM
                                                           STOCK     CAPITAL     (DEFICIT)    SHAREHOLDERS      TOTAL
                                                          -------- ------------ ------------- -------------- -------------
<S>                                                       <C>      <C>          <C>           <C>            <C>
Balance at December 31, 1993  ...........................   $ 4     $  5,251     $    (914)     $      -      $   4,341
Issuance of 216,428 shares of common stock at $6.19 per
 share, net of stock issuance costs .....................     1        1,034             -             -          1,035
Accretion of discount on redeemable preferred stock
 (note 9)   .............................................     -         (372)            -             -           (372)
Dividends declared - redeemable preferred stock .........     -            -          (653)            -           (653)
Net earnings   ..........................................     -            -           394             -            394
                                                            ----    --------     ---------      --------      ---------
Balance at December 31, 1994  ...........................     5        5,913        (1,173)            -          4,745
Issuance of 3,450,000 shares of common stock at $9.50 per
 share, net of stock issuance costs (note 13)   .........     9       27,580             -             -         27,589
Redemption of preferred stock of $8,167 and exercise of
 warrants for 1,331,814 shares of common stock at par
 value   ................................................     3       (2,006)            -             -         (2,003)
Amortization of restricted stock awards   ...............     -          100             -             -            100
Accretion of discount on redeemable preferred stock
 (note 9)   .............................................     -         (231)            -             -           (231)
Dividends declared - redeemable preferred stock .........     -            -          (408)            -           (408)
Net earnings   ..........................................     -            -         1,449             -          1,449
                                                            ----    --------     ---------      --------      ---------
Balance at December 31, 1995  ...........................    17       31,356          (132)            -         31,241
Exercise of employee stock options for 33,385 shares of
 common stock at prices ranging from $3.71 to $10.11
 per share  .............................................     -          160             -             -            160
Issuance of 581,627 shares of common stock in connection
 with acquisitions at prices ranging from $8.44 to $11.77
 per share (note 2)  ....................................     2        4,949             -        (1,444)         3,507
Net loss ................................................     -            -       (18,905)            -        (18,905)
                                                            ----    --------     ---------      --------      ---------
Balance at December 31, 1996  ...........................    19       36,465       (19,037)       (1,444)        16,003
                                                            ----    --------     ---------      --------      ---------
Net loss (unaudited) ....................................     -            -          (477)            -           (477)
                                                            ----    --------     ---------      --------      ---------
Balance at March 31, 1997 (unaudited)  ..................   $19     $ 36,465     $ (19,514)     $ (1,444)     $ (15,526)
                                                            ====    ========     =========      ========      =========
</TABLE>


          See accompanying notes to consolidated financial statements.

                                      F-3

<PAGE>

               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     CONSOLIDATED STATEMENTS OF CASH FLOWS
                            (dollars in thousands)


<TABLE>
<CAPTION>
                                                                                           YEARS ENDED DECEMBER 31,
                                                                                     -------------------------------------
                                                                                        1994         1995         1996
                                                                                     ------------ ------------ -----------
<S>                                                                                  <C>          <C>          <C>
Cash flows from operating activities:
 Net earnings (loss) ............................................................... $     394    $   1,449    $(18,905)
 Adjustments to reconcile net earnings (loss) to net cash provided by (used in)
  operating activities:
  Loss on impairment of investments and other non-recurring charges  ...............         -            -      22,128
  Depreciation and amortization  ...................................................     1,465        2,033       3,021
  Amortization of deferred financing costs   .......................................        68          123         399
  Extraordinary charge, net of tax  ................................................         -          992           -
  Amortization of restricted stock award  ..........................................         -          100           -
  Deferred income taxes ............................................................         -          541      (9,465)
  Net change in operating assets and liabilities:
   Increase in accounts receivables ................................................    (4,479)      (4,609)     (3,615)
   Decrease (increase) in inventory, prepaid expenses and other current
     assets ........................................................................       (89)      (1,787)      2,999
   Increase (decrease) in accounts payable and accrued liabilities   ...............    (4,154)       4,179         993
                                                                                     ----------   ----------   ---------
   Net cash provided by (used in) operating activities   ...........................    (6,795)       3,021      (2,445)
                                                                                     ----------   ----------   ---------
Cash flows from investing activities:
 Property, plant and equipment additions, including costs of terminated activities
  of $9,258 in 1996  ...............................................................    (2,472)      (6,647)    (12,117)
 Business acquisitions (note 2)  ...................................................       (78)     (10,719)     (6,132)
 Notes receivable ..................................................................         -       (2,533)       (233)
 Deposits   ........................................................................     2,000       (3,194)       (519)
 Other assets  .....................................................................      (443)        (877)        798
                                                                                     ----------   ----------   ---------
   Net cash used in investing activities  ..........................................      (993)     (23,970)    (18,203)
                                                                                     ----------   ----------   ---------
Cash flows from financing activities:
 Proceeds from issuances of common stock, net of stock issuance costs   ............       402       27,589         160
 Redemption of preferred stock and warrants (notes 9 and 15)   .....................         -       (8,142)          -
 Dividends on preferred stock ......................................................      (490)        (571)          -
 Principal reductions on long-term debt   ..........................................   (24,233)     (60,404)    (19,782)
 Proceeds from long-term debt borrowings  ..........................................    30,719       61,733      41,931
 Deferred financing costs, including terminated offerings of $1,677 in 1996.........    (1,179)        (696)     (2,437)
                                                                                     ----------   ----------   ---------
   Net cash provided by financing activities .......................................     5,219       19,509      19,872
                                                                                     ----------   ----------   ---------
Decrease in cash  ..................................................................    (2,569)      (1,440)       (776)
Cash and cash equivalents, beginning of period  ....................................     6,494        3,925       2,485
                                                                                     ----------   ----------   ---------
Cash and cash equivalents, end of period  .......................................... $   3,925    $   2,485    $  1,709
                                                                                     ==========   ==========   =========
<PAGE>

<CAPTION>
                                                                                          THREE MONTHS
                                                                                              ENDED
                                                                                            MARCH 31,
                                                                                     -----------------------
                                                                                        1996        1997
                                                                                     ----------- -----------
                                                                                           (unaudited)
<S>                                                                                  <C>         <C>         <C>
Cash flows from operating activities:
 Net earnings (loss) ............................................................... $  1,352    $   (477)
 Adjustments to reconcile net earnings (loss) to net cash provided by (used in)
  operating activities:
  Loss on impairment of investments and other non-recurring charges  ...............        -           -
  Depreciation and amortization  ...................................................      604         806
  Amortization of deferred financing costs   .......................................       41          49
  Extraordinary charge, net of tax  ................................................        -           -
  Amortization of restricted stock award  ..........................................        -           -
  Deferred income taxes ............................................................        -        (162)
  Net change in operating assets and liabilities:
   Increase in accounts receivables ................................................   (1,420)     (1,526)
   Decrease (increase) in inventory, prepaid expenses and other current
     assets ........................................................................    1,522        (193)
   Increase (decrease) in accounts payable and accrued liabilities   ...............      392       1,405
                                                                                     ---------   ---------
   Net cash provided by (used in) operating activities   ...........................    2,491        (100)
                                                                                     ---------   ---------
Cash flows from investing activities:
 Property, plant and equipment additions, including costs of terminated activities
  of $9,258 in 1996  ...............................................................   (2,417)       (386)
 Business acquisitions (note 2)  ...................................................     (348)          -
 Notes receivable ..................................................................       30           -
 Deposits   ........................................................................   (1,366)          -
 Other assets  .....................................................................   (1,726)       (105)
                                                                                     ---------   ---------
   Net cash used in investing activities  ..........................................   (5,827)       (491)
                                                                                     ---------   ---------
Cash flows from financing activities:
 Proceeds from issuances of common stock, net of stock issuance costs   ............        -           -
 Redemption of preferred stock and warrants (notes 9 and 15)   .....................        -           -
 Dividends on preferred stock ......................................................        -           -
 Principal reductions on long-term debt   ..........................................   (1,435)     (1,371)
 Proceeds from long-term debt borrowings  ..........................................    2,808       1,173
 Deferred financing costs, including terminated offerings of $1,677 in 1996.........      (34)       (309)
                                                                                     ---------   ---------
   Net cash provided by financing activities .......................................    1,339        (507)
                                                                                     ---------   ---------
Decrease in cash  ..................................................................   (1,997)     (1,098)
Cash and cash equivalents, beginning of period  ....................................    2,485       1,709
                                                                                     ---------   ---------
Cash and cash equivalents, end of period  .......................................... $    488    $    611
                                                                                     =========   =========
</TABLE>


          See accompanying notes to consolidated financial statements.

                                      F-4

<PAGE>


               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
                (dollars in thousands, except per share amounts)


(1) Summary of Significant Accounting Policies

     (a) Organization and Basis of Presentation

     Community Care of America, Inc. (CCA) is a Delaware corporation  originally
incorporated on December 28, 1992. CCA began incurring start-up expenses in 1993
but had no significant operations until its acquisition of all the capital stock
of MeritWest,  Inc. ("MeritWest") on December 30, 1993. For accounting purposes,
this  acquisition  has been  treated as  effective  as of December 31, 1993 and,
accordingly,  the results of operations of this acquired company are included in
CCA's consolidated financial statements beginning on January 1, 1994.

     The consolidated  financial  statements include the accounts of CCA and its
wholly-owned  subsidiaries  (collectively the Company).  In  consolidation,  all
significant  intercompany  balances and transactions  have been  eliminated.  At
December 31, 1996, CCA owned,  leased or managed 54 long-term  care  facilities,
one hospital,  two  physician  practices,  two primary care  clinics,  one rural
healthcare clinic, one outpatient  rehabilitation center, one child care center,
one home healthcare  agency and an aggregate of 115 assisted living units in six
communities the Company serves.

     (b) Patient Service Revenues

     Patient service revenues are recorded at established rates and adjusted for
differences between such rates and estimated amounts reimbursable by third-party
payors. Estimated settlements under third-party payor retrospective rate setting
programs (primarily Medicare and Medicaid) are accrued in the period the related
services are rendered.  Settlements  receivable and related  revenues under such
programs are based on annual cost reports  prepared in  accordance  with Federal
and state  regulations,  which  reports  are  subject  to audit and  retroactive
adjustment in future periods.  In the opinion of management,  adequate provision
has been made in the  consolidated  financial  statements for such  adjustments;
however,  the  ultimate  amount of  adjustments  could be in  excess of  amounts
provided.

     (c) Management Fee Revenues

     Management fee revenues are recognized  when earned and  collectibility  is
reasonably assured.

     (d) Cash and Cash Equivalents

     Cash  equivalents  consist of highly liquid debt  instruments with original
maturities of three months or less.

     (e) Property, Plant and Equipment

     The  Company  capitalizes  costs  associated  with  acquiring  health  care
facilities and related interests therein. Pre-acquisition costs represent direct
costs of the  investigation  and  negotiation  of the  acquisition  of operating
facilities;  indirect  and  general  expenses  related  to such  activities  are
expensed as incurred.  Pre-acquisition  costs and  construction  in progress are
transferred to depreciable  asset categories when the related tasks are achieved
or are charged to  operating  expenses  when it is  determined  that the related
acquisition will not be consummated. Interest costs incurred during construction
and renovation are capitalized.

     The Company  capitalizes  development  costs which represent the direct and
incremental costs of developing healthcare delivery networks using the Company's
long-term  care  facilities  or rural  hospitals as platforms  for  providing an
expanded  range of services  (i.e.  primary care clinics,  rehabilitation,  home
health,  etc.).  Development costs include consulting fees, salaries and related
costs of  development  personnel and other direct costs of performing  functions
such as market research and feasibility, promotion and marketing, recruitment of
physicians  and other service  providers,  training and related costs during the
period the new facility or service attains complete operational status.


                                      F-5

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(1) Summary of Significant Accounting Policies - (Continued)

     Total  costs  of   facilities   acquired  are   allocated  to  land,   land
improvements,  equipment and buildings (or leasehold interests therein) based on
their respective fair values determined generally by independent appraisal.

     (f) Depreciation and Amortization

     Depreciation and amortization are provided on the straight-line  basis over
the estimated useful lives of the assets,  generally 40 years for buildings,  25
years for land  improvements,  10 years for equipment,  5 years for  development
costs and the initial term and expected renewal terms of the leases for costs of
leasehold interests and improvements.

     (g) Deferred Financing Costs

     The Company defers  financing  costs incurred to obtain  long-term debt and
amortizes  such costs  using the  interest  method  over the term of the related
debt.

     (h) Excess of Cost Over Fair Value of Net Assets Acquired

     The assets and  liabilities  of acquired  entities  accounted for under the
purchase  method of accounting are adjusted to their estimated fair values as of
the acquisition dates. The amounts recorded as excess of cost over fair value of
net assets  acquired  represent  amounts paid that exceed  estimated fair values
assigned to the assets and liabilities of each acquired  business.  Such amounts
are being amortized on a straight-line  basis over periods ranging from 10 to 40
years, depending on the specific circumstances of each acquisition.

     (i) Income Taxes

     Deferred income taxes are recognized for the tax  consequences of temporary
differences  between  financial  statement  carrying amounts and the related tax
bases of assets and  liabilities,  primarily  related to business  acquisitions.
Such tax effects are measured by applying enacted statutory tax rates applicable
to future years in which the differences are expected to reverse, and the effect
of a change in tax rates is  recognized  in the period that includes the date of
enactment.

     (j) Earnings per Common Share

     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.  Options and warrants issued from May
1994 through  August 15, 1995 have been treated as  outstanding  for all periods
presented.  Dividends  related to the Company's 8% redeemable  preferred  stock,
Series A, of $653 in 1994 and $408 in 1995,  are deducted  from net earnings for
the purpose of calculating earnings per share. On August 15, 1995, the preferred
stock was  redeemed  with the  proceeds  of the initial  public  offering of the
Company's common stock and related warrants were exercised (see note 9). Had the
redemption of preferred  stock and related  issuance of common stock occurred on
January 1, 1995,  earnings per common share for the year ended December 31, 1995
would be as follows:

    Earnings before extraordinary charge  ...................    $.45
    Net earnings  ...........................................    .26


     (k) Accounting for Stock Options


     The Company applies Accounting Principles Board Opinion No. 25, "Accounting
for Stock Issued to  Employees"  ("APB No.  25"),  in  accounting  for its stock
options.  Additional  information  required by Statement of Financial Accounting
Standards No. 123,  "Accounting for Stock-Based  Compensation" ("SFAS No. 123"),
is discussed in Note 10.



                                      F-6

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)


(1) Summary of Significant Accounting Policies - (Continued)


     (l) Use of Estimates

     Management  of the Company has made a number of estimates  and  assumptions
relating  to the  reporting  of assets and  liabilities  and the  disclosure  of
contingent  assets and  liabilities  to prepare  these  financial  statements in
conformity with generally accepted accounting  principles.  Actual results could
differ from those estimates.

     (m) Impairment of Long-Lived Assets

     Management  regularly  evaluates whether events or changes in circumstances
have  occurred  that could  indicate an  impairment  in the value of  long-lived
assets.  During the second  quarter of 1996,  the Company  adopted SFAS No. 121,
"Accounting for the Impairment of Long-Lived Assets and for Long-Lived Assets to
Be Disposed Of." In accordance  with the provisions of SFAS No. 121, if there is
an  indication  that the  carrying  amount of an asset is not  recoverable,  the
Company estimates the projected  undiscounted cash flows, excluding interest, of
the related  individual  facilities to determine if an impairment loss should be
recognized.  The  amount of  impairment  loss is  determined  by  comparing  the
carrying value of the asset to its estimated fair value. Estimated fair value is
determined  through an evaluation of recent financial  performance and projected
discounted  cash  flows of its  facilities  using  standard  industry  valuation
techniques,   including  the  use  of  independent  appraisals  when  considered
necessary.  If an asset  tested for  recoverability  was  acquired in a business
combination  accounted for using the purchase  method,  the related  goodwill is
included as part of the  carrying  value and  evaluated  as  described  above in
determining the recoverability of that asset.

     In addition to  consideration  of impairment  upon the events or changes in
circumstances  described  above,  management  regularly  evaluates the remaining
lives of its long-lived assets. If estimates are changed,  the carrying value of
affected assets is allocated over the remaining lives.

     Prior to  adoption  of SFAS No.  121 in 1996,  the  Company  performed  its
analyses of impairment of long-lived  assets by  consideration  of the projected
undiscounted  cash flows on an entity-wide  basis. The effect of the adoption of
SFAS 121 in the second  quarter of 1996  required  the  Company to perform  this
analysis on a facility-by-facility basis (see note 12).

     (n) Interim Consolidated Financial Statements

     The  consolidated  financial  statements  as of March 31,  1997 and for the
three months ended March 31, 1996 and 1997 are  unaudited and have been prepared
on a basis  substantially  consistent  with the audited  consolidated  financial
statements,  and,  in  the  opinion  of  management,   include  all  adjustments
(consisting   of  only  normal   recurring   adjustments)   necessary  for  fair
presentation of the results of these interim  periods.  The results of the three
months ended March 31, 1997 are not necessarily  indicative of the results to be
expected for the entire year.

(2) Business Acquisitions

     The following is a summary of significant  business  acquisitions  by year.
Such   acquisitions  have  been  accounted  for  by  the  purchase  method  and,
accordingly,  the results of  operations  have been  included  in the  Company's
consolidated financial statements from the respective dates of acquisition.


1994 Acquisitions

     In November 1994, the Company acquired leasehold interests in two long-term
care facilities  located in Colorado and Wyoming  (Tealwood) for a total cost of
approximately  $400,  including  legal  fees  and  other  direct  costs  of  the
acquisition of $78 and accrued liabilities of $322.


                                      F-7

<PAGE>


               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(2) Business Acquisitions - (Continued)


1995 Acquisitions

     Effective  as of February 1, 1995,  the Company  acquired all the assets of
the Georgiana Doctor's Hospital,  two primary care clinics and a home healthcare
agency (Georgiana)  located in Alabama.  The Company issued a 9% promissory note
for $1,250 to the seller at closing (see note 6).

     Effective  April 1, 1995, the Company  acquired all of the capital stock of
three  subsidiaries  of Quality  Health Care,  Inc.  (Quality),  which owned and
operated three long-term care facilities located in Nebraska. In connection with
the transaction,  Quality sold 11 facilities to Health and Retirement Properties
Trust (HRPT) for $14,200.  The Company  borrowed $5,845 from HRPT and leased the
latter facilities from HRPT as discussed more fully in notes 6 and 7.

     Effective  July  1,  1995,  the  Company  obtained  operating  leases  with
wholly-owned  subsidiaries of American Health  Corporation  (American) for three
long-term care facilities in Alabama. The agreements provide for an initial term
of twelve years,  with one five-year  renewal  option,  annual minimum rental of
$1,200 and rights of first refusal with respect to the sale of the facilities.

     Effective  August  1,  1995,  the  Company  purchased  all the  assets of a
physician  practice,  including  a primary  care  clinic  (Voreis),  located  in
Alabama,  and on October 1, 1995, the Company acquired  substantially all of the
assets  of a 39-bed  long-term  care  facility  in  Palmer,  Nebraska  (Coolidge
Center).

     Effective  November 1, 1995, the Company  acquired all of the capital stock
of an outpatient  rehabilitation  head trauma clinic in Maine (MHTU). As partial
consideration  in this  transaction,  the Company issued 25,061 shares of common
stock to the seller. These shares are subject to repurchase under the terms of a
settlement  agreement  dated  October 27, 1996 as amended on March 1, 1997, at a
price equal to the greater of the average  closing price of the stock for the 15
days  prior to the date of  repurchase  or $13.21  per share  (see note 13).  In
addition,  the Company may be required to make additional payments to the Seller
up to $200 if operating  results for the five year period  beginning  January 1,
1996 exceed base year amounts.

     Acquisitions in 1995 and the manner of payment are summarized as follows:


<TABLE>
<CAPTION>
                                                                                             CASH PAID
                                                                         COOLIDGE           FOR ACCRUED
         DESCRIPTION           GEORGIANA   QUALITY   AMERICAN   VOREIS    CENTER     MHTU      COSTS      TOTAL
- ------------------------------ ----------- --------- ---------- -------- ---------- ------- ------------ --------
<S>                            <C>         <C>       <C>        <C>      <C>        <C>     <C>          <C>
Seller financing  ............   $1,250          -        -         -         -           -         -      $ 1,25
Common stock issued(1)  ......        -          -        -         -         -         331         -          33
Accrued liabilities  .........      540      1,000       50         -       100         280    (1,970)
Cash paid   ..................      372      5,864      500       925       450         638     1,970       10,71
                                 -------     ------     ----      ----      ----     ------   -------     -------
Total cost  ..................   $2,162      6,864      550       925       550       1,249         -      $12,30
                                 =======     ======     ====      ====      ====     ======   =======     =======
</TABLE>
- ----------

(1) Represents 25,061 shares of common stock.

                                      F-8

<PAGE>


               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(2) Business Acquisitions - (Continued)


     The  allocation  of the total cost of the 1995  acquisitions  to the assets
acquired and liabilities assumed is summarized as follows:


<TABLE>
<CAPTION>
                                                                                         COOLIDGE
                 DESCRIPTION                   GEORGIANA   QUALITY   AMERICAN   VOREIS    CENTER    MHTU     TOTAL
- ---------------------------------------------- ----------- --------- ---------- -------- --------- ------- -----------
<S>                                            <C>         <C>       <C>        <C>      <C>       <C>     <C>
Current assets  ..............................  $    618    1,512         -       140         -     129     $  2,399
Property, plant and equipment  ...............     2,040    4,818         -       385       550       -        7,793
Other assets .................................         -    1,241       400         -         -       -        1,641
Intangible assets (10, 20 and 20 years)                -        -       150       400         -    1,142       1,692
Current liabilities   ........................      (496)    (525)        -         -         -     (22)      (1,043)
Long-term liabilities ........................         -     (182)        -         -         -                 (182)
                                                --------    -----       ----      ----      ----            --------
Total cost   .................................  $  2,162    6,864       550       925       550    1,249    $ 12,300
                                                ========    =====       ====      ====      ====   =====    ========
</TABLE>

1996 Acquisitions

     Effective  January 1, 1996,  the Company  purchased  certain  assets of the
Family  Care  Medical  Center of Arcadia,  Inc.  (Arcadia),  a  certified  rural
healthcare  clinic in Florida.  Pursuant to the asset  purchase  agreement,  the
Company issued a promissory note for $110 and 12,739 shares of common stock with
a fair value of $150 to the seller at closing.  The promissory  note was paid in
full as of December 31, 1996.

     On May 16, 1996,  Southern Care Centers,  Inc. ("Southern Care") was merged
into CCA Acquisition I, Inc., ("Newco"), a newly formed wholly-owned  subsidiary
of the Company.  As a result of the merger,  the  subsidiaries  of Southern Care
("Acquired  Subsidiaries"),  which  leased five  long-term  care  facilities  in
Georgia  and  one  long-term  care  facility  in  Louisiana,   became   indirect
wholly-owned  subsidiaries  of the Company.  In addition,  another  wholly-owned
subsidiary of the Company became the manager, under a Management Agreement dated
as of May 1, 1996,  of a  long-term  care  facility  in Texas  owned by a former
subsidiary of Southern Care which was not acquired by the Company. Additionally,
Newco is providing accounting,  internal auditing, billing, accounts payable and
certain other  services  under an Agreement to Provide  Accounting  and Auditing
Services and Rural Healthcare  Provider Network Services dated as of May 1, 1996
to a company owned by the former  shareholders  of Southern Care which  operates
another long-term care facility in Georgia.

     Pursuant to the merger  agreement,  the  shareholders of Southern Care (the
selling shareholders) received $2,700 of cash and 568,888 shares of common stock
of  the  Company  with  a  fair  value  of  $4,800.  In  addition,  the  selling
shareholders were entitled to receive, on or before March 31, 1997, up to $2,000
in common  stock of the  Company  based on the amount  that  Newco's  annualized
contribution margin on a consolidated basis for the year ended December 31, 1996
exceeds $4,400.  As of December 31, 1996, no such events  occurred.  The Company
has agreed to file two shelf registration statements under the Securities Act of
1933,  as amended,  covering  the shares  issued and issuable in the merger and,
upon request of the holders, to "piggyback" such shares in certain  registration
statements filed by the Company.

     The  merger  agreement  provides  that  the  consideration  to the  selling
shareholders  shall be reduced to the extent that current  liabilities  exceeded
current  assets by more  than  $1,850  at the  closing  date.  The  Company  has
determined  that such  condition  existed at the closing date and has recorded a
receivable  from the selling  shareholders  of $1,444 at December 31, 1996. Such
claim has been disputed by the selling  shareholders.  The Company  believes the
claim is valid and fully collectible;  accordingly,  no valuation  allowance has
been  recorded  with respect to this  matter.  Because the  receivable  arose in
connection with the issuance of the Company's  common stock, the related balance
at December 31, 1996 is presented as a reduction of stockholder's equity.


                                      F-9

<PAGE>


               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(2) Business Acquisitions - (Continued)

     In a series of related  transactions,  the  subsidiaries  of Southern  Care
acquired the five leased Georgia  facilities and, in turn, sold those facilities
to Health and Retirement  Properties  Trust ("HRPT").  HRPT thereupon leased the
five Georgia  facilities back to the Acquired  Subsidiaries  for an initial term
ending on December  31, 2010 with two renewal  options for six year and thirteen
year terms,  each at the option of the  Acquired  Subsidiaries.  After the first
lease year,  rent is subject to increase based on year over year  increases,  if
any, in net patient revenues and non-inpatient  revenues, each as defined in the
master lease agreement.  The Louisiana facility continues to be leased under the
terms of the lease existing prior to the merger.

     Acquisitions in 1996 and the manner of payment are summarized as follows:

<TABLE>
<CAPTION>
                                                                     CASH PAID FOR
           DESCRIPTION                 ARCADIA     SOUTHERN CARE     ACCRUED COSTS      TOTAL
- ------------------------------------   ---------   ---------------   ---------------   ----------
<S>                                    <C>         <C>               <C>               <C>
Seller financing  ..................     $110               -                 -        $   110
Common stock issued(1)  ............      150           4,800                 -          4,950
Accrued liabilities  ...............        -           2,500            (3,409)          (909)
Cash paid   ........................       40           2,683             3,409          6,132
Receivable from shareholders  ......        -          (1,444)                -         (1,444)
                                         -----        -------           -------        --------
Total cost  ........................     $300           8,539                 -        $ 8,839
                                         =====        =======           =======        ========
</TABLE>
- ----------
(1)  Represents shares of common stock as follows: 12,379 shares for Arcadia and
     568,888 shares for Southern Care Centers, Inc.

     The  allocation  of the total cost of the 1996  acquisitions  to the assets
acquired and liabilities assumed is summarized as follows:

<TABLE>
<CAPTION>
                DESCRIPTION                      ARCADIA     SOUTHERN CARE      TOTAL
- ----------------------------------------------   ---------   ---------------   -----------
<S>                                              <C>         <C>               <C>
Current assets  ..............................     $  36            753         $    789
Property, plant, and equipment ...............        60          5,400            5,460
Other assets .................................         -          1,741            1,741
Intangible assets (10 and 20.67 years)  ......       204         10,855           11,059
Current liabilities   ........................         -         (4,784)          (4,784)
Long-term liabilities ........................         -         (5,426)          (5,426)
                                                   ------       -------         --------
Total cost   .................................     $ 300          8,539         $  8,839
                                                   ======       =======         ========
</TABLE>

     The  following  unaudited  pro forma  consolidated  results  of  operations
information is presented as if the acquisition  transactions described above had
occurred as of the beginning of the respective periods  presented,  after giving
effect to certain  adjustments,  including  depreciation and amortization of the
new cost basis of the assets acquired,  increased  interest and rent expense and
related income tax effects.

<TABLE>
<CAPTION>
                                                        Years ended December 31,
                                                        -------------------------
                                                         1995          1996
                                                        ----------   ------------
<S>                                                     <C>          <C>
Total operating revenues  ...........................   $122,495      $ 133,506
Earnings (loss) before extraordinary charge .........     3,821         (18,652)
Earnings (loss) applicable to common stock before ex-
 traordinary charge .................................     2,901         (18,652)
Earnings (loss) per common share before extraordi-
 nary charge ........................................       .53       $   (2.53)
                                                        =========     =========
</TABLE>


                                      F-10

<PAGE>


               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(3) Accounts Receivable

     Accounts receivable consist of the following:


                                                       1995       1996
                                                      ---------   --------
    Patient accounts receivable  ..................   $10,909     $15,832
    Third-party payor settlements   ...............     2,696       4,228
    Other   .......................................     1,307       1,180
                                                      --------    --------
                                                       14,912      21,240
    Allowance for doubtful accounts and contractual
      adjustments .................................     1,978       4,833
                                                      --------    --------
                                                      $12,934     $16,407
                                                      ========    ========

     The Company  generally  does not require  collateral  or other  security in
extending credit to patients; however, the Company routinely obtains assignments
of (or is otherwise  entitled to receive)  benefits  receivable under the health
insurance  programs,  plans or policies of patients (e.g.,  Medicare,  Medicaid,
commercial  insurance and managed care  organizations).  The  Company's  patient
service  revenues  derived from the Medicare and Medicaid  programs were 17% and
52%,  respectively,  for the year  ended  December  31,  1995,  and 20% and 50%,
respectively,  for the year ended December 31, 1996. Patient accounts receivable
from the Federal  government  (Medicare)  were $1,777 and $3,421 at December 31,
1995 and 1996,  respectively.  Amounts receivable from various states (Medicaid)
were $4,883 and $6,302, respectively, at December 31, 1995 and 1996.

     Third-party  payor  settlements  receivable  from  the  Federal  government
(Medicare) were  approximately  $1,718 and $2,794 at December 31, 1995 and 1996,
respectively; the remainder relates primarily to net amounts receivable from the
states of Colorado and Nebraska (Medicaid). Certain of the Medicaid and Medicare
cost  reports for prior years were settled  during 1995 and 1996,  the impact of
which was not material.  At December 31, 1996, the Company had open cost reports
for the 1993, 1994 and 1995 years which, after related allowances,  are recorded
at estimated net realizable value.

     The  allowance  for  doubtful  accounts  and  contractual   adjustments  is
determined by management  using  estimates of potential  losses and  contractual
settlements  based on an analysis of current and past due  accounts,  collection
experience in relation to amounts billed, prior settlement  experience and other
relevant  information.  Although  the  Company  believes  amounts  provided  are
adequate,  the ultimate  uncollectible amounts could be in excess of the amounts
provided.  The Company's  provision for bad debts was $658 in 1995 and $1,867 in
1996.


(4) Property, Plant and Equipment

     Property, plant and equipment are summarized as follows:

                                                            1995       1996
                                                           ---------   --------
    Land  ..............................................   $ 5,983     $ 5,926
    Land improvements ..................................       612         613
    Buildings and improvements .........................    32,214      39,911
    Leasehold improvements and leasehold interests  ....     8,598       9,135
    Equipment   ........................................     7,269       7,880
    Construction in progress   .........................       987         255
    Pre-acquisition and development costs  .............     1,867         425
                                                           --------    --------
                                                            57,530      64,145
    Less accumulated depreciation and amortization  ....     3,203       5,721
                                                           --------    --------
    Net property, plant and equipment   ................   $54,327     $58,424
                                                           ========    ========


                                      F-11

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(5) Accounts Payable and Accrued Expenses

     Accounts payable and accrued expenses consist of the following:



                                                          DECEMBER 31,     
                                                      -------------------- 
                                                       1995       1996     
                                                      ---------   -------- 
    Accounts payable  ............                    $ 8,860     $15,595  
    Accrued compensation .........                      4,422       3,473  
    Other accrued expenses  ......                      1,587       4,334  
                                                      --------    -------- 
                                                      $14,869     $23,402  
                                                      ========    ======== 
                                              

(6) Long-Term Debt

     Long-term debt is summarized as follows:





<TABLE>
<CAPTION>
                                                                                 DECEMBER 31,
                                                                             --------------------
                                                                              1995       1996
                                                                             ---------   --------
<S>                                                                          <C>         <C>
Mortgage notes:
 11.5% note payable in monthly principal and interest installments of $138
   commencing January 31, 1996 through June 30, 1996; interest only pay-
   ments of $130 commencing July 31, 1996 through June 30, 1998; princi-
   pal and interest payments of $138 commencing on July 31, 1998 and
   maturing on December 31, 2016   .......................................   $13,600     $13,551
 9%note  payable  in  monthly   principal  and  interest   installments  
   of $50 commencing  January 31, 1996 through June 30, 1996;  interest 
   payments of $45 commencing  July 31, 1996  through  June 30,  1998;  
   principal  and  interest payments of $50 commencing on July 31, 1998 
   and maturing on December 31, 2016   ...................................     6,000      5,967
 10% note payable in monthly interest only payments through December
   31, 1996; principal and interest payments of $19 commence January 31,
   1997 through December 31, 2021  .......................................     2,045      2,045
 9% note payable in semi-annual installments through March 9, 1998, plus
   interest payable quarterly   ..........................................     1,125        750
                                                                             --------    --------
 Total mortgage notes payable   ..........................................    22,770     22,313
Revolving line of credit with bank, due on December 31, 1996  ............     8,410          -
Revolving line of credit with bank, due on December 27, 1999  ............         -     14,495
Revolving line of credit with Integrated Health Services, Inc., due on De-
 cember 27, 1998 (see note 14)                                                     -      2,000
11% note secured by property and equipment, interest only due monthly;
 principal due December 31, 2008   .......................................         -     10,000
</TABLE>


                                      F-12

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(6) Long-Term Debt - (Continued)




<TABLE>
<CAPTION>
                                                                                     DECEMBER 31,
                                                                                 --------------------
                                                                                  1995       1996
                                                                                 ---------   --------
<S>                                                                              <C>         <C>
11% notes maturing December 30, 2016, interest and principal payable in
 monthly  installments of $47 commencing  January 31, 1997; secured by a lien on
 substantially all of the leasehold assets of several long-term care
 facilities ..................................................................     2,892       4,835
Notes payable, secured by equipment and land, maturing from June 19, 1997
 to April 4, 2005; principal payable in monthly installments of $25, with
 interest payable monthly at variable rates up to 15.13% .....................       740         512
13% capital lease payable in monthly principal and interest installments
 ranging from $54 to $65 through April 30, 2015, with a final payment of
 $2,414  .....................................................................         -       5,401
7% unsecured note payable, due on demand  ....................................         -         600
10% unsecured note payable in monthly principal and interest installments
 of $8, maturing on August 1, 1998  ..........................................         -         141
Other ........................................................................       853          74
                                                                                 --------    --------
                                                                                  35,665      60,371
Less current portion .........................................................     1,258       6,341
                                                                                 --------    --------
                                                                                 $34,407     $54,030
                                                                                 ========    ========
</TABLE>

     Mortgage  notes  aggregating  $21,563 at  December  31, 1996 are payable to
Health and  Retirement  Properties  Trust  ("HRPT")  and are secured by deeds of
trust on 18 long-term care facilities located in Colorado and Nebraska and liens
on  substantially   all  of  the  common  stock  of  certain  of  the  Company's
subsidiaries. These mortgage notes are subject to cross-default provisions under
the  Company's  leases with HRPT (see note 7). The  remaining  mortgage  note is
secured by a deed of trust on one hospital  (Georgiana) located in Alabama.  The
mortgage notes also provide for additional interest payable quarterly commencing
in 1996 equal to the  greater of (a) 5% of excess net  patient  revenues  over a
base  year  amount  or  (b)  the  amount  of the  additional  interest  for  the
immediately preceding loan year.

     On April 4, 1996, the Company  borrowed  $10,000 from HRPT,  pursuant to an
11%  promissory  note (the "HRPT Note"),  to provide  additional  renovation and
acquisition  funding and general  working  capital.  No  principal  payments are
required  until the maturity  date of December 31, 2008 with  interest  payments
made monthly.  The HRPT Note is secured by all of the collateral  security which
secures  the  Company's  current  obligations  to HRPT and is  subject  to cross
default with other  obligations  to HRPT. As a result of closing this loan,  the
Company  increased  the  refundable  security  deposit  held  by  HRPT  for  all
obligations by $550.


                                      F-13

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(6) Long-Term Debt - (Continued)


Revolving Lines of Credit

     On  August 7,  1995,  the  Company  entered  into a  Revolving  Credit  and
Reimbursement  Agreement  with  NationsBank  of  Florida,  N.A.  ("NationsBank")
providing for a revolving  credit  facility (the "Loan  Agreement")  pursuant to
which  the  Company  was  entitled  to borrow  from time to time up to  $15,000,
subject to a borrowing  base of 80% of  eligible  accounts  receivable.  In July
1996,  the  agreement  was modified to reflect a revised  scheduled  maturity of
December 31, 1996.  Outstanding loans bore interest equal to, as selected by the
Company, either a floating rate (the greater of the federal funds rate plus .50%
or NationsBank's  prime rate) or a rate equal to the applicable  Eurodollar rate
plus 1.75%  (subject to  adjustment  after  September  30, 1996 based on certain
financial  ratios  achieved by the Company).  The Loan  Agreement was secured by
substantially all of the unencumbered  assets of the borrowing  entities and the
capital  stock of the  Company's  subsidiaries,  Community  Care of  America  of
Alabama,  Inc. and CCA of Maine, Inc. The Loan Agreement required the Company to
maintain a  prescribed  level of tangible net worth (as  defined),  and current,
fixed charge coverage and leverage ratios,  placed  limitations on indebtedness,
liens,  investments and transactions  with affiliates and prohibited the payment
of dividends.  The revolving  credit  facility was paid in full in December 1996
with the proceeds from the Daiwa  Securities of America,  Inc.  revolving credit
facility (see below).

     On December 27,  1996,  the Company  entered into a Healthcare  Receivables
Purchase and Transfer Agreement with Daiwa Securities of America, Inc. ("Daiwa")
providing for a 36 month revolving credit facility pursuant to which the Company
may borrow from time to time up to $15,000, subject to a borrowing base formula.
The Loan Agreement is secured by the assignment to the lender of all patient and
third party settlement  receivables.  Proceeds from the line of credit were used
to repay  borrowings  and  terminate  the  Revolving  Credit  and  Reimbursement
Agreement  with  NationsBank  discussed  above.  As of December 31, 1996,  Daiwa
advanced the Company an amount in excess of the borrowing base by  approximately
$4,800.  Such amount has been  classified  as current  portion of long term debt
since repayment is due upon demand.  The remaining  outstanding loan will mature
on December 27, 1999 and amounts  advanced  bear interest at a rate equal to the
LIBOR rate at the time of each  revolving  advance  plus  2.00% per  annum.  The
interest  rate at December  31, 1996 was  7.9065%.  The  agreement  requires the
Company to  maintain a  prescribed  tangible  net worth ratio as well as various
other  financial  and  non-  financial   covenants  (see  Note  13  for  further
information).

     The  Company  and IHS  entered  into a loan  agreement  which,  as amended,
entitles the Company to borrow,  until December 27, 1998, amounts on a revolving
credit  basis so that no more than $5,000 is  outstanding  at any time  provided
that,  unless  such  advance is applied to the payment of  management  fees that
become due to IHS under the Management  Agreement (see Note 14), IHS consents to
the making of advances,  which consent may not be  unreasonably  withheld.  This
revolving credit facility bears interest at a rate per annum equal to the annual
rate of interest set forth in IHS's  revolving  credit  agreement with Citibank,
N.A.,  plus 2%.  Repayment  of  amounts  advanced  under this line of credit are
subordinated  to the payment of up to an aggregate  of $30,000 of principal  and
interest on the Company's obligations to HRPT and Daiwa.


                                      F-14

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(6) Long-Term Debt - (Continued)

     In connection with entering into the revolving credit facility, the Company
issued  warrants to purchase an  aggregate  of 752,182  shares of the  Company's
Common Stock,  one-half of which are exercisable until January 13, 1999 at $3.22
per share (the average of the high and low trading price of the Company's Common
Stock on  January  14 and 15,  1997)  and the  remaining  one-half  of which are
exercisable  until  January  13,  2002 at $6.44 per share.  The number of shares
subject to the  warrants and the exercise  prices are subject to  adjustment  in
certain  instances,  including  the Company  issuing  shares of Common Stock (or
securities  convertible into Common Stock) at less than the applicable  exercise
price. In connection therewith, the Company has granted to IHS certain rights to
cause the shares  issuable upon exercise of the warrants to be registered  under
the Securities Act of 1933, as amended, at the Company's expense.

     Aggregate  principal  maturities of long-term  debt for the next five years
are as follows:  1997, $6,341;  1998, $2,666;  1999, $10,007;  2000, $328; 2001,
$356 and thereafter $40,673.

     Information concerning interest expense is as follows:





<TABLE>
<CAPTION>
                                                              YEARS ENDED DECEMBER
                                                                       31,
                                                             -----------------------
                                                             1994     1995     1996
                                                             ------   ------   -----
<S>                                                          <C>      <C>      <C>
Interest income applied to reduce interest expense  ......   $63        $ 96   $ 11
Interest capitalized to construction in progress .........   $92        $107   $277
</TABLE>

(7) Leases

     The  Company  is  lessee  under  operating  leases  of  34  long-term  care
facilities,  of which one expires in February  2006,  three expire in June 2007,
and 30 expire in December 2010. The Company also leases certain office space and
computer  equipment  expiring in 1998 and 1999.  Minimum rent payments due under
operating leases in effect at December 31, 1996 are summarized as follows:



<TABLE>
<S>                                                         <C>      
    1997  .............................................     $ 10,458 
    1998  .............................................       10,369 
    1999  .............................................       10,014 
    2000  .............................................       10,043 
    2001  .............................................       10,103 
    Thereafter  .......................................      146,363 
                                                            ---------
      Total  ..........................................     $197,350 
                                                            =========
</TABLE>                                                    

     The leases for the 30 health care  facilities are with HRPT and provide for
two consecutive renewal options of six and thirteen years, respectively, at fair
market rentals at the  expiration of the initial term. In connection  with these
lease agreements,  the Company was required to pay refundable  deposits totaling
$5,660 as of December  31, 1996 which has been  subsequently  reduced  (see note
13). The leases for the three health care  facilities,  also with HRPT,  provide
for one  renewal  option for five  years.  The lease for one  facility  does not
currently have a renewal option.


                                      F-15

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(7) Leases - (Continued)


     With respect to the leases for the 30 health care  facilities,  the Company
has the right of first  refusal and an option to purchase  the  facilities  at a
price equal to the greater of a formula as defined in the lease agreement or the
fair market value of the facilities.  Minimum  rentals are generally  subject to
adjustment  for  renovations  made to the  facilities by the lessor.  Also,  the
leases provide for contingent  rentals,  based on a percentage of gross revenues
of the facilities in excess of base year amounts.  Contingent  rentals were $150
in 1996;  none were  incurred  during the period from  inception to December 31,
1995. The lease agreements require the Company to maintain a current ratio of at
least one to one and a minimum tangible net worth, as defined, of $5,000,  which
conditions  were  not met as of  December  31,  1996.  In  addition,  the  lease
agreements  restrict the Company's ability to pay dividends,  incur indebtedness
or make distributions to affiliates. See note 13.


     The lease for office space provides for two,  one-year  renewal options and
the equipment lease may be renewed for one year.


(8) Income Taxes


     The income tax benefit for 1996, all of which relates to deferred taxes, is
summarized as follows:



<TABLE>
<S>                                                         <C>          
Federal income taxes  .................................      $ (7,375)   
State income taxes ....................................        (2,090)   
                                                             --------    
                                                             $ (9,465)   
                                                             ========    
</TABLE>                                                    

     In 1995,  the  Federal  and state  income tax  provision  was offset by net
operating loss carryovers of $280.


     The expected  income tax rate of 34% differs from the rate  resulting  from
the provision in the financial statements as follows:






<TABLE>
<CAPTION>
                                                           1994         1995           1996
                                                          ---------   ------------   -----------
<S>                                                       <C>         <C>            <C>
   Income tax (benefit) at statutory rate (34%)  ......      34 %         34 %          (34)%
   State income tax, net of federal benefit   .........       4 %          4 %           (4)%
   Tax benefit of net operating loss carryover   ......      (38)%        (7)%            - %
   Increase (decrease) in valuation allowance .........       - %         (1)%            3 %
   Other  .............................................       - %          - %            2 %
                                                           -------     ------        ------
                                                              - %         30 %       $  (33)%
                                                           #######     ######        ######
</TABLE>


     The sources of deferred income tax (assets) and liabilities are as follows:




<TABLE>
<CAPTION>
                                                                          1995          1996
                                                                         ----------   -----------
<S>                                                                      <C>          <C>
Excess of book over tax basis of assets ..............................   $10,025       $ 11,179
Allowance for doubtful accounts   ....................................      (651)        (1,262)
Accrued expenses   ...................................................      (803)        (3,173)
Net operating loss carryovers  .......................................      (870)        (8,717)
Pre-acquisition separate company net operating loss carryovers  ......    (1,365)        (1,406)
Other  ...............................................................        22           (184)
                                                                         --------      --------
                                                                         $ 6,358       $ (3,563)
Valuation allowance   ................................................     2,976          3,725
                                                                         --------      --------
Deferred income tax liability  .......................................   $ 9,334       $    162
                                                                         ========      ========
</TABLE>

                                      F-16

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(8) Income Taxes - (Continued)

     At  December  31,  1996,  the  Company had net  operating  loss  carryovers
available for Federal income tax purposes of approximately  $26,293 which expire
in the years 2007 through 2011,  including  pre-acquisition  net operating  loss
carryovers of approximately  $3,652 which expire in the years 2007 through 2011.
The utilization of the  pre-acquisition net operating loss carryovers is subject
to certain annual limitations under the Internal Revenue Code and, under "change
in ownership" provisions of the Code, other net operating loss carryovers may be
subject to similar limitations.

     The valuation allowance relates, in part, to deferred tax assets that, when
subsequently  realized,  will be applied to reduce goodwill and other intangible
assets acquired to the extent that such allowances resulted in intangible assets
when  originally  recorded in connection with  acquisitions.  As of December 31,
1996,  the Company did not fully  reserve all  deferred  tax assets since future
operations are expected to generate  sufficient  taxable income to realize these
assets.  As of December 31, 1996,  the portion of the valuation  allowance to be
applied to reduce goodwill in future years is approximately $3,725.


(9) Redeemable Preferred Stock

     On December 30, 1993, the Company issued Series A 8% Redeemable  Cumulative
Preferred Stock and warrants to purchase  1,331,814  shares of common stock at a
price of $.0198 per share. The warrants were valued at $2,631 in accordance with
the agreement of the parties and recorded as  additional  paid-in  capital.  The
difference  between the value  allocated to the  preferred  stock at issuance of
$5,536 and the  aggregate  redemption  price of such  shares of $8,167 was being
accreted to preferred  stock and charged  against  common  stockholders'  equity
through the dates of mandatory redemption.  Such accretion was $372 for the year
ended  December  31, 1994 and $231 for the year ended  December  31,  1995.  The
preferred  stock was redeemed at $100 per share and the warrants were  exercised
in August 1995 (see note 15).


(10) Capital Stock

     On July 28, 1995,  the Company  amended its  certificate  of  incorporation
decreasing  the  Company's  authorized  common stock from  35,000,000  shares to
15,000,000  shares,  increasing  the  authorized  shares of  preferred  stock to
1,000,000 shares and effecting a reverse common stock split of one-for-7.9.  All
share and per share data presented herein give effect to such changes.

At December  31, 1995 and 1996,  the Company had  outstanding  stock  options as
follows:

Stock options outstanding pursuant to:



<TABLE>
<CAPTION>
                                                   1995       1996
                                                  ---------   --------
<S>                                               <C>         <C>
1993 Stock Option Plan ........................   265,196     216,928
1993 Senior Executive Stock Option Plan  ......    57,799      16,565
1995 Stock Option Plan ........................   153,910     208,894
1995 Non-Employee Directors Option Plan  ......    14,835      71,978
                                                  --------    --------
Total Stock Options Outstanding ...............   491,740     514,365
                                                  ========    ========
</TABLE>


                                      F-17

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(10) Capital Stock - (Continued)

     The  Company  established  the 1993 Stock  Option  Plan and the 1993 Senior
Executive  Stock Option Plan  effective July 1, 1993. The 1993 Stock Option Plan
provides that up to 289,258  shares of common stock may be issued to certain key
employees and  consultants  of the Company.  Options  granted to date under this
plan vest either  immediately  or over three years and expire ten years from the
date of grant.  The 1993 Senior  Executive Stock Option Plan provides that up to
74,364  options  may be issued  to senior  executive  officers  of the  Company.
Options granted to date under this plan vest over a period of seven years,  with
accelerated  vesting in some  instances,  based upon the  occurrence  of certain
events,  including the achievement of earnings targets.  The outstanding options
at December 31, 1996 expire ten years from the date of grant  subject to earlier
termination in certain cases.

     In 1995,  the Company  established  the 1995 Stock Option Plan and the 1995
Non-Employee  Directors Option Plan. The 1995 Stock Option Plan provides that up
to 500,000  shares of common  stock may be issued to certain key  employees  and
consultants of the Company  pursuant to options  granted from time to time under
this plan.  Options  granted to date under this plan vest either  immediately or
over  periods  from  three to seven  years,  with  accelerated  vesting  in some
instances,   based  upon  the  occurrence  of  certain  events,   including  the
achievement of earnings  targets.  The outstanding  options at December 31, 1996
expire ten years from the date of grant  subject to the earlier  termination  in
certain cases. The 1995  Non-Employee  Directors Option Plan provides that up to
100,000 shares of common stock may be issued to non-employee  directors pursuant
to options automatically granted under that plan upon election as a director and
annually  following  the annual  meeting  of  shareholders  electing  directors.
Options  granted  to date  under  this  plan  vest in  three  equal  semi-annual
installments  beginning  six months after the date of grant and expire ten years
from the date of grant subject to the earlier termination in certain cases.

     All stock  options  issued by the Company have been  granted with  exercise
prices  equal to or greater than the  estimated  fair market value of the common
stock on the date of grant. Stock option transactions are summarized as follows:




<TABLE>
<CAPTION>
                                                       1995                        1996
                                             -------------------------   ------------------------
                                                            WEIGHTED                    WEIGHTED
                                                            AVERAGE                     AVERAGE
                                                            EXERCISE                    EXERCISE
                                              SHARES         PRICE        SHARES        PRICE
                                             ------------   ----------   ------------   ---------
<S>                                          <C>            <C>          <C>            <C>
Outstanding at beginning of year .........     292,936        $ 4.44        491,740       $ 7.68
Granted  .................................     230,339         11.42        226,132        11.23
Exercised   ..............................           -             -        (33,385)        4.62
Canceled .................................     (31,535)         6.75       (170,122)        8.95
                                              --------        -------     ---------      -------
Outstanding at end of year ...............     491,740        $ 7.68        514,365       $ 9.03
                                              ========        =======     =========      =======
Options Exercisable at end of year  ......     206,006        $ 5.10        222,310       $ 6.34
                                              ========        =======     =========      =======
</TABLE>


     The following summarizes  information about stock options outstanding as of
December 31, 1996:





<TABLE>
<CAPTION>
                                      OPTIONS OUTSTANDING                          OPTIONS EXERCISABLE
                     -----------------------------------------------------   -------------------------------
   RANGE OF            NUMBER         WEIGHTED AVG.         WEIGHTED           NUMBER          WEIGHTED
   EXERCISE          OUTSTANDING        REMAINING            AVERAGE         EXERCISABLE       AVERAGE
    PRICES           AT 12/31/96     CONTRACTUAL LIFE     EXERCISE PRICE     AT 12/31/96     EXERCISE PRICE
- ------------------   -------------   ------------------   ----------------   -------------   ---------------
<S>                  <C>             <C>                  <C>                <C>             <C>
    $3.71             150,685             6.54                 $ 3.71           141,219          $ 3.71
  $9.50 - $10.50      210,048             8.93                   9.84            61,567           10.11
 $10.51 - $14.00      153,632             9.10                  13.12            19,524           13.49
                      -------             ----                 -------          --------         -------
                      514,365             8.28                 $ 9.03           222,310          $ 6.34
                      =======             ====                 =======          ========         =======
</TABLE>


                                      F-18

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(10) Capital Stock - (Continued)

     The Company  applies APB  Opinion  No. 25 and  related  interpretations  in
accounting for its stock options.  Accordingly, no compensation expense has been
recognized in connection with its stock options.  Had  compensation  expense for
the  Company's  stock  options  been  determined  consistent  with  Statement of
Financial   Accounting   Standards   No.  123,   "Accounting   for   Stock-Based
Compensation," the Company's net earnings and earnings per share would have been
reduced to the pro forma amounts indicated below:




<TABLE>
<CAPTION>
                                                                    1995                           1996
                                                         ---------------------------   -----------------------------
                                                         AS REPORTED     PRO FORMA     AS REPORTED     PRO FORMA
                                                         -------------   -----------   -------------   -------------
<S>                                                      <C>             <C>           <C>             <C>
Net earnings (loss) applicable to common stock  ......     $ 1,041        $   890       $ (18,905)      $ (19,283)
Per common share:
 Earnings (loss) before extraordinary charge .........        0.42           0.49           (2.56)          (2.61)
 Extraordinary charge   ..............................       (0.20)         (0.26)           0.00            0.00
                                                           -------        -------       ---------       ---------
 Net earnings (loss) .................................        0.22           0.23           (2.56)          (2.61)
                                                           =======        =======       =========       =========
</TABLE>


     The  fair  value  of  the  options  for  purposes  of the  above  pro-forma
disclosure was calculated using the  Black-Scholes  option pricing model and the
following  assumptions:  risk  free  interest  rate of 6.58%,  weighted  average
expected  lives of 5 to 8.5 years,  no dividend  payments,  and a volatility  of
35.8% based on the annualized 10 year industry average.  The effects of applying
SFAS No. 123 in the pro forma net  earnings  and earnings per share for 1995 and
1996 may not be representative of the effects on such pro-forma  information for
future years.


(11) Fair Value of Financial Instruments

     The  carrying  amount  of  cash  and  cash  equivalents,  patient  accounts
receivable,  other  current  assets,  accounts  payable,  and  accrued  expenses
approximates fair value because of the short-term maturity of these instruments.
The fair value of  third-party  payor  settlements  receivable  is  estimated by
discounting  anticipated  cash flows using  estimated  market  discount rates to
reflect the time value of money.  The fair value of the Company's long term debt
is  estimated  based  on  current  rates  offered  to the  Company  for  similar
instruments  with the  same  remaining  maturities.  Management  of the  Company
believes the carrying amount of the above financial instruments approximates the
estimated fair value.


(12) Loss on Impairment of Long-Lived Assets and Other Non-recurring Charges

     Operating  expenses for 1996 include total  non-recurring  charges of $22.1
million and consist of the following:



<TABLE>
<CAPTION>
                                                                                              Exit
                                                                Loss on         Other       Costs and
                                                             Impairment of      Asset       Employee
                                                               Investment    Write-offs   Terminations    Total
                                                             --------------- ------------ -------------- --------
<S>                                                          <C>             <C>          <C>            <C>
Sandy River management contract termination  ...............     $ 5,453        $1,086        $3,360       $ 9,89
Aurora and Toledo facilities closed or voluntarily decer-
 tified                                                            1,450             -           207         1,65
Costs of a physician practice, primary care clinics, adult
 day care centers, and other programs closed ...............       3,013             -         1,484         4,49
Memorial Health Group acquisition termination   ............       3,924           264           210         4,39
Termination of offerings of debt and equity securities   ...           -         1,677             -         1,67
                                                                 --------       -------       -------     -------
                                                                 $13,840        $3,027        $5,261       $22,12
                                                                 ========       =======       =======     =======
</TABLE>

                                      F-19

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(12) Loss on Impairment of Long-Lived Assets and Other Non-recurring Charges -
  (Continued)

     In the second quarter of 1996, management made the decision to exit certain
activities,  including the  termination of the management  agreement and related
purchase  option for the Sandy River  facilities and the closing of four primary
care clinics, four adult day care centers and one physician practice.

     The Company  terminated its management and purchase option  agreements with
the Sandy River Group since the facilities  were not generating  sufficient cash
flows to pay the Company's  management fees. As a result,  management  evaluated
its  investment  related to the  management  agreement  and purchase  option for
impairment.   This  analysis  identified  approximately  $9,899  in  write-offs,
including  the  write-offs  of (1)  the  $5,000  purchase  option  deposit,  (2)
unsecured  management fees of $1,086,  (3) direct  acquisition costs of $453 and
(4) accrued exit and termination costs of $3,360 to transfer the properties back
to the Sandy River Group. As of December 31, 1996, substantially all exits costs
have been paid.

     The  four  primary  care  clinics,  four  adult  day care  centers  and one
physician  practice  were  closed  as a result  of their  unfavorable  financial
performance and the negative impact these centers had on the Company's long-term
care business. As a result, the Company wrote-off development costs and property
and equipment  relating to these activities of $3,013. In addition,  the closure
of these clinics resulted in eliminating  approximately 14 positions,  primarily
doctors and clinical  staff,  through an involuntary  severance  program.  Total
employee  termination benefits provided in the financial statements were $454 as
of December 31, 1996,  of which $138 was unpaid as of December 31, 1996 and will
be paid in 1997. Other costs to exit these activities  include lease termination
costs of $964  which  will paid over the  remaining  lease  terms and other exit
costs  of  $66.  Both of  these  obligations  were  incurred  under  contractual
obligations  that existed prior to the  commitment  date and will continue after
the plan is  completed  with no  economic  benefit to the  Company.  Total lease
termination  and other exit costs  accrued but not paid as of December  31, 1996
was  $873.  Management  anticipates  that an  additional  $750 of costs  will be
incurred in 1997 .  Management  expects the  necessary  activities to exit these
operations will be complete by December 31, 1997.


     On December 31, 1996, the Company  terminated an agreement to acquire other
rural hospitals in Georgia and transferred Memorial Healthcare, Inc. d/b/a Smith
Hospital  (Smith)  back to the  sellers  since  CCA was not able to  secure  the
necessary financing to complete the transaction.  The total non-recurring charge
to income related to this transaction was approximately  $4,398 and consisted of
(1) the write-off of the investment in Smith's net assets, including transaction
costs of $3,924 (2) other asset write-offs of $264 and (3) exit costs of $210.


     Other non-recurring charges represent the write-off of approximately $1,677
in  deferred  financing  costs as a result  of  unsuccessful  attempts  to raise
capital through a secondary stock offering and a high yield debt offering. Also,
the Company reviewed the long-lived  assets of the Aurora and Toledo  facilities
for  recoverability  and determined that an additional  write-down of $1,450 was
required.  Such write-down has been reflected in  non-recurring  charges for the
period ended December 31, 1996.


     The  revenues and net  operating  losses from  activities  that will not be
continued are as follows:





<TABLE>
<CAPTION>
                                                                                    1994      1995        1996
                                                                                    ------   ---------   ----------
<S>                                                                                 <C>      <C>         <C>
Revenue from primary care clinics, adult day care centers, a physician practice
 and other programs closed ......................................................    -        $1,177      $5,107
Net operating losses from primary care clinics, adult day care centers, a physi-
 cian practice and other programs closed                                             -        $  (95)     $ (880)
Revenue from management contracts and agreements terminated .....................    -        $1,318      $3,336
Net operating income from management contracts and agreements terminated.            -        $  427      $1,126
</TABLE>

                                      F-20

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(12) Loss on Impairment of Long-Lived Assets and Other Non-recurring Charges -
  (Continued)

     In 1996, the Company adopted Financial  Accounting Standard (SFAS) No. 121,
"Loss on  Impairment  of  Long-Lived  Assets  and for  Long-Lived  Assets  to be
Disposed Of." As a result,  the Company  performed a review of the events and/or
changes in  circumstances  that would  suggest that the  carrying  amount of the
Company's asset may not be recoverable.  This analysis  included a consideration
of (1) the business,  legal and economic climate for events that could adversely
affect the carrying value of an asset, (2) any physical  changes in assets,  (3)
the accumulated  costs in excess of the amounts  originally  expected to acquire
and/or  construct an asset,  (4) decreases in the market value of assets and (5)
current period operating or cash flow losses that demonstrate  continuing losses
associated with an asset used for the purpose of producing revenue. In addition,
the Company estimated the future cash flows expected to result from assets to be
held and used.

     In  estimating  the future cash flows for  determining  whether an asset is
impaired, the Company grouped its assets at the lowest level for which there are
identifiable  cash flows  independent  of other groups of assets (i.e.,  by long
term care facility).  The results of comparing future undiscounted cash flows to
historical  carrying  value,  together  with the  evaluation  of the  facts  and
circumstances that may indicate an asset may not be recoverable,  indicated that
the Toledo and Aurora facilities were eligible for an impairment charge. None of
the Company's remaining  facilities were reduced since the carrying value of the
assets were less than the undiscounted cash flows.

     During  1996,  the  Company  closed  its  Aurora   facility  and  voluntary
decertified its Toledo facility from the Medicare program due to quality of care
issues,  unfavorable  market  conditions,  the reduction in  reimbursement  from
third-party payors and competition. Accordingly, these events and circumstances,
together with the unfavorable undiscounted future cash flows, caused the Company
to perform  further  evaluations of whether the carrying  amount of these assets
were recoverable.

     After  determining  that an  impairment  charge  for  Toledo and Aurora was
appropriate,  the Company determined the estimated fair value of such facilities
using  standard  industry  valuation  techniques.  The excess  carrying value of
goodwill, buildings and improvements, leasehold improvements and equipment above
the fair value was $1,450 and is included in the  statement  of  operations  for
1996 as loss on impairment of long-lived assets.

     Prior to the adoption of SFAS 121, the Company evaluated  impairment on the
entity level. Such evaluation yielded no impairment charge.


(13) Certain Significant Risks and Uncertainties

     The Company has undergone major  restructuring  and  reorganization in 1996
resulting  in the closure or  termination  of certain  business  activities  and
acquisitions  and the  termination  of offerings of debt and equity  securities.
During the year ended  December 31, 1996 the Company  incurred a loss of $18,905
and had negative cash flow from operating  activities.  As of December 31, 1996,
the Company had a working capital  deficiency of $10,952 and was in default with
respect to certain of its debt, lease and other agreements.  These circumstances
would naturally  raise doubt about the Company's  ability to continue as a going
concern. Management's plans with respect to this matter are discussed below.


                                      F-21

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(13) Certain Significant Risks and Uncertainties - (Continued)

     In October 1996, management engaged Smith Barney, Inc. as financial adviser
to assist in evaluating debt and equity  financing  alternatives,  including the
possible sale of the Company.  Management is evaluating the  possibilities  with
respect to the interest expressed by potential acquirers, joint venture partners
and organizations which might provide an infusion of capital.  Also,  management
is pursuing a financial  restructuring  plan and, in order to obtain  sufficient
financial  resources,  the Company has accomplished the following  subsequent to
December 31, 1996:

   1. Refinanced  the  revolving  line of  credit  with its bank to  extend  the
      payment  terms  related  to $4,800 of debt due on demand at  December  31,
      1996, and issued five year warrants to purchase 1,787,568 shares of Common
      Stock (subject to reduction as payments of such debt is made) at $2.25 per
      share (subject to repayment in certain circumstances).

   2. Obtained the release of approximately  $4,000 of security deposits through
      a modification of the lease with HRPT to reduce rental payments.

   3. Obtained a settlement  agreement dated March 1, 1997 with the shareholders
      of  219,798  shares  of  common  stock  subject  to  repurchase  (the  put
      contract),  which provides that, in lieu of repurchasing  the shares,  the
      Company pay $500 and issue an 8.5% note  payable due on  September 1, 1997
      in an amount equal to $1,681 less the proceeds from the sale of the shares
      by the shareholders.

   4. Obtained  waivers of financial  covenant  violations and related  defaults
      under debt and lease agreements through February 1998.

   5. Obtained  a  guarantee   from  IHS  with  respect  to  debt   payments  of
      approximately  $4,800 and lease  payments of up to $10,000 in exchange for
      warrants which allow IHS to purchase up to 379,900 shares of the Company's
      common stock at $1.937 per share.

   6. Obtained  an  extension  on the  payment of fees  payable to IHS under the
      management agreement discussed in note 14 through April 1998 (estimated to
      be $2,200 for 1997).

     In  addition,  the  Company  continues  to  pursue  negotiations  to obtain
additional  debt or equity  capital and  anticipates  finalizing  its  financial
restructuring  plan  soon.  The  Company  believes  it has  obtained  sufficient
financing commitments for the next year. However,  other commitments will likely
be necessary to successfully  accomplish the financial restructuring plan beyond
the next year.

     The  Company  acquires  or  leases  and  operates   long-term  health  care
facilities in medically-underserved rural communities,  and uses such facilities
as platforms to develop networks offering a range of other healthcare  services.
Facilities  owned  or  leased  by the  Company  are in the  states  of  Alabama,
Colorado,  Georgia,  Iowa,  Kansas,  Louisiana,  Missouri,  Nebraska,  Texas and
Wyoming.  The  Company  and others in the  healthcare  business  are  subject to
certain inherent risks, including the following:

     o    Substantial  dependence on revenues derived from  reimbursement by the
          Federal Medicare and state Medicaid programs;

     o    Government  regulation,  government budgetary constraints and proposed
          legislative and regulatory changes; and

     o    awsuits alleging malpractice and related claims.

     Such inherent risks require the use of certain management  estimates in the
preparation of the Company's financial  statements and it is reasonably possible
that a change in such estimates may occur.


                                      F-22

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(13) Certain Significant Risks and Uncertainties - (Continued)

     The Medicare and various state Medicaid  reimbursement programs represented
20% and 50%, respectively, of the Company's revenues for the year ended December
31,  1996,  and the  Company's  operations  are  subject  to a variety  of other
Federal, state and local regulatory  requirements.  Failure to maintain required
regulatory approvals and licenses and/or changes in such regulatory requirements
could have a significant  adverse effect on the Company.  Changes in Federal and
state reimbursement funding mechanisms, related government budgetary constraints
and differences between final settlements and estimated  settlements  receivable
under  Medicare and Medicaid  retrospective  reimbursement  programs,  which are
subject to audit and retroactive adjustment as discussed in note 3, could have a
significant  adverse  effect on the Company.  Also,  the Company is from time to
time subject to malpractice and related claims and lawsuits,  which arise in the
normal  course of  business  and which  could have a  significant  effect on the
Company.  The Company believes that adequate  provision for these items has been
made in the  accompanying  consolidated  financial  statements  and  that  their
ultimate  resolution  will  not  have a  material  effect  on  the  consolidated
financial statements.

     Since its  inception,  the  Company  has grown  through  acquisitions,  and
realization of acquisition costs,  including excess costs over fair value of net
assets   acquired,   is  dependent   initially  upon  the  consummation  of  the
acquisitions  and  subsequently  upon  the  Company's  ability  to  successfully
integrate and manage  acquired  operations.  Also, the Company's  development of
integrated   healthcare  networks  is  dependent  upon  successfully   effecting
economies of scale,  the  recruitment of skilled  personnel and the expansion of
services and related  revenues.  The Company has not completed  implementing its
network strategy at any facilities, and realization of related development costs
cannot  be  assured.  Finally,  see note 12 for  certain  significant  risks and
uncertainties,  resulting in the loss on  impairment  of  investments  and other
non-recurring charges in 1996.


(14) Related Party Transactions

     On January  19,  1994,  the  Company  entered  into a  Medicare  consulting
agreement with Symphony Care Consulting,  Inc. (SCCI), a wholly-owned subsidiary
of Integrated  Health Services,  Inc., as amended on May 1, 1995. The consulting
agreement provided Medicare  reimbursement and certification  services including
training,  cost report preparation and accounting services through January 1996.
Costs paid to SCCI were $410 in 1994,  $453 in 1995,  and $148 in 1996. In 1996,
the Company paid Symphony  Rehabilitation  Services (SRS) and Symphony  Pharmacy
Services (SPS),  wholly owned  subsidiaries of IHS, $162 for therapy and $98 for
pharmacy services,  respectively.  Also, the Company paid IHS approximately $500
in 1994 and $186 in 1995 to reimburse IHS for expenses incurred on behalf of the
Company in connection with the start-up of CCA's operations,  the acquisition of
MeritWest and due diligence  service in connection with the public offering.  No
amounts were paid to IHS in 1996. Two of the Company's  directors are employees,
directors and  stockholders  of IHS. The Company  believes that the terms of the
agreement with SCCI and the amounts paid to IHS, SRS and SPS for services are on
terms as favorable as could have been obtained from unaffiliated third parties.

     Loans  receivable  from officers and directors of $425 at December 31, 1996
mature on various dates with accrued interest at 8% per annum.


                                      F-23

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(14) Related Party Transactions - (Continued)

     On December  27, 1996,  the Company and IHS entered  into a loan  agreement
which,  as amended,  entitles  the Company to borrow,  until  December 27, 1998,
amounts on a revolving  credit basis so that no more than $5,000 is outstanding.
Loan advances are subject to the consent of IHS to the making of advances, which
consent may not be unreasonably  withheld.  This revolving credit facility bears
interest at a rate per annum  equal to the annual rate of interest  set forth in
IHS's revolving  credit  agreement with Citibank,  N.A.,  plus 2%.  Repayment of
amounts advanced under this line of credit are subordinated to the payment of up
to  an  aggregate  of  $30,000  of  principal  and  interest  on  the  Company's
obligations  to HRPT and Daiwa.  As of December 31,  1996,  IHS had advanced the
Company $2,000.

     In connection with entering into the revolving credit facility, the Company
issued  warrants to purchase an  aggregate  of 752,182  shares of the  Company's
Common Stock,  one-half of which are exercisable until January 13, 1999 at $3.22
per share (the average of the high and low trading price of the Company's Common
Stock on  January  14 and 15,  1997)  and the  remaining  one-half  of which are
exercisable  until  January  13,  2002 at $6.44 per share.  The number of shares
subject to warrants and the exercise prices are subject to adjustment in certain
instances, including if the Company issues shares of Common Stock (or securities
convertible  into Common Stock) at less than the applicable  exercise  price. In
connection therewith, the Company has granted to IHS certain rights to cause the
shares  issuable  upon  exercise  of the  warrants  to be  registered  under the
Securities Act of 1933, as amended, at the Company's expense.

     On December 27, 1996, the Company entered into a Management  Agreement (the
"Management  Agreement") with Integrated Health Services,  Inc. ("IHS") pursuant
to which the  Company is  employing  IHS to  supervise,  manage and  operate the
financial,  accounting,  MIS,  reimbursement and ancillary services  contracting
functions  for the Company until  December 31, 2001.  The  Management  Agreement
provides  for the Company to pay to IHS for its  services,  until  December  31,
1997,  an amount equal to the lesser of 2% of the Company's  gross  revenues (as
defined) or the Company's  annualized  cost of performing  those services itself
based on the period July 1, 1996  through  December 31,  1996.  Thereafter,  the
management  fee payable to IHS is to be the lesser of 2% of the Company's  gross
revenues or a percentage of gross revenues determined by comparing the Company's
cost of  performing  such  functions  during  the  period  July 1, 1996  through
December  31, 1996 to its gross  revenues for that  period.  The gross  revenues
percentage which is fixed may be increased from 2.0% to 2.5% by mutual agreement
of the parties following IHS's review of the Company.


(15) Initial Public Offering

     In August 1995, the Company issued  3,450,000 shares of common stock to the
public in an initial public offering at a price of $9.50 per share. Net proceeds
after underwriting discounts and expenses of the offering were $27,589.

     The Company used the net  proceeds of the offering to, among other  things,
pay $10,800 of indebtedness to HRPT plus a prepayment  penalty of  approximately
$600  and  redeem  the  Series  A  Preferred  Stock  for  approximately  $8,167.
Concurrently  with the  completion  of the  offering,  the  Series  A  Preferred
Stockholders  purchased an aggregate of 1,331,814 shares of Common Stock through
their  exercise of warrants by applying 263 shares of Series A Preferred  Stock,
having an aggregate redemption value of $26,300, in payment of the full exercise
price of the warrants.

     As  a  result  of  the  repayment  of  certain   indebtedness  through  the
application of a portion of the proceeds from the offering and the proceeds from
a concurrent borrowing, the Company recorded an extraordinary charge to earnings
of  $1,398  related  to  prepayment  penalties  and the  write-off  of  deferred
financing costs ($992, net of income tax benefit of $406).


                                      F-24

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(16) Sandy River Transaction

     Effective  as of August 15,  1995,  the  Company  entered  into  management
agreements for ten long-term  care  facilities  (the "Sandy River  Facilities"),
obtained an option to acquire all of the entities  which own the ten  facilities
(the "Option") and agreed to make fully secured loans to such entities for up to
$3,100.  Effective as of August 15, 1996, the Company  terminated the management
agreements since the Sandy River Facilities were not generating  sufficient cash
flows to pay CCA's management fees.

     Under  the  prior  management   agreements,   the  Company's  monthly  base
management  fee was 7% of gross  revenues (as defined)  during the initial term.
Management fees were  subordinated to the prior payment of all costs,  expenses,
certain capital expenditures, lease payments and scheduled payments of principal
and  interest  on  the  indebtedness  of  the  facilities,  and  a  portion  was
subordinated  to  certain  advances  and fees of  approximately  $400 per  annum
payable to Sandy River  Development,  Inc. ("SRD"), a service company whose four
principals were also principals of certain owners of the Sandy River Facilities.
In accordance with the settlement  agreement,  unpaid  management fees of $1,086
were waived by the Company upon the  termination of the  management  agreements.
See note 12.

     The Company recorded management fee revenue of $1,136 in 1995 and $1,266 in
1996. As part of the Company's strategy to make operational  improvements at the
time it assumed the  operations of facilities  acquired or managed,  the Company
implemented  an  action  plan to  improve  the  cash  flows of the  Sandy  River
Facilities,  which included specific steps to increase patient census,  increase
Medicare  utilization (which program has a higher per diem reimbursement  rate),
maximize total third party  reimbursement  and introduce a cost savings  program
through  efficiencies and other  professional  management  techniques.  However,
despite  the  implementation  of  management's  action  plan,  the  Sandy  River
Facilities did not generate  sufficient cash flows to pay the entire  management
fee, and it became apparent in 1996 that the facilities  could not be managed on
a profitable basis.

     The Company had also loaned $2,533 under secured revolving credit notes and
term promissory notes to certain entities (the "Borrowing  Entities") which owed
indebtedness  that was  personally  guaranteed by the principals of the entities
which own the Sandy River  Facilities.  The loans were  primarily  to enable the
Borrowing  Entities  to  retire  such  indebtedness  and  thereby  release  such
principals from their personal  guaranties.  The loans to the Borrowing Entities
matured on August 10, 1996. The Company's  loans to the Borrowing  Entities bore
interest at the rate payable by the Company under the Company's revolving credit
facility  and were  secured (on a several  basis) by,  among other  assets,  the
accounts  receivable of the Sandy River  Facilities  and mortgages on certain of
the Sandy River Facilities.  Pursuant to the settlement agreement,  CCA released
the Borrowing  Entities from their  obligations as consideration for the amounts
the Company owed to the Sandy River Group as a result of the  termination of the
management agreement and related agreements.

     Under a related option agreement, the Company had the right to purchase the
entities which own the ten facilities, during the initial three year term of the
management  agreements,  and the Company  had a  nonrefundable  $5,000  purchase
option deposit,  of which $1,850 was paid through the issuance of 194,737 shares
of Common Stock valued at $9.50 per share.  In 1996, the Company  terminated the
option and wrote-off the purchase option deposit of $5,000.


                                      F-25

<PAGE>





               COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                  Years ended December 31, 1994, 1995 and 1996
         (dollars in thousands, except per share amounts)- (Continued)

(16) Sandy River Transaction - (Continued)

     The Company  granted the  holders of the  194,737  shares of Common  Stock,
issued  as  partial  payment  of the  purchase  option  deposit,  the  right  to
"piggyback" such shares on one occasion in certain registration statements filed
by the Company under the  Securities  Act. As of April 14, 1997 such shares have
not been included in certain registration  statements filed by the Company under
the  Securities  Act. In  addition,  each  holder was also  granted the right to
require the Company to  repurchase up to 25%, 25% and 50% of their shares during
the one month period  following  each of March 15, 1996,  September 15, 1996 and
March 15, 1997, respectively,  at a price equal to $9.50 per share, or if higher
and a  registration  statement  under the  Securities  Act with  respect to such
shares is not then  effective,  the market  price of the shares.  On October 27,
1996, as a result of the terminated management  agreement,  the holders of these
shares  exercised  rights under the Option agreement and required the Company to
repurchase the  aforementioned  shares for $9.50 per share. The total amount due
to holders of stock of $2,181 has been  classified as a current  liability as of
December 31, 1996. The agreement was superseded by a settlement  agreement dated
March 1, 1997. See note 13 for further information.


(17) Supplemental Cash Flow Information

     Significant  non-cash financing and investing  activities are summarized in
notes 2 and 12 and as follows:

     o    Accretion of the discount on preferred  stock  resulted in an increase
          in preferred  stock and a decrease in  additional  paid-in  capital of
          $371 in 1994 and $231 in 1995.

     o    Preferred stock dividends of $163 in 1994 were accrued but not paid.

     o    Common Stock with fair value of $150 was issued for legal  services in
          connection with acquisitions in 1994.

     o    The  realization  of deferred  tax assets  relating  to the  MeritWest
          acquisition and the corresponding reduction of the valuation allowance
          decreased the excess of cost over fair value of net assets acquired by
          $215 in 1995.

     o    The Sandy  River  transaction  resulted  in an increase in deposits of
          $1,850 which was financed by issuance of common stock in 1995.

     o    The  transfer  in 1996 of  Smith  Hospital  back to the  prior  owners
          resulted  in a non cash charge to income of $4,398  which  consists of
          the following:



<TABLE>
<S>                                            <C>
       Property, plant and equipment  ......    $  5,907
       Long term debt  .....................      (3,000)
       Deferred financing costs ............         264
       Other  ..............................       1,227
                                                --------
                                                $  4,398
                                                ========
</TABLE>

     Cash payments for interest, net of amounts capitalized, were $3,678 in 1995
and $5,008 in 1996.  Cash  payments  for income taxes were $3 in 1995 and $32 in
1996.


                                      F-26

<PAGE>






                                                                         Annex A



                       [LETTERHEAD OF SMITH BARNEY INC.]



CONFIDENTIAL


August 1, 1997



The Board of Directors
Community Care of America, Inc.
3050 North Horseshoe Drive
Naples, Florida 33942



Members of the Board:

You have  requested  our opinion as to the fairness,  from a financial  point of
view,  to the holders of the common  stock of  Community  Care of America,  Inc.
("CCA") of the  consideration  to be  received by such  holders  pursuant to the
terms and  subject  to the  conditions  set forth in the  Agreement  and Plan of
Merger,  dated as of August 1, 1997 (the "Merger  Agreement"),  among Integrated
Health Services,  Inc.  ("IHS"),  IHS Acquisition XXVI, Inc., an indirect wholly
owned subsidiary of IHS ("Sub"),  and CCA. As more fully described in the Merger
Agreement,  (i) IHS will cause Sub to commence a tender  offer to  purchase  all
outstanding shares of the common stock, par value $0.0025 per share, of CCA (the
"CCA Common Stock") at a purchase price of $4.00 per share, net to the seller in
cash (the "Tender Offer") and (ii)  subsequent to the Tender Offer,  Sub will be
merged with and into CCA (the "Merger" and,  together with the Tender Offer, the
"Transaction")  and each  outstanding  share of CCA Common Stock not  previously
tendered will be converted into the right to receive $4.00 in cash.

In  arriving  at  our  opinion,  we  reviewed  the  Merger  Agreement  and  held
discussions  with certain senior officers,  directors and other  representatives
and advisors of CCA and certain senior officers and other representatives of IHS
concerning the business,  operations  and prospects of CCA. We examined  certain
publicly available business and financial information relating to CCA as well as
certain  financial  forecasts and other  information and data for CCA which were
provided to or otherwise discussed with us by the management of CCA. We reviewed
the  financial  terms of the  Merger as set  forth in the  Merger  Agreement  in
relation  to,  among other  things:  current and  historical  market  prices and
trading volumes of CCA Common Stock;  the historical and projected  earnings and
other operating data of CCA; and the capitalization  and financial  condition of
CCA. We considered,  to the extent  publicly  available,  the financial terms of
certain  other  similar  transactions  recently  effected  which  we  considered
relevant in evaluating the Merger and analyzed certain  financial,  stock market
and other  publicly  available  information  relating to the businesses of other
companies whose operations we considered relevant in evaluating those of CCA. In
connection  with  our  engagement,  we were  requested  to  approach,  and  held
discussions with, third parties to solicit indications of interest in a possible
acquisition of or investment in CCA. In addition to the foregoing,  we conducted
such other  analyses  and  examinations  and  considered  such other  financial,
economic  and  market  criteria  as we deemed  appropriate  in  arriving  at our
opinion.

In  rendering  our  opinion,  we have  assumed and relied,  without  independent
verification,  upon the accuracy and  completeness  of all  financial  and other
information and data publicly available or furnished to or otherwise reviewed by
or discussed with us. With respect to financial  forecasts and other information
and data provided to or otherwise reviewed by or discussed with us, we have been
advised by the management of CCA that such forecasts and other  information  and
data were reasonably  prepared on bases reflecting the best currently  available
estimates  and  judgments of the  management  of CCA as to the future  financial
performance  of CCA.  We have  not  made or been  provided  with an  independent
evaluation or appraisal of the assets or  liabilities  (contingent or otherwise)
of CCA nor have we made



                                      A-1

<PAGE>






The Board of Directors
Community Care of America, Inc.
Page 2
August 1, 1997


any  physical  inspection  of the  properties  or assets of CCA.  Our opinion is
necessarily based upon information available to us, and financial,  stock market
and other conditions and  circumstances  existing and disclosed to us, as of the
date hereof.

Smith Barney has been engaged to render  financial  advisory  services to CCA in
connection  with  the  proposed  Transaction  and  will  receive  a fee for such
services,  a significant portion of which is contingent upon the consummation of
the  Transaction.  We also will receive a fee upon the delivery of this opinion.
In the ordinary course of our business, we and our affiliates may actively trade
or hold the  securities of CCA and IHS for our own account or for the account of
our customers and, accordingly, may at any time hold a long or short position in
such securities. We have in the past provided investment banking services to CCA
and IHS  unrelated  to the  proposed  Transaction,  for which  services  we have
received  compensation.  In addition, we and our affiliates (including Travelers
Group Inc. and its affiliates) may maintain relationships with CCA and IHS.

Our  advisory  services  and the opinion  expressed  herein are provided for the
information  of the Board of Directors of CCA in its  evaluation of the proposed
Transaction,  and our opinion is not  intended to be and does not  constitute  a
recommendation  to any stockholder as to whether or not such stockholder  should
tender  shares of CCA Common Stock in the Tender  Offer or how such  stockholder
should  vote  on the  proposed  Merger.  Our  opinion  may not be  published  or
otherwise used or referred to, nor shall any public reference to Smith Barney be
made,  without our prior written consent;  provided that this opinion letter may
be included in its entirety in the Solicitation/Recommendation  Statement of CCA
relating to the proposed Transaction.

Based upon and subject to the foregoing,  our experience as investment  bankers,
our work as described above and other factors we deemed relevant,  we are of the
opinion that, as of the date hereof,  the cash  consideration  to be received by
the  holders of CCA Common  Stock  (other  than IHS and its  affiliates)  in the
Transaction is fair, from a financial point of view, to such holders.


Very truly yours, 

SMITH BARNEY INC.


                                      A-2

<PAGE>






                                                                         Annex B


                          [Letterhead of Wheat, First]



August 1, 1997



CONFIDENTIAL


The Board of Directors
Community Care of America, Inc.
3050 North Horseshoe Drive, Suite 260
Naples, FL 33942



Ladies and Gentlemen:


     You have requested our opinion as to the fairness,  from a financial  point
of view, to the holders of the  outstanding  shares of Common  Stock,  par value
$0.0025  per share (the  "Shares"),  of  Community  Care of America,  Inc.  (the
"Company") of the cash  consideration to be received by such holders pursuant to
the terms and subject to the  conditions  set forth in the Agreement and Plan of
Merger  dated as of August 1, 1997 (the  "Agreement"),  by and among  Integrated
Health Services,  Inc. (the  "Acquiror"),  its  wholly-owned  subsidiary and the
Company.

     As  described  in the  Agreement,  Acquiror  will  cause  its  wholly-owned
subsidiary to commence a tender offer (the "Offer") to purchase all  outstanding
Shares at a purchase  price of $4.00 per  Share,  and  following  the Offer such
subsidiary of Acquiror will be merged with and into the Company (the "Merger").

     Wheat, First Securities,  Inc. ("Wheat"), as part of its investment banking
business,  is  regularly  engaged  in the  valuation  of  businesses  and  their
securities   in   connection   with   mergers   and   acquisitions,   negotiated
underwritings,  competitive  biddings,  secondary  distributions  of listed  and
unlisted securities, private placements and valuations for estate, corporate and
other purposes.  In the ordinary course of our business as a  broker-dealer,  we
may actively trade or hold the securities of the Company or the Acquiror for our
own account or for the account of our  customers  and,  accordingly,  may at any
time hold a long or short position in such securities.  Wheat will receive a fee
from the Company for rendering this opinion.


     In arriving at our opinion, we have, among other things:

     (1)  reviewed  the  financial  and  other  information   contained  in  the
          Company's  Annual Reports to  Shareholders  and Annual Reports on Form
          10-K for the fiscal  years ended  December  31, 1996 and  December 31,
          1995, and the Company's  Quarterly Report on Form 10-Q for the quarter
          ended March 31, 1997;

     (2)  reviewed  the  financial  and  other  information   contained  in  the
          Acquiror's  Annual Reports to Shareholders  and Annual Reports on Form
          10-K for the fiscal years ended  December 31, 1996,  December 31, 1995
          and December 31, 1994,  and the  Acquiror's  Quarterly  Report on Form
          10-Q for the quarter ended March 31, 1997;


     (3)  conducted discussions with members of senior management of the Company
          concerning its businesses, operations and prospects;


     (4)  reviewed  other  financial  information  concerning the businesses and
          operations  of  the  Company   including   certain  audited  financial
          information and certain internal  financial analyses and forecasts for
          the Company prepared by senior management of the Company;

                                      B-1


<PAGE>





     (5)  reviewed  certain  publicly  available  information  with  respect  to
          historical market prices and trading activity for the Company's Common
          Stock  and for  certain  publicly  traded  companies  which we  deemed
          relevant;

     (6)  compared  the  results  of  operations  of the  Company  with those of
          certain publicly traded companies which we deemed relevant;

     (7)  compared  the proposed  financial  terms of the  transaction  with the
          financial  terms of certain  other mergers and  acquisitions  which we
          deemed to be relevant;

     (8)  reviewed the Agreement; and

     (9)  reviewed such other financial  studies and analyses and performed such
          other  investigations  and taken into account such other matters as we
          deemed necessary.

     In rendering our opinion,  we have assumed and relied upon the accuracy and
completeness  of all  information  supplied or otherwise made available to us by
the  Company,  and we  have  not  assumed  any  responsibility  for  independent
verification of such  information or any  independent  valuation or appraisal of
any of the assets of the  Company.  We have  relied upon the  management  of the
Company  as to the  reasonableness  and  achievability  of their  financial  and
operational  forecasts and projections,  and the assumptions and bases therefor,
provided to us, and we have assumed that such forecasts and projections  reflect
the best currently available estimates and judgments of such management and that
such forecasts and  projections  will be realized in the amounts and in the time
periods currently estimated by such management. Our opinion is necessarily based
upon market, economic and other conditions as they exist and can be evaluated on
the date  hereof and the  information  made  available  to us  through  the date
hereof. We were not requested to, and did not, participate in the negotiation or
structuring of the transaction contemplated by the Agreement.

     Our advisory  services and the opinion expressed herein are provided solely
for the use of the Company's  Board of Directors in evaluating  the  transaction
contemplated  by the Agreement and are not on behalf of, and are not intended to
confer rights or remedies upon the Acquiror,  any stockholder of the Acquiror or
the Company,  or any person other than the Company's  Board of  Directors.  This
opinion may not be summarized,  excerpted from or otherwise publicly referred to
without our prior written  consent;  provided,  that this opinion  letter may be
included   in   its    entirety    in   the   Offer   to   Purchase    and   the
Solicitation/Recommendation  Statement of the Company  relating to the Offer and
the Merger.

     On the basis of, and subject to the  foregoing,  we are of the opinion that
as of the date hereof the cash  consideration  of $4.00 per Share to be received
by the holders of the Shares  (other than  Acquiror and its  affiliates)  in the
Offer and Merger is fair, from a financial point of view, to such holders.


Very truly yours,


WHEAT, FIRST SECURITIES, INC.


                                      B-2

<PAGE>





                                                                         ANNEX C




                    RIGHTS OF DISSENTING STOCKHOLDERS UNDER
                 THE DELAWARE GENERAL CORPORATION LAW ("DGCL")


         IN VIEW OF THE COMPLEXITY OF THESE PROVISIONS OF THE DGCL, ANY
          STOCKHOLDER WHO IS CONSIDERING EXERCISING DISSENTERS' RIGHTS
                    SHOULD CONSULT HIS OR HER LEGAL ADVISOR.


     STATUTORY  APPRAISAL  PROCEDURES.  The  following is a brief summary of the
statutory  procedures to be followed by a holder of Shares at the Effective Time
who does not wish to accept the per Share  cash  consideration  pursuant  to the
Merger (a  "Remaining  Stockholder")  in order to  dissent  from the  Merger and
perfect  appraisal rights under Delaware law. This summary is not intended to be
complete  and is  qualified  in the  entirety by reference to Section 262 of the
DGCL, the text of which is set forth in this Annex C. Any Remaining  Stockholder
considering  demanding appraisal is advised to consult legal counsel.  Appraisal
rights will not be available  unless and until the Merger (or a similar business
combination) is consummated.

     Remaining  Stockholders  of record who desire to exercise  their  appraisal
rights must fully satisfy all of the following conditions.  A written demand for
appraisal of Shares must be delivered to the Secretary of the Company (x) before
the taking of the vote on the approval  and adoption of the Merger  Agreement if
the Merger is not being effected as a "short-form"  merger but, rather, is being
consummated   following   approval   thereof  at  a  meeting  of  the  Company's
stockholders  (a  "long-form"  merger) or (y) within 20 days after the date that
the  Surviving  Corporation  mails to the Remaining  Stockholders  a notice (the
"Notice  of  Merger")  to the  effect  that the  Merger  is  effective  and that
appraisal  rights are  available  (and includes in such notice a copy of Section
262 of DGCL and any other  information  required thereby) if the Merger is being
effected as a  "short-form"  merger  without a vote or meeting of the  Company's
stockholders.  If the Merger is effected as a "long-form"  merger,  this written
demand for  appraisal  of Shares must be in addition  to and  separate  from any
proxy or vote abstaining from or against the approval and adoption of the Merger
Agreement,  and neither voting against,  abstaining from voting,  nor failing to
vote on the Merger  Agreement will constitute a demand for appraisal  within the
meaning of Section 262 of the DGCL.  In the case of a  "long-form"  merger,  any
stockholder seeking to demand appraisal must hold the Shares for which appraisal
is sought on the date of the making of the demand, continuously hold such Shares
through the Effective Time, and otherwise  comply with the provisions of Section
262 of the DGCL.


     In the case of both a "short-form"  and a "long-form"  merger, a demand for
appraisal  must be  executed  by or for the  stockholder  of  record,  fully and
correctly,  as such  stockholder's  name appears on the stock  certificates.  If
Shares  are owned of  record  in a  fiduciary  capacity,  such as by a  trustee,
guardian or custodian,  such demand must be executed by the fiduciary. If Shares
are owned of record by more than one person, as in a joint tenancy or tenancy in
common,  such demand must be executed by all joint owners.  An authorized agent,
including  an agent for two or more joint  owners,  may  execute  the demand for
appraisal  for a  stockholder  of record;  however,  the agent must identify the
record owner and expressly  disclose the fact that in exercising the demand,  he
is acting as agent for the record owner.



     A record owner, such as a broker, who holds Shares as a nominee for others,
may  exercise  appraisal  rights with respect to the Shares held for all or less
than all beneficial owners of Shares as to which the holder is the record owner.
In such case the written  demand must set forth the number of Shares  covered by
such demand. Where the number of Shares is not expressly stated, the demand will
be presumed to cover all Shares  outstanding  in the name of such record  owner.
Beneficial owners who are not record owners and who intend to exercise appraisal
rights  should  instruct the record owner to comply  strictly with the statutory
requirements with respect to the exercise of appraisal rights before the date of
any meeting of  stockholders  of the Company called to approve the Merger in the
case of a  "long-form"  merger and within 20 days  following  the mailing of the
Notice of Merger in the case of a "short-form" merger.


                                      C-1

<PAGE>






     Remaining  Stockholders who elect to exercise appraisal rights must mail or
deliver their written demands to:  Secretary,  Community Care of America,  Inc.,
3050 North Horseshoe Drive, Suite 260, Naples, Florida 34104. The written demand
for appraisal should specify the  stockholder's  name and mailing  address,  the
number of Shares  covered  by the  demand  and that the  stockholder  is thereby
demanding  appraisal of such Shares.  In the case of a "long-form"  merger,  the
Company must,  within ten days after the Effective  Time,  provide notice of the
Effective  Time to all  stockholders  who have  complied with Section 262 of the
DGCL and have not voted for approval and adoption of the Merger Agreement.

     In the case of a "long-form"  merger,  Remaining  Stockholders  electing to
exercise their appraisal rights under Section 262 must not vote for the approval
and adoption of the Merger  Agreement or consent  thereto in writing.  Voting in
favor of the  approval  and adoption of the Merger  Agreement,  or  delivering a
proxy in connection with the stockholders'  meeting called to approve the Merger
Agreement (unless the proxy votes against,  or expressly  abstains from the vote
on, the approval and adoption of the Merger Agreement), will constitute a waiver
of the stockholder's  right of appraisal and will nullify any written demand for
appraisal submitted by the stockholder.

     Regardless of whether the Merger is effected as a  "long-form"  merger or a
"short-form"  merger,  within  120 days  after the  Effective  Time,  either the
Company or any  stockholder  who has complied  with the required  conditions  of
Section  262 and who is  otherwise  entitled  to  appraisal  rights  may  file a
petition in the Delaware Court of Chancery demanding a determination of the fair
value  of the  Shares  of the  dissenting  stockholders.  If a  petition  for an
appraisal is timely filed, after a hearing on such petition,  the Delaware Court
of Chancery will determine which  stockholders  are entitled to appraisal rights
and thereafter will appraise the Shares owned by such stockholders,  determining
the fair value of such Shares,  exclusive  of any element of value  arising from
the  accomplishment  or expectation of the Merger,  together with a fair rate of
interest to be paid, if any, upon the amount determined to be the fair value.

     The cost of the  appraisal  proceeding  may be  determined  by the Delaware
Court of Chancery and taxed upon the parties as the  Delaware  Court of Chancery
deems  equitable  in  the  circumstances.   Upon  application  of  a  dissenting
stockholder,  the Delaware  Court of Chancery may order that all or a portion of
the expenses  incurred by any  dissenting  stockholder  in  connection  with the
appraisal proceeding,  including, without limitation, reasonable attorneys' fees
and the fees and  expenses of experts,  be charged pro rata against the value of
all Shares  entitled  to  appraisal.  In the  absence of such  determination  or
assessment, each party shall bear its own expenses.


     Any Remaining  Stockholder  who has duly  demanded  appraisal in compliance
with Section 262 of the DGCL will not, after the Effective  Time, be entitled to
vote for any purpose the Shares subject to such demand or to receive  payment of
dividends or other  distributions on such Shares,  except for dividends or other
distributions payable to stockholders of record at a date prior to the Effective
Time.



     Any time  within 60 days after the  Effective  Time,  any former  holder of
Shares shall have the right to withdraw his or her demand for  appraisal  and to
accept the per Share  cash  consideration  pursuant  to the  Merger.  After this
period,  such holder may withdraw his or her demand for appraisal  only with the
consent of the Surviving Corporation. If no petition for appraisal is filed with
the Delaware  Court of Chancery  within 120 days after the Effective  Time,  the
stockholders'  rights to  appraisal  shall cease and all  stockholders  shall be
entitled to receive the per Share cash consideration pursuant to the Merger.

     Failure  to take any  required  step in  connection  with the  exercise  of
appraisal rights may result in the termination or waiver of such rights.

     APPRAISAL  RIGHTS  CANNOT BE EXERCISED AT THIS TIME.  THE  INFORMATION  SET
FORTH ABOVE IS FOR  INFORMATIONAL  PURPOSES  ONLY WITH  RESPECT TO  ALTERNATIVES
AVAILABLE TO STOCKHOLDERS IF THE MERGER (OR ANY SIMILAR BUSINESS COMBINATION) IS
CONSUMMATED. STOCKHOLDERS WHO WILL BE ENTITLED TO APPRAISAL RIGHTS IN CONNECTION
WITH THE MERGER WILL RECEIVE ADDITIONAL  INFORMATION CONCERNING APPRAISAL RIGHTS
AND  THE  PROCEDURES  TO  BE  FOLLOWED  IN  CONNECTION   THEREWITH  BEFORE  SUCH
STOCKHOLDERS HAVE TO TAKE ANY ACTION RELATING THERETO.


                                      C-2

<PAGE>





     STOCKHOLDERS WHO SELL SHARES IN THE OFFER WILL NOT BE ENTITLED TO EXERCISE
APPRAISAL RIGHTS WITH RESPECT THERETO BUT, RATHER, WILL RECEIVE THE PRICE PAID
IN THE OFFER THEREFOR.



                            GENERAL CORPORATION LAW
                           OF THE STATE OF DELAWARE


\s262. APPRAISAL RIGHTS.

     (a) Any  stockholder  of a  corporation  of this State who holds  shares of
stock on the date of the making of a demand  pursuant to subsection  (d) of this
section with respect to such shares,  who continuously holds such shares through
the effective date of the merger or  consolidation,  who has otherwise  complied
with  subsection  (d) of this section and who has neither  voted in favor of the
merger or  consolidation  nor consented  thereto in writing pursuant to \s228 of
this title  shall be entitled  to an  appraisal  by the Court of Chancery of the
fair  value  of the  stockholder's  shares  of  stock  under  the  circumstances
described in subsections  (b) and (c) of this section.  As used in this section,
the word "stockholder"  means a holder of record of stock in a stock corporation
and also a member of record of a nonstock  corporation;  the words  "stock"  and
"share"  mean and  include  what is  ordinarily  meant by those  words  and also
membership or membership interest of a member of a nonstock corporation; and the
words  "depository  receipt"  mean a  receipt  or other  instrument  issued by a
depository representing an interest in one or more shares, or fractions thereof,
solely of stock of a corporation, which stock is deposited with the depository.


     (b)  Appraisal  rights  shall be  available  for the shares of any class or
series of stock of a constituent  corporation in a merger or consolidation to be
effected pursuant to \s251 (other than a merger effected pursuant to \s251(g) of
this title), \s252, \s254, \s257, \s258, \s263 or \s264 of this title:


       (1) Provided,  however, that no appraisal rights under this section shall
    be available for the shares of any class or series of stock, which stock, or
    depository  receipts  in  respect  thereof,  at the  record  date  fixed  to
    determine the stockholders  entitled to receive notice of and to vote at the
    meeting  of   stockholders   to  act  upon  the   agreement   of  merger  or
    consolidation,  were either (i) listed on a national  securities exchange or
    designated as a national market system security on an interdealer  quotation
    system by the National Association of Securities Dealers,  Inc. or (ii) held
    of record by more than 2,000 holders; and further provided that no appraisal
    rights  shall be  available  for any  shares  of  stock  of the  constituent
    corporation  surviving  a  merger  if the  merger  did not  require  for its
    approval  the  vote of the  stockholders  of the  surviving  corporation  as
    provided in subsection (f) of \s251 of this title.

       (2)  Notwithstanding  paragraph (1) of this subsection,  appraisal rights
    under this section  shall be available for the shares of any class or series
    of stock of a constituent corporation if the holders thereof are required by
    the terms of an  agreement of merger or  consolidation  pursuant to \s\s251,
    252,  254,  257,  258,  263 and 264 of this  title to accept  for such stock
    anything except:


          a. Shares of stock of the corporation surviving or resulting from
       such merger or consolidation, or depository receipts in respect thereof;




          b. Shares of stock of any other corporation, or depository receipts in
       respect  thereof,  which  shares of stock or  depository  receipts at the
       effective date of the merger or consolidation  will be either listed on a
       national  securities  exchange or designated as a national  market system
       security on an interdealer  quotation system by the National  Association
       of Securities Dealers, Inc. or held of record by more than 2,000 holders;

          c. Cash in lieu of fractional shares or fractional depository
       receipts described in the foregoing subparagraphs a. and b. of this
       paragraph; or



          d. Any combination of the shares of stock, depository receipts and
       cash in lieu of fractional shares or fractional depository receipts
       described in the foregoing subparagraphs a., b. and c. of this
       paragraph.


                                      C-3

<PAGE>







          (3) In the event all of the stock of a subsidiary Delaware corporation
        party to a merger effected under \s253 of this title is not owned by the
        parent  corporation  immediately  prior to the merger,  appraisal rights
        shall  be  available   for  the  shares  of  the   subsidiary   Delaware
        corporation.

     (c) Any corporation may provide in its  certificate of  incorporation  that
appraisal  rights  under this section  shall be available  for the shares of any
class or series of its stock as a result of an amendment to its  certificate  of
incorporation,  any  merger  or  consolidation  in which  the  corporation  is a
constituent corporation or the sale of all or substantially all of the assets of
the corporation.  If the certificate of incorporation contains such a provision,
the procedures of this section, including those set forth in subsections (d) and
(e) of this section, shall apply as nearly as is practicable.

     (d) Appraisal rights shall be perfected as follows:


       (1) If a proposed merger or consolidation  for which appraisal rights are
    provided  under this section is to be submitted for approval at a meeting of
    stockholders,  the corporation,  not less than 20 days prior to the meeting,
    shall  notify each of its  stockholders  who was such on the record date for
    such meeting with respect to shares for which appraisal rights are available
    pursuant to subsection (b) or (c) hereof that appraisal rights are available
    for any or all of the  shares  of the  constituent  corporations,  and shall
    include in such notice a copy of this section.  Each stockholder electing to
    demand the appraisal of his shares shall deliver to the corporation,  before
    the taking of the vote on the merger or consolidation,  a written demand for
    appraisal of his shares.  Such demand will be  sufficient  if it  reasonably
    informs the  corporation  of the  identity of the  stockholder  and that the
    stockholder  intends thereby to demand the appraisal of his shares.  A proxy
    or vote  against the merger or  consolidation  shall not  constitute  such a
    demand. A stockholder  electing to take such action must do so by a separate
    written demand as herein  provided.  Within 10 days after the effective date
    of such merger or  consolidation,  the  surviving or  resulting  corporation
    shall  notify  each  stockholder  of each  constituent  corporation  who has
    complied with this  subsection and has not voted in favor of or consented to
    the merger or consolidation of the date that the merger or consolidation has
    become effective; or

       (2) If the merger or  consolidation  was  approved  pursuant  to \s228 or
    \s253  of this  title,  each  constituent  corporation,  either  before  the
    effective date of the merger or consolidation or within ten days thereafter,
    shall  notify  each of the  holders  of any class or series of stock of such
    constituent corporation who are entitled to appraisal rights of the approval
    of the merger or  consolidation  and that appraisal rights are available for
    any or all  shares  of such  class or  series  of stock of such  constituent
    corporation,  and  shall  include  in such  notice  a copy of this  section;
    provided  that, if the notice is given on or after the effective date of the
    merger or  consolidation,  such notice  shall be given by the  surviving  or
    resulting corporation to all such holders of any class or series of stock of
    a constituent corporation that are entitled to appraisal rights. Such notice
    may,  and,  if  given  on or  after  the  effective  date of the  merger  or
    consolidation, shall, also notify such stockholders of the effective date of
    the merger or  consolidation.  Any stockholder  entitled to appraisal rights
    may,  within 20 days  after the date of mailing  of such  notice,  demand in
    writing from the  surviving or resulting  corporation  the appraisal of such
    holder's shares. Such demand will be sufficient if it reasonably informs the
    corporation  of the  identity of the  stockholder  and that the  stockholder
    intends  thereby to demand the  appraisal of such holder's  shares.  If such
    notice did not notify  stockholders  of the effective  date of the merger or
    consolidation,  either (i) each such  constituent  corporation  shall send a
    second  notice  before the  effective  date of the  merger or  consolidation
    notifying  each of the  holders  of any  class  or  series  of stock of such
    constituent  corporation  that  are  entitled  to  appraisal  rights  of the
    effective  date of the  merger or  consolidation  or (ii) the  surviving  or
    resulting corporation shall send such a second notice to all such holders on
    or within 10 days after such effective date; provided, however, that if such
    second  notice is sent more than 20 days  following the sending of the first
    notice,  such  second  notice need only be sent to each  stockholder  who is
    entitled to appraisal rights and who has demanded appraisal of such holder's
    shares in accordance with this subsection.  An affidavit of the secretary or
    assistant  secretary or of the  transfer  agent of the  corporation  that is
    required to give either notice that such notice has been given shall,



                                      C-4

<PAGE>






   in the absence of fraud, be prima facie evidence of the facts stated therein.
   For  purposes of  determining  the  stockholders  entitled to receive  either
   notice, each constituent  corporation may fix, in advance, a record date that
   shall  be not more  than 10 days  prior to the  date  the  notice  is  given,
   provided,  that if the notice is given on or after the effective  date of the
   merger or consolidation,  the record date shall be such effective date. If no
   record date is fixed and the notice is given prior to the effective date, the
   record date shall be the close of business on the day next  preceding the day
   on which the notice is given.


     (e)  Within  120  days   after  the   effective   date  of  the  merger  or
consolidation, the surviving or resulting corporation or any stockholder who has
complied with  subsections  (a) and (d) hereof and who is otherwise  entitled to
appraisal  rights,  may file a petition  in the Court of  Chancery  demanding  a
determination   of  the   value  of  the   stock   of  all  such   stockholders.
Notwithstanding  the  foregoing,  at any time within 60 days after the effective
date of the merger or  consolidation,  any  stockholder  shall have the right to
withdraw  his demand for  appraisal  and to accept  the terms  offered  upon the
merger or consolidation.  Within 120 days after the effective date of the merger
or  consolidation,  any  stockholder  who has complied with the  requirements of
subsections  (a) and (d)  hereof,  upon  written  request,  shall be entitled to
receive  from  the  corporation  surviving  the  merger  or  resulting  from the
consolidation a statement setting forth the aggregate number of shares not voted
in favor of the merger or  consolidation  and with respect to which  demands for
appraisal have been received and the aggregate number of holders of such shares.
Such written  statement shall be mailed to the stockholder  within 10 days after
his  written  request  for such a statement  is  received  by the  surviving  or
resulting  corporation  or within 10 days  after  expiration  of the  period for
delivery of demands for  appraisal  under  subsection  (d) hereof,  whichever is
later.


     (f) Upon the filing of any such  petition  by a  stockholder,  service of a
copy thereof  shall be made upon the surviving or resulting  corporation,  which
shall  within 20 days after such  service  file in the office of the Register in
Chancery in which the petition was filed a duly  verified  list  containing  the
names and  addresses of all  stockholders  who have  demanded  payment for their
shares and with whom  agreements  as to the value of their  shares have not been
reached by the  surviving or  resulting  corporation.  If the petition  shall be
filed  by  the  surviving  or  resulting  corporation,  the  petition  shall  be
accompanied  by such a duly  verified  list.  The  Register in  Chancery,  if so
ordered by the  Court,  shall  give  notice of the time and place  fixed for the
hearing of such  petition by  registered  or certified  mail to the surviving or
resulting corporation and to the stockholders shown on the list at the addresses
therein  stated.  Such notice shall also be given by 1 or more  publications  at
least  1  week  before  the  day of  the  hearing,  in a  newspaper  of  general
circulation published in the City of Wilmington, Delaware or such publication as
the Court deems  advisable.  The forms of the notices by mail and by publication
shall be  approved  by the Court,  and the costs  thereof  shall be borne by the
surviving or resulting corporation.

     (g) At the  hearing  on  such  petition,  the  Court  shall  determine  the
stockholders who have complied with this section and who have become entitled to
appraisal  rights.  The Court may require the  stockholders who have demanded an
appraisal for their shares and who hold stock  represented  by  certificates  to
submit  their  certificates  of stock to the  Register in Chancery  for notation
thereon of the pendency of the  appraisal  proceedings;  and if any  stockholder
fails to comply with such direction, the Court may dismiss the proceedings as to
such stockholder.

     (h) After determining the stockholders entitled to an appraisal,  the Court
shall appraise the shares, determining their fair value exclusive of any element
of value  arising  from the  accomplishment  or  expectation  of the  merger  or
consolidation,  together  with a fair rate of interest,  if any, to be paid upon
the amount  determined to be the fair value. In determining such fair value, the
Court shall take into account all relevant factors. In determining the fair rate
of interest, the Court may consider all relevant factors,  including the rate of
interest which the surviving or resulting  corporation  would have had to pay to
borrow money  during the pendency of the  proceeding.  Upon  application  by the
surviving or resulting corporation or by any stockholder entitled to participate
in the appraisal proceeding, the Court may, in its discretion,  permit discovery
or other pretrial  proceedings and may proceed to trial upon the appraisal prior
to the final  determination  of the  stockholder  entitled to an appraisal.  Any
stockholder  whose name appears on the list filed by the  surviving or resulting
corporation pursuant to subsection (f) of this



                                      C-5

<PAGE>






section  and who has  submitted  his  certificates  of stock to the  Register in
Chancery, if such is required, may participate fully in all proceedings until it
is finally  determined  that he is not entitled to  appraisal  rights under this
section.

     (i) The Court  shall  direct the  payment of the fair value of the  shares,
together with interest, if any, by the surviving or resulting corporation to the
stockholders entitled thereto.  Interest may be simple or compound, as the Court
may direct.  Payment shall be so made to each such  stockholder,  in the case of
holders of  uncertificated  stock  forthwith,  and the case of holders of shares
represented  by  certificates  upon  the  surrender  to the  corporation  of the
certificates  representing  such stock.  The  Court's  decree may be enforced as
other decrees in the Court of Chancery may be enforced,  whether such  surviving
or resulting corporation be a corporation of this State or of any state.

     (j) The costs of the  proceeding  may be  determined by the Court and taxed
upon the  parties  as the  Court  deems  equitable  in the  circumstances.  Upon
application  of a  stockholder,  the Court  may  order  all or a portion  of the
expenses   incurred  by  any   stockholder  in  connection  with  the  appraisal
proceeding,  including,  without limitation,  reasonable attorneys' fees and the
fees and  expenses of experts,  to be charged pro rata  against the value of all
the shares entitled to an appraisal.

     (k) From and after the effective  date of the merger or  consolidation,  no
stockholder who has demanded his appraisal  rights as provided in subsection (d)
of this  section  shall be  entitled  to vote such  stock for any  purpose or to
receive  payment  of  dividends  or other  distributions  on the  stock  (except
dividends or other  distributions  payable to  stockholders  of record at a date
which is prior to the effective date of the merger or consolidation);  provided,
however,  that if no petition  for an  appraisal  shall be filed within the time
provided in subsection (e) of this section, or if such stockholder shall deliver
to the surviving or resulting corporation a written withdrawal of his demand for
an appraisal and an acceptance of the merger or consolidation,  either within 60
days after the  effective  date of the merger or  consolidation  as  provided in
subsection  (e) of this section or thereafter  with the written  approval of the
corporation,  then the right of such  stockholder  to an appraisal  shall cease.
Notwithstanding the foregoing,  no appraisal proceeding in the Court of Chancery
shall be dismissed as to any stockholder  without the approval of the Court, and
such approval may be conditioned upon such terms as the Court deems just.

     (l) The  shares of the  surviving  or  resulting  corporation  to which the
shares  of such  objecting  stockholders  would  have  been  converted  had they
assented to the merger or consolidation  shall have the status of authorized and
unissued shares of the surviving or resulting corporation.



                                      C-6


                            LETTER OF TRANSMITTAL
                       TO TENDER SHARES OF COMMON STOCK
                                      OF
                       COMMUNITY CARE OF AMERICA, INC.
                      PURSUANT TO THE OFFER TO PURCHASE
                             DATED AUGUST 7, 1997
                                      BY

                          IHS ACQUISITION XXVI, INC.
                         A WHOLLY OWNED SUBSIDIARY OF
                       INTEGRATED HEALTH SERVICES, INC.

THE OFFER AND WITHDRAWAL RIGHTS WILL EXPIRE AT 12:00 MIDNIGHT, NEW YORK CITY
TIME, ON THURSDAY, SEPTEMBER 4, 1997, UNLESS THE OFFER IS EXTENDED (SUCH
          DATE, AS THE SAME MAY BE EXTENDED, THE "EXPIRATION DATE").

                       THE DEPOSITARY FOR THE OFFER IS:
                                CITIBANK, N.A.


<TABLE>
<CAPTION>
<S>                                    <C>                                    <C>                           
              By Mail:                    By Overnight Courier Delivery:               By Hand:
           Citibank, N.A.                         Citibank, N.A.                    Citibank, N.A.
c/o Citicorp Data Distribution, Inc.   c/o Citicorp Data Distribution, Inc.     Corporate Trust Window
           P.O. Box 7072                         404 Sette Drive              111 Wall Street, 5th Floor
     Paramus, New Jersey 07653              Paramus, New Jersey 07653          New York, New York 10043
                                       Facsimile for Eligible Institutions:
                                                  (201) 262-3240
                                           Facsimile Confirmation Only:
                                                  (800) 422-2077

</TABLE>


     DELIVERY  OF THIS  LETTER OF  TRANSMITTAL  TO AN ADDRESS  OTHER THAN AS SET
FORTH ABOVE, OR TRANSMISSION OF INSTRUCTIONS  VIA A FACSIMILE  NUMBER OTHER THAN
AS SET FORTH ABOVE,  WILL NOT  CONSTITUTE A VALID  DELIVERY.  YOU MUST SIGN THIS
LETTER OF TRANSMITTAL WHERE INDICATED BELOW AND COMPLETE THE SUBSTITUTE FORM W-9
PROVIDED BELOW.

     THE  INSTRUCTIONS  ACCOMPANYING  THIS LETTER OF TRANSMITTAL  SHOULD BE READ
CAREFULLY BEFORE THIS LETTER OF TRANSMITTAL IS COMPLETED.

     This Letter of Transmittal is to be completed by  stockholders of Community
Care of America,  Inc., either if certificates for Shares (as defined below) are
to be forwarded  herewith or, unless an Agent's Message (as defined in the Offer
to  Purchase)  is  utilized,  if tenders of Shares are to be made by  book-entry
transfer into the account of Citibank,  N.A., as Depositary (the  "Depositary"),
at the Depository  Trust Company ("DTC") or the  Philadelphia  Depository  Trust
Company  ("PDTC") (each a "Book-Entry  Transfer  Facility" and  collectively the
"Book-Entry  Transfer  Facilities")  pursuant to the  procedures set forth under
"THE OFFER--Procedure for Accepting the Offer and Tendering Shares" in the Offer
to Purchase (as defined  below).  Stockholders  who tender  Shares by book-entry
transfer  are  referred  to herein as  "Book-Entry  Stockholders."  DELIVERY  OF
DOCUMENTS TO A BOOK-ENTRY  TRANSFER FACILITY DOES NOT CONSTITUTE DELIVERY TO THE
DEPOSITARY.

     Holders of Shares whose  certificates  for such Shares are not  immediately
available or who cannot deliver such Share  certificates  and all other required
documents to the Depositary prior to the Expiration Date, or who cannot complete
the  procedure  for  book-entry  transfer on a timely  basis,  must tender their
Shares according to the guaranteed delivery procedure set forth under "THE OFFER
- --  Procedure  for  Accepting  the Offer and  Tendering  Shares" in the Offer to
Purchase. See Instruction 2.


<PAGE>
<TABLE>
<CAPTION>

                         DESCRIPTION OF SHARES TENDERED
- --------------------------------------------------------------------------------------------------
   Name(s) and Address(es) of Registered
Holder(s) (Please fill in, if blank, exactly as   Share Certificate(s) and Share(s) Tendered
    name(s) appear(s) on certificate(s))          (Attach additional schedule, if necessary)
- --------------------------------------------------------------------------------------------------
                                                                 Total Number
                                                 Share           of Shares          Number of
                                                 Certificate     Represented By     Shares
                                                 Number(s)*      Certificate(s)*    Tendered**
- --------------------------------------------------------------------------------------------------
<S>                                              <C>

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


- --------------------------------------------------------------------------------------------------
                                                 Total Shares:
                                                 -------------------------------------------------
</TABLE>
- ----------

*    Need not be completed by Book-Entry Stockholders.

**   Unless  otherwise   indicated,   all  Shares  represented  by  certificates
     delivered  to the  Depositary  will be deemed to have  been  tendered.  See
     Instruction 4.

[ ]  CHECK HERE IF SHARES ARE BEING  TENDERED BY BOOK-ENTRY  TRANSFER MADE TO AN
     ACCOUNT  MAINTAINED BY THE DEPOSITARY WITH A BOOK-ENTRY  TRANSFER  FACILITY
     AND COMPLETE THE  FOLLOWING  (ONLY  PARTICIPANTS  IN A BOOK-ENTRY  TRANSFER
     FACILITY MAY DELIVER SHARES BY BOOK-ENTRY TRANSFER):

     Name of Tendering Institution

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

     Check box of Book-Entry  Transfer  Facility and provide  Account Number and
     Transaction Code Number:

     [ ]  The Depository Trust Company

     [ ]  The Philadelphia Depository Trust Company

     Account Number                     Transaction Code Number
                    -------------------                         ----------------

[ ]  CHECK HERE IF SHARES ARE BEING TENDERED  PURSUANT TO A NOTICE OF GUARANTEED
     DELIVERY PREVIOUSLY SENT TO THE DEPOSITARY AND COMPLETE THE FOLLOWING:

     Name(s) of Record Holder(s):

     ---------------------------------------------------------------------------
     Window Ticket Number (if any):
                                   ---------------------------------------------

     Date of Execution of Notice of Guaranteed Delivery:
                                                        ------------------------

     Name of Institution that Guaranteed Delivery:
                                                  ------------------------------


     If delivered  by  Book-Entry  Transfer,  check box of  Book-Entry  Transfer
     Facility and provide Account Number and Transaction Code Number:

     [ ]  The Depository Trust Company

     [ ]  The Philadelphia Depository Trust Company

     Account Number                     Transaction Code Number
                    -------------------                         ----------------


                                        2

<PAGE>

                     NOTE: SIGNATURE MUST BE PROVIDED BELOW
               PLEASE READ THE ACCOMPANYING INSTRUCTIONS CAREFULLY

Ladies and Gentlemen:


     The undersigned  hereby tenders to IHS Acquisition  XXVI,  Inc., a Delaware
corporation (the "Purchaser") and a wholly owned subsidiary of Integrated Health
Services,  Inc., a Delaware  corporation  (the  "Parent"),  the  above-described
shares of Common Stock, par value $.0025 per share (the "Shares"),  of Community
Care of America,  Inc., a Delaware  corporation (the  "Company"),  at a purchase
price of $4.00 per Share, net to the seller in cash,  without interest  thereon,
upon the terms and subject to the  conditions set forth in the Offer to Purchase
dated  August 7, 1997 (the  "Offer  to  Purchase"),  receipt  of which is hereby
acknowledged,  and in this Letter of Transmittal (which together  constitute the
"Offer").  The undersigned  understands that the Purchaser reserves the right to
transfer or assign, in whole or from time to time in part, to one or more of its
affiliates,  the right to  purchase  all or any  portion of the Shares  tendered
pursuant to the Offer.

     Subject  to,  and  effective  upon,  acceptance  for  payment of the Shares
tendered  herewith in accordance  with the terms of the Offer,  the  undersigned
hereby sells,  assigns and transfers to, or upon the order of, the Purchaser all
right,  title and  interest in and to all of the Shares that are being  tendered
hereby and any and all dividends, distributions (including additional Shares) or
rights declared,  paid or issued with respect to the tendered Shares on or after
the date hereof and payable or  distributable to the undersigned on a date prior
to the  transfer to the name of the  Purchaser or nominee or  transferee  of the
Purchaser  on the  Company's  stock  transfer  records  of the  Shares  tendered
herewith (collectively, a "Distribution"),  and appoints the Depositary the true
and lawful agent and  attorney-in-fact  of the undersigned  with respect to such
Shares (and any  Distribution)  with full power of  substitution  (such power of
attorney  being deemed to be an  irrevocable  power coupled with an interest) to
(a) deliver  certificates  representing  such Shares (and any  Distribution)  or
transfer  ownership of such Shares (and any  Distribution)  on the account books
maintained  by a  Book-Entry  Transfer  Facility,  together  in either case with
appropriate  evidences of transfer and  authenticity,  to the Depositary for the
account of the  Purchaser,  (b) present such Shares (and any  Distribution)  for
transfer on the books of the Company and (c) receive all benefits and  otherwise
exercise   all  rights  of   beneficial   ownership  of  such  Shares  (and  any
Distribution), all in accordance with the terms and subject to the conditions of
the Offer.

     The  undersigned  irrevocably  appoints  designees of the Purchaser as such
stockholder's  attorney-in-fact  and proxy, with full power of substitution,  to
the full extent of such stockholder's rights with respect to the Shares tendered
by such  stockholder  and accepted for payment by the Purchaser and with respect
to any and all other Shares or other securities issued or issuable in respect of
such Shares on or after the date  hereof.  Such  appointment  will be  effective
when,  and only to the  extent  that,  the  Purchaser  accepts  such  Shares for
payment.  Upon such  acceptance  for  payment,  all prior powers of attorney and
proxies  given by such  stockholder  with respect to such Shares (and such other
Shares and securities) will be revoked without further action, and no subsequent
powers of attorney and proxies may be given nor any subsequent  written consents
executed  (and,  if  given  or  executed,  will not be  deemed  effective).  The
designees  of the  Purchaser  will,  with  respect to the Shares (and such other
Shares and securities) for which such appointment is effective,  be empowered to
exercise all voting and other rights of such  stockholder  as they in their sole
discretion  may deem  proper at any annual or special  meeting of the  Company's
stockholders or any adjournment or postponement  thereof,  by written consent in
lieu of any such  meeting or  otherwise.  The  Purchaser  reserves  the right to
require that,  in order for Shares to be deemed  validly  tendered,  immediately
upon the  Purchaser's  payment  for such  Shares the  Purchaser  must be able to
exercise full voting  rights,  including  rights in respect of acting by written
consent, with respect to such Shares.

     The undersigned hereby represents and warrants that (a) the undersigned has
full power and  authority to tender,  sell,  assign and transfer the Shares (and
any  Distribution)  tendered  hereby and (b) when the Shares  are  accepted  for
payment by the  Purchaser,  the  Purchaser  will acquire  good,  marketable  and
unencumbered title to the Shares (and any  Distribution),  free and clear of all
liens, restrictions,  charges and encumbrances, and the same will not be subject
to any adverse claim. The undersigned,


                                        3

<PAGE>

upon request,  will execute and deliver any additional  documents  deemed by the
Depositary  or the  Purchaser to be necessary or desirable to complete the sale,
assignment and transfer of the Shares tendered hereby (and any Distribution). In
addition,  the  undersigned  shall promptly remit and transfer to the Depositary
for the account of the Purchaser any and all  Distributions in respect of Shares
tendered  hereby,  accompanied by  appropriate  documentation  of transfer,  and
pending such remittance or appropriate assurance thereof, the Purchaser will be,
subject to applicable law, entitled to all rights and privileges as owner of any
such  Distribution and may withhold the entire purchase price or deduct from the
purchase  price the amount or value  thereof,  as determined by the Purchaser in
its sole discretion.

     All  authority  herein  conferred  or agreed to be  conferred  shall not be
affected by and shall survive the death or incapacity of the undersigned and any
obligation  of the  undersigned  hereunder  shall be  binding  upon  the  heirs,
personal representatives, successors and assigns of the undersigned.

     Tenders of Shares made pursuant to the Offer are  irrevocable,  except that
Shares tendered  pursuant to the Offer may be withdrawn at any time prior to the
Expiration  Date and, unless  theretofore  accepted for payment by the Purchaser
pursuant to the Offer,  may also be withdrawn at any time after October 6, 1997.
See "THE OFFER--Withdrawal Rights" in the Offer to Purchase.

     The undersigned  understands  that tenders of Shares pursuant to any of the
procedures  described in the Offer to Purchase under "THE  OFFER--Procedure  for
Accepting the Offer and Tendering  Shares" and in the  instructions  hereto will
constitute a binding  agreement  between the  undersigned and the Purchaser upon
the terms and subject to the  conditions  set forth in the Offer,  including the
undersigned's   representation  that  the  undersigned  owns  the  Shares  being
tendered.

     Unless otherwise  indicated  herein under "Special  Payment  Instructions,"
please  issue  the check  for the  purchase  price  and/or  issue or return  any
certificate(s)  for Shares  not  tendered  or not  accepted  for  payment in the
name(s)  of  the  record  holder(s)   appearing  under  "Description  of  Shares
Tendered." Similarly,  unless otherwise indicated herein under "Special Delivery
Instructions,"  please  mail  the  check  for  the  purchase  price  and/or  any
certificate(s)  for  Shares  not  tendered  or not  accepted  for  payment  (and
accompanying  documents,  as  appropriate)  to the  address(es)  of  the  record
holder(s)  appearing under  "Description of Shares  Tendered." In the event that
both the Special Delivery  Instructions and the Special Payment Instructions are
completed,   please  issue  the  check  for  the   purchase   price  and/or  any
certificate(s)  for Shares not  tendered or accepted for payment in the name of,
and deliver  such check  and/or such  certificates  to, the person or persons so
indicated.   Unless   otherwise   indicated   herein  under   "Special   Payment
Instructions," please credit any Shares tendered herewith by book-entry transfer
that are not  accepted for payment by  crediting  the account at the  Book-Entry
Transfer  Facility  designated  above.  The  undersigned   recognizes  that  the
Purchaser has no obligation,  pursuant to the Special Payment  Instructions,  to
transfer  any Shares  from the  name(s) of the record  holder(s)  thereof if the
Purchaser does not accept for payment any of the Shares so tendered.

     All  capitalized  terms used herein and not defined  herein  shall have the
meanings ascribed to them in the Offer to Purchase.

                                4


<PAGE>



<TABLE>
<S>                                     <C>
   SPECIAL PAYMENT INSTRUCTIONS (SEE       SPECIAL DELIVERY INSTRUCTIONS (SEE   
      INSTRUCTIONS 1, 5, 6 AND 7)            INSTRUCTIONS 1, 4, 5, 6 AND 7)     
                                                                                
To be completed ONLY if  certificate(s)  To be completed ONLY if  certificate(s)
for Shares not tendered or not accepted  for Shares not tendered or not accepted
for  payment  and/or  the check for the  for  payment  and/or  the check for the
purchase  price of Shares  accepted for  purchase  price of Shares  accepted for
payment are to be issued in the name of  payment are to be sent to someone other
someone other than the  undersigned  or  than   the   undersigned   or  to   the
if  Shares   tendered   by   book-entry  undersigned  at an  address  other than
transfer  which  are not  accepted  for  that shown above.                      
payment are to be returned by credit to                                         
an account  maintained  at a Book-Entry  Mail: [ ] check [ ] certificates to:   
Transfer   Facility   other   than  the                                         
account indicated above.                 Name___________________________________
                                                                  (Please Print)
Issue: [ ] check [ ] certificates to:                                           
                                         Address________________________________
Name___________________________________                                         
                         (Please Print)  _______________________________________
                                                              (Include Zip Code)
Address________________________________                                         
                                         _______________________________________
_______________________________________      (TAX ID OR SOCIAL SECURITY NO.)    
                     (Include Zip Code)                                         
                                                                                
_______________________________________                                         
    (TAX ID OR SOCIAL SECURITY NO.)                                             
  (ALSO COMPLETE SUBSTITUTE FORM W-9)                                           
                                                (SEE SUBSTITUTE FORM W-9)       
[ ]   Credit    Shares    tendered   by                                         
book-entry   transfer   that   are  not  
accepted for payment to (check one):

        [ ] DTC         [ ] PDTC

_______________________________________
       (DTC OR PDTC Account No.)

</TABLE>

                                5

<PAGE>



________________________________________________________________________________
                                    SIGN HERE
                       (AND COMPLETE SUBSTITUTE FORM W-9)
________________________________________________________________________________


________________________________________________________________________________

                         (Signature(s) of Holder(s))


Dated:______________________________, 1997


(Must be signed by record holder(s) exactly as name(s) appear(s) on certificates
representing  the  Shares or on a  security  position  listing  or by  person(s)
authorized  to  become  registered   holder(s)  by  certificates  and  documents
transmitted  herewith. If signature is by trustees,  executors,  administrators,
guardians,  attorneys-in-fact,  officers of  corporations  or others acting in a
fiduciary or representative  capacity,  please provide the following information
and see Instruction 5).


Name(s):________________________________________________________________________
 
________________________________________________________________________________
                               (Please Print)

Capacity:_______________________________________________________________________

Address:________________________________________________________________________

________________________________________________________________________________
                              (Include Zip Code)

Area Code and Telephone No.:____________________________________________________

Tax Identification or Social Security Number:___________________________________

                            GUARANTEE OF SIGNATURE(S)
                           (See Instructions 1 and 5)


Authorized Signature____________________________________________________________

Name____________________________________________________________________________

Name of Firm____________________________________________________________________
                                 (Please Print)

Address_________________________________________________________________________

________________________________________________________________________________
                               (Include Zip Code)

Area Code and Telephone Number__________________________________________________

Dated _____________________________________________, 1997

                                        6

<PAGE>




                                 INSTRUCTIONS
            FORMING PART OF THE TERMS AND CONDITIONS OF THE OFFER

     To complete the Letter of Transmittal, you must do the following:

     --   Fill in the box entitled "Description of Shares Tendered."

     --   Sign and date the  Letter of  Transmittal  in the box  entitled  "Sign
          Here."

     --   Fill in and sign in the box entitled "Substitute Form W-9."

     In completing the Letter of Transmittal,  you may (but are not required to)
     also do the following:

     --   If you want the payment for any Shares purchased issued in the name of
          another   person,   complete   the  box  entitled   "Special   Payment
          Instructions."

     --   If you want any  certificate  for  Shares not  tendered  or Shares not
          purchased  issued  in the name of  another  person,  complete  the box
          entitled "Special Payment Instructions."

     --   If you want any  payment  for  Shares or  certificate  for  Shares not
          tendered  or  purchased  delivered  to  an  address  other  than  that
          appearing  under your  signature,  complete the box entitled  "Special
          Delivery Instructions."

     If you complete the box entitled "Special Payment Instructions" or "Special
Delivery  Instructions," you must have your signature  guaranteed by an Eligible
Institution (as defined in Instruction 1 below) unless the Letter of Transmittal
is signed by an Eligible Institution.

     1.  GUARANTEE OF  SIGNATURES.  No  signature  guarantee is required on this
Letter of Transmittal  (a) if this Letter of Transmittal is signed by the record
holder(s) of Shares  tendered  herewith,  unless such  holder(s)  has  completed
either the box  entitled  "Special  Payment  Instructions"  or the box  entitled
"Special  Delivery  Instructions"  above, or (b) if such Shares are tendered for
the account of a firm which is a bank,  broker,  dealer,  credit union,  savings
association or other entity which is a member in good standing of the Securities
Transfer Agents Medallion Program (each of the foregoing being referred to as an
"Eligible  Institution").  In all other cases,  all signatures on this Letter of
Transmittal must be guaranteed by an Eligible Institution.  See Instruction 5 of
this Letter of Transmittal.

     2. REQUIREMENTS OF TRANSFER.  This Letter of Transmittal is to be completed
by stockholders  either if certificates are to be forwarded  herewith or, unless
an  Agent's  Message is  utilized,  if tenders  are to be made  pursuant  to the
procedure   for   tender  by   book-entry   transfer   set  forth   under   "THE
OFFER--Procedure  for Accepting the Offer and Tendering  Shares" in the Offer to
Purchase.   Certificates   evidencing  physically  tendered  Shares,  or  timely
confirmation (a "Book-Entry  Confirmation")  of a book-entry  transfer of Shares
into the Depositary's account at a Book-Entry Transfer Facility, as well as this
Letter of  Transmittal  (or a facsimile  hereof),  properly  completed  and duly
executed,  with any  required  signature  guarantees,  or an Agent's  Message in
connection with a book-entry transfer,  and any other documents required by this
Letter  of  Transmittal,  must  be  received  by  the  Depositary  at one of its
addresses set forth herein prior to the Expiration  Date. If Share  certificates
are forwarded to the Depositary in multiple deliveries, a properly completed and
duly  executed  Letter  of  Transmittal   must  accompany  each  such  delivery.
Stockholders  whose Share  certificates  are not  immediately  available  or who
cannot deliver their Share  certificates and all other required documents to the
Depositary prior to the Expiration Date or who cannot complete the procedure for
delivery by  book-entry  transfer on a timely  basis may tender  their Shares by
properly  completing and duly executing a Notice of Guaranteed Delivery pursuant
to the guaranteed delivery procedure set forth under "THE OFFER -- Procedure for
Accepting the Offer and Tendering Shares" in the Offer to Purchase.  Pursuant to
such  procedure:  (i)  such  tender  must  be  made by or  through  an  Eligible
Institution;  (ii) a properly  completed and duly executed  Notice of Guaranteed
Delivery,  substantially  in the form made available by the  Purchaser,  must be
received by the Depositary prior to the Expiration Date; and (iii)  certificates
representing  the  Shares (or a  Book-Entry  Confirmation),  in proper  form for
transfer,  in each case together with the Letter of Transmittal  (or a facsimile
thereof),  properly  completed and duly  executed,  with any required  signature
guarantees (or, in the case of a book-entry  delivery,  an Agent's  Message) and
any other documents required by this Letter of Transmittal,  must be received by
the Depositary within three NASDAQ trading days after the date of


                                        7

<PAGE>




execution of such Notice of Guaranteed  Delivery.  A "NASDAQ Trading Day" is any
day on which  The  Nasdaq  Stock  Market,  Inc.'s  National  Market  is open for
business.

     The term "Agent's  Message"  means a message,  transmitted  by a Book-Entry
Transfer  Facility to, and received by, the Depositary and forming a part of the
Book-Entry Confirmation,  which states that the Book-Entry Transfer Facility has
received  an express  acknowledgment  from the  participants  in the  Book-Entry
Transfer  Facility  tendering the Shares that such participant has received this
Letter of  Transmittal  and  agrees  to be bound by the terms of this  Letter of
Transmittal  and  that  Purchaser  may  enforce  such  agreement   against  such
participant.

     THE  METHOD  OF  DELIVERY  OF  THIS  LETTER  OF  TRANSMITTAL,  CERTIFICATES
REPRESENTING  THE SHARES AND ALL OTHER REQUIRED  DOCUMENTS,  INCLUDING  DELIVERY
THROUGH  ANY  BOOK-ENTRY  TRANSFER  FACILITY,  IS AT THE  OPTION AND RISK OF THE
TENDERING  STOCKHOLDER  AND THE DELIVERY  WILL BE DEEMED MADE ONLY WHEN ACTUALLY
RECEIVED BY THE DEPOSITARY  (INCLUDING,  IN THE CASE OF BOOK-ENTRY TRANSFER,  BY
BOOK-ENTRY  CONFIRMATION).  IF DELIVERY IS BY MAIL,  REGISTERED MAIL WITH RETURN
RECEIPT REQUESTED,  PROPERLY INSURED, IS RECOMMENDED.  IN ALL CASES,  SUFFICIENT
TIME SHOULD BE ALLOWED TO ENSURE TIMELY DELIVERY.

     No alternative,  conditional or contingent  tenders will be accepted and no
fractional Shares will be purchased. All tendering stockholders, by execution of
this Letter of Transmittal (or a facsimile  hereof),  waive any right to receive
any notice of the acceptance of their Shares for payment.

     3. INADEQUATE  SPACE.  If the space provided  herein under  "Description of
Shares  Tendered" is inadequate,  the  certificate  numbers and/or the number of
Shares and any other required  information should be listed on a separate signed
schedule attached hereto.

     4. PARTIAL  TENDERS.  (Not applicable to Book-Entry  Stockholders) If fewer
than all the Shares  evidenced by any certificate  submitted are to be tendered,
fill in the  number  of  Shares  which are to be  tendered  in the box  entitled
"Number of Shares Tendered." In such cases, new certificates for the Shares that
were  evidenced  by your old  certificates  but were not tendered by you will be
sent to you, unless  otherwise  provided in the box entitled  "Special  Delivery
Instructions"  in this Letter of Transmittal,  as soon as practicable  after the
Expiration  Date.  All  Shares  represented  by  certificates  delivered  to the
Depositary will be deemed to have been tendered unless otherwise indicated.

     5. SIGNATURES ON LETTER OF TRANSMITTAL,  STOCK POWERS AND ENDORSEMENTS.  If
this  Letter of  Transmittal  is signed by the  record  holder(s)  of the Shares
tendered hereby, the signature(s) must correspond with the name(s) as written on
the face of the  certificate(s)  without  alteration,  enlargement or any change
whatsoever.

     If any of the  Shares  tendered  hereby  are owned of record by two or more
joint owners, all such owners must sign this Letter of Transmittal.

     If any of the tendered  Shares are registered in different names on several
certificates, it will be necessary to complete, sign and submit as many separate
Letters of Transmittal as there are different registrations of certificates.

     If this  Letter of  Transmittal  or any  certificates  or stock  powers are
signed by trustees,  executors,  administrators,  guardians,  attorneys-in-fact,
officers  of  corporations  or others  acting in a fiduciary  or  representative
capacity,  such persons  should so indicate  when signing,  and proper  evidence
satisfactory to the Purchaser of their authority so to act must be submitted.

     If this  Letter of  Transmittal  is signed by the record  holder(s)  of the
Shares  listed and  transmitted  hereby,  no  endorsements  of  certificates  or
separate  stock  powers  are  required  unless  payment  is  to  be  made  to or
certificates  for Shares not tendered or not  purchased  are to be issued in the
name of a person other than the record holder(s), in which case the certificates
for Shares tendered hereby must be endorsed or accompanied by appropriate  stock
powers,  in either  case signed  exactly as the name(s) of the record  holder(s)
appear(s) on such Share certificate(s). Signatures on such certificates or stock
powers must be guaranteed by an Eligible Institution.

     If this Letter of  Transmittal  is signed by a person other than the record
holder(s) of the certificate(s)  listed, the certificate(s)  must be endorsed or
accompanied by appropriate stock powers, in either

                                8

<PAGE>



case  signed  exactly  as the  name(s)  of the  record  holder(s)  appear on the
certificate(s).  Signatures  on  such  certificates  or  stock  powers  must  be
guaranteed by an Eligible Institution.

     6. STOCK TRANSFER TAXES.  Except as otherwise  provided in this Instruction
6, the Purchaser  will pay any stock transfer taxes with respect to the transfer
and sale of  Shares to it or its  order  pursuant  to the  Offer.  If,  however,
payment of the purchase price is to be made to, or if certificate(s)  for Shares
not  tendered or accepted for payment are to be  registered  in the name of, any
person  other than the  record  holder(s),  or if  tendered  certificate(s)  are
registered  in the name of any person  other  than the  person(s)  signing  this
Letter of Transmittal,  the amount of any stock transfer taxes (whether  imposed
on the record  holder(s) or such  person)  payable on account of the transfer to
such  person  will be  deducted  from the  purchase  price  unless  satisfactory
evidence of the payment of such taxes or an exemption therefrom is submitted.

     Except  as  otherwise  provided  in this  Instruction  6,  it  will  not be
necessary for transfer tax stamps to be affixed to the certificate(s)  listed in
this Letter of Transmittal.

     7. SPECIAL PAYMENT AND DELIVERY INSTRUCTIONS. If a check is to be issued in
the name of,  and/or  certificates  for Shares not  tendered or not accepted for
payment are to be issued or returned  to, a person other than the signer of this
Letter of Transmittal or if a check and/or such  certificates are to be returned
to a person other than the person(s) signing this Letter of Transmittal or to an
address  other  than  that  shown in the box  entitled  "Description  of  Shares
Tendered" in this Letter of Transmittal, the appropriate boxes on this Letter of
Transmittal must be completed.  A stockholder  delivering Shares tendered hereby
by  book-entry  transfer  may request  that Shares not  accepted  for payment be
credited to such account  maintained at a Book-Entry  Transfer  Facility as such
stockholder  may designate  under  "Special  Payment  Instructions."  If no such
instructions are given, such Shares not accepted for payment will be returned by
crediting the same account at the  Book-Entry  Transfer  Facility as the account
from which such Shares were delivered.

     8. WAIVER OF CONDITIONS.  Subject to the terms and conditions of the Merger
Agreement  (as defined in the Offer to  Purchase),  the  conditions of the Offer
(other than the Minimum  Condition (as defined in the Offer to Purchase)) may be
waived by the Purchaser in whole or in part at any time and from time to time in
its sole discretion.

     9. 31% BACKUP  WITHHOLDING;  SUBSTITUTE FORM W-9. Under U.S. Federal income
tax law, a  stockholder  whose  tendered  Shares  are  accepted  for  payment is
required to provide the  Depositary  with such  stockholder's  correct  taxpayer
identification number ("TIN") on Substitute Form W-9 below. If the Depositary is
not provided with the correct TIN, the Internal  Revenue Service may subject the
stockholder or other payee to a $50 penalty. In addition, payments that are made
to such stockholder or other payee with respect to Shares purchased  pursuant to
the Offer may be subject to 31% backup withholding.

     Certain stockholders (including, among others, all corporations and certain
foreign  individuals) are not subject to these backup  withholding and reporting
requirements.  In  order  for a  foreign  individual  to  qualify  as an  exempt
recipient,  the  stockholder  must submit a Form W-8,  signed under penalties of
perjury,  attesting  to  that  individual's  exempt  status.  A Form  W-8 can be
obtained from the Depositary.  See the enclosed "Guidelines for Certification of
Taxpayer Identification Number on Substitute Form W-9" for more instructions.

     If backup withholding  applies,  the Depositary is required to withhold 31%
of any such payments made to the stockholder or other payee.  Backup withholding
is not an additional tax. Rather, the tax liability of persons subject to backup
withholding  will be  reduced  by the  amount of tax  withheld.  If  withholding
results in an  overpayment  of taxes, a refund may be obtained from the Internal
Revenue Service.

     The  box  in  Part 3 of the  Substitute  Form  W-9  may be  checked  if the
tendering  stockholder  has not been  issued a TIN and has  applied for a TIN or
intends to apply for a TIN in the near future.  If the box in Part 3 is checked,
the  stockholder  or other payee must also complete the  Certificate of Awaiting
Taxpayer  Identification  Number  below in order  to avoid  backup  withholding.
Notwithstanding  that  the  box in Part 3 is  checked  and  the  Certificate  of
Awaiting Taxpayer Identification Number is completed,

                                        9

<PAGE>



the  Depositary  will  withhold  31% of all  payments  made  prior to the time a
properly certified TIN is provided to the Depositary.

     The  stockholder is required to give the  Depositary the TIN (e.g.,  social
security  number or employer  identification  number) of the record owner of the
Shares or of the last  transferee  appearing  on the  transfers  attached to, or
endorsed  on, the Shares.  If the Shares are in more than one name or are not in
the name of the actual owner, consult the enclosed "Guidelines for Certification
of  Taxpayer  Identification  Number  on  Substitute  Form  W-9" for  additional
guidance on which number to report.


     10. QUESTIONS AND REQUESTS FOR ASSISTANCE OR ADDITIONAL  COPIES.  Questions
or  requests  for  assistance  may be  directed  to the  Dealer  Manager  or the
Information Agent at their respective  addresses and telephone numbers set forth
below.  Additional  copies of the Offer to Purchase,  this Letter of Transmittal
and the Notice of Guaranteed  Delivery may also be obtained from the Information
Agent or the Dealer Manager or from brokers, dealers,  commercial banks or trust
companies.

     11. LOST, DESTROYED OR STOLEN CERTIFICATES. If any certificate representing
Shares has been lost,  destroyed  or stolen,  the  stockholder  should  promptly
notify the Depositary.  The stockholder  will then be instructed as to the steps
that  must be  taken in  order  to  replace  the  certificate.  This  Letter  of
Transmittal and related  documents  cannot be processed until the procedures for
replacing lost or destroyed certificates have been followed.

     IMPORTANT:  THIS LETTER OF TRANSMITTAL  (OR A FACSIMILE  HEREOF),  TOGETHER
WITH  ANY  REQUIRED  SIGNATURE  GUARANTEES,  OR,  IN THE  CASE  OF A  BOOK-ENTRY
TRANSFER, AN AGENT'S MESSAGE, AND ANY OTHER REQUIRED DOCUMENTS, MUST BE RECEIVED
BY THE  DEPOSITARY  PRIOR TO THE  EXPIRATION  OF THE  OFFER,  AND  EITHER  SHARE
CERTIFICATES  FOR TENDERED  SHARES MUST BE RECEIVED BY THE  DEPOSITARY OR SHARES
MUST BE DELIVERED  PURSUANT TO THE PROCEDURES FOR BOOK-ENTRY  TRANSFER,  IN EACH
CASE PRIOR TO THE  EXPIRATION  DATE OF THE OFFER,  OR THE TENDERING  STOCKHOLDER
MUST COMPLY WITH THE PROCEDURES FOR GUARANTEED DELIVERY.


                                       10

<PAGE>


<TABLE>
<S>                      <C>
_____________________________________________________________________________________________________________

                         PAYER'S NAME: CITIBANK, N.A.

_____________________________________________________________________________________________________________


SUBSTITUTE                  Part       1 -- PLEASE  PROVIDE YOUR TIN IN THE BOX      Social Security Number
                                       AT RIGHT  AND  CERTIFY  BY  SIGNING  AND            or Employer     
                                       DATING BELOW.                                  Identification Number
                                                                                     
                            Part       2 --  Certification  -- Under penalties of perjury,  I certify that: 
FORM W-9                               (1)  The  number   shown  on  this  form  is  my  correct   taxpayer 
                                       identification  number (or I am waiting for a number to be issued to 
                                       me), and (2) I am not subject to backup withholding  because:  (a) I 
Department of the Treasury             am exempt from backup  withholding,  or (b) I have not been notified 
Internal Revenue Service               by the Internal  Revenue Service ("IRS") that I am subject to backup 
                                       withholding  as a result of a  failure  to report  all  interest  or 
Payer's Request for                    dividends,  or (c)  the  IRS has  notified  me  that I am no  longer 
Taxpayer Identification                subject to backup withholding.                                       
Number ("TIN")              

                                        CERTIFICATION  INSTRUCTIONS  -- You must cross out item (2) above if
                                        you have been notified by the IRS that you are currently  subject to
                                        backup withholding  because of under reporting interest or dividends
                                        on your tax return. However, if after being notified by the IRS that
                                        you  were  subject  to  backup   withholding  you  received  another
                                        notification  from the IRS that you are no longer  subject to backup
                                        withholding, do not cross out such item (2).
_____________________________________________________________________________________________________________

    SIGN                                SIGNATURE:______________________________           Part 3
    HERE
                                        DATE:___________________________________          Awaiting TIN  [ ]


_____________________________________________________________________________________________________________

                                                          
                                                          
                                                          

NOTE:     FAILURE TO COMPLETE THIS FORM MAY RESULT IN BACKUP  WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU
          PURSUANT TO THE OFFER.  PLEASE  REVIEW THE  ENCLOSED  "GUIDELINES  FOR  CERTIFICATION  OF TAXPAYER
          IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9" FOR ADDITIONAL DETAILS.

                         YOU MUST COMPLETE THE FOLLOWING CERTIFICATE IF YOU CHECKED
                                THE BOX IN PART 3 OF THE SUBSTITUTE FORM W-9


                              CERTIFICATE OF AWAITING TAX IDENTIFICATION NUMBER


   I certify  under  penalties  of perjury  that a taxpayer  identification  number has not been issued to me, and either (1) I have
mailed or delivered an application to receive a taxpayer identification number to the appropriate Internal Revenue Service Center or
Social Security  Administration  Office or (2) I intend to mail or deliver an application in the near future. I understand that if I
do not provide a taxpayer  identification  number by the time of payment,  31% of all  reportable  cash  payments made to me will be
withheld. 

Signature ___________________________________________________ 

Date __________________________________________________, 1997
</TABLE>


                                                     11

<PAGE>



                     THE INFORMATION AGENT FOR THE OFFER IS:


                            MACKENZIE PARTNERS, INC.
                                156 FIFTH AVENUE
                            NEW YORK, NEW YORK 10010
                                 (212) 929-5500
                                       OR
                                 (800) 322-2885
                      THE DEALER MANAGER FOR THE OFFER IS:

                         SHATTUCK HAMMOND PARTNERS INC.

                                630 FIFTH AVENUE
                            NEW YORK, NEW YORK 10111
                                 (212) 314-0400

                                12





                          NOTICE OF GUARANTEED DELIVERY
                                       FOR
                        TENDER OF SHARES OF COMMON STOCK
                                       OF

                         COMMUNITY CARE OF AMERICA, INC.
                        PURSUANT TO THE OFFER TO PURCHASE
                              DATED AUGUST 7, 1997

     THIS  NOTICE OF  GUARANTEED  DELIVERY  OR A FORM  SUBSTANTIALLY  EQUIVALENT
HERETO  MUST BE USED TO ACCEPT THE OFFER,  IF TIME WILL NOT PERMIT THE LETTER OF
TRANSMITTAL,   CERTIFICATES  REPRESENTING  THE  SHARES  OR  ANY  OTHER  REQUIRED
DOCUMENTS TO REACH THE  DEPOSITARY,  OR THE PROCEDURES  FOR BOOK-ENTRY  TRANSFER
CANNOT BE COMPLETED, ON OR PRIOR TO THE EXPIRATION DATE (AS DEFINED BELOW). THIS
FORM MAY BE  DELIVERED  BY AN ELIGIBLE  INSTITUTION  (AS DEFINED IN THE OFFER TO
PURCHASE) BY HAND  DELIVERY,  TELEGRAM,  FACSIMILE  TRANSMISSION  OR MAIL TO THE
DEPOSITARY AS SET FORTH BELOW. ALL CAPITALIZED TERMS USED HEREIN BUT NOT DEFINED
HEREIN SHALL HAVE THE MEANINGS  ASCRIBED TO THEM IN THE OFFER TO PURCHASE  DATED
AUGUST 7, 1997 (AS THE SAME MAY BE  AMENDED OR  SUPPLEMENTED  FROM TIME TO TIME,
THE "OFFER TO  PURCHASE").  SEE "THE OFFER -- PROCEDURE  FOR ACCEPTING THE OFFER
AND TENDERING SHARES" IN THE OFFER TO PURCHASE.

                       The Depositary for the Offer is:
                                CITIBANK, N.A.


<TABLE>
<CAPTION>
<S>                                   <C>                                     <C>
              By Mail:                        By Overnight Courier:                    By Hand:
           Citibank, N.A.                         Citibank, N.A.                    Citibank, N.A.
c/o Citicorp Data Distribution, Inc.   c/o Citicorp Data Distribution, Inc.     Corporate Trust Window
           P.O. Box 7072                         404 Sette Drive              111 Wall Street, 5th Floor
     Paramus, New Jersey 07653              Paramus, New Jersey 07653          New York, New York 10043
                                                  By Facsimile:
                                         (For Eligible Institutions Only)
                                                  (201) 262-3240
                                           Facsimile Confirmation Only:
                                                  (800) 422-2077
</TABLE>

     DELIVERY  OF  THIS  NOTICE  OF  GUARANTEED   DELIVERY  TO  AN  ADDRESS,  OR
TRANSMISSION OF INSTRUCTIONS VIA FACSIMILE TRANSMISSION, OTHER THAN AS SET FORTH
ABOVE, WILL NOT CONSTITUTE A VALID DELIVERY.

     This form is not to be used to guarantee signatures.  If a signature on the
Letter of  Transmittal  is required to be guaranteed by an Eligible  Institution
under the  instructions  thereto,  such  signature  guarantee must appear in the
applicable space provided in the signature box on the Letter of Transmittal.

<PAGE>



Ladies and Gentlemen:


     The undersigned  hereby tenders to IHS Acquisition  XXVI,  Inc., a Delaware
corporation (the "Purchaser") and a wholly owned subsidiary of Integrated Health
Services,  Inc.,  a  Delaware  corporation  (the  "Parent"),  upon the terms and
subject to the  conditions  set forth in the Offer to  Purchase  and the related
Letter of Transmittal  (collectively,  the "Offer"), receipt of each of which is
hereby  acknowledged,  the number of Shares  set forth  below,  pursuant  to the
guaranteed  delivery  procedures  set forth in the Offer to  Purchase  under the
heading "THE OFFER -- Procedure for Accepting the Offer and Tendering Shares."

     The  undersigned  understands  that  tenders of Shares may be  withdrawn by
written notice of withdrawal  received by the Depositary at any time on or prior
to 12:00 midnight,  New York City time, on the Expiration Date. If the Purchaser
makes a material change in the terms of the Offer or the information  concerning
the Offer, the Purchaser will disseminate  additional Offer materials and extend
such Offer, to the extent required by law.

     The  undersigned  understands  that  payment by the  Depositary  for Shares
tendered and accepted for payment  pursuant to the Offer will be made only after
timely receipt by the Depositary of such Shares (or book-entry  confirmation  of
the  transfer  of such  Shares  into the  Depositary's  account at a  Book-Entry
Transfer  Facility)  and a Letter of  Transmittal  (or  facsimile  thereof) with
respect to such Shares  properly  completed  and duly executed with any required
signature  guarantees  and  any  other  documents  required  by  the  Letter  of
Transmittal or a properly transmitted Agent's Message.

     All authority  herein conferred or agreed to be conferred by this Notice of
Guaranteed Delivery shall survive the death or incapacity of the undersigned and
every  obligation of the  undersigned  under this Notice of Guaranteed  Delivery
shall  be  binding  upon  the  heirs,   personal   representatives,   executors,
administrators,  successors,  assigns,  trustees in  bankruptcy  and other legal
representatives of the undersigned.

     Capitalized  terms used  herein,  but not  defined  herein,  shall have the
meanings ascribed to them in the Offer to Purchase.



<PAGE>



                           PLEASE SIGN AND COMPLETE


Signature(s) of Record Holders or       Address(es):____________________________
Authorized Signatory:                                                         
                                        ________________________________________
______________________________________                                        
                                        ________________________________________
______________________________________  Area Code and Telephone No.:          
                                                                              
______________________________________  ________________________________________
                                        
Name(s) of Record Holder(s):

______________________________________

______________________________________

______________________________________

Number of Shares to be Tendered:

______________________________________

Certificate No(s). of Shares (if
available)

______________________________________
                                        If  Shares  will  be   delivered  by  a 
______________________________________  book-entry   transfer,    check   trust 
                                        company:                                
                                                                                
                                        [-]  The Depository Trust Company       
                                                                                
                                        [-]  Philadelphia    Depository   Trust 
                                             Company                            
                                                                                
                                        Transaction Code No.:________________   
Dated: ______, 1997                     Depository Account No.:________________ 
                                        

This Notice of  Guaranteed  Delivery  must be signed by the record  holder(s) of
Shares  exactly  as  their  name(s)  appear(s)  on the  Shares  or by  person(s)
authorized to become record holder(s) by endorsements and documents  transmitted
with this Notice of Guaranteed Delivery. If signature is by a trustee, guardian,
attorney-in-fact,  officer of a corporation,  executor, administrator,  agent or
other representative, such person must provide the following information:

                      Please print name(s) and address(es)

Name(s):       _________________________________________________________________

               _________________________________________________________________

Capacity:      _________________________________________________________________

               _________________________________________________________________

DO NOT SEND  SHARES  WITH THIS FORM.  SHARES  SHOULD BE SENT TO THE  DEPOSITARY,
TOGETHER WITH A PROPERLY COMPLETED AND VALIDLY EXECUTED LETTER OF TRANSMITTAL.


<PAGE>



                                  GUARANTEE
                   (NOT TO BE USED FOR SIGNATURE GUARANTEE)


     The  undersigned,  a member of the  Securities  Transfer  Agents  Medallion
Program,  the Stock  Exchange  Medallion  Program or the New York Stock Exchange
Medallion Signature Program, hereby guarantees that, within three NASDAQ trading
days from the date of this Notice of Guaranteed  Delivery,  a properly completed
and validly  executed Letter of Transmittal (or a facsimile  thereof),  together
with Shares tendered hereby in proper form for transfer (or  confirmation of the
book-entry transfer of such Shares into the Depositary's account at a Book-Entry
Transfer Facility  pursuant to the procedures for book-entry  transfer set forth
in the Offer to Purchase under the caption "THE OFFER -- Procedure for Accepting
the Offer  and  Tendering  Shares")  and all other  required  documents  will be
deposited by the undersigned with the Depositary at its address set forth above.

     The Eligible  Institution  that  completes this form must  communicate  the
guarantee  to the  Depositary  and must  deliver  the Letter of  Transmittal  or
Agent's  Message  and  Shares to the  Depositary  within the time  period  shown
herein.  Failure  to do so could  result in a  financial  loss to such  Eligible
Institution.

Name of Firm:___________________________  ______________________________________
                                                  Authorized Signature
 Address:_______________________________
                                          Name:_________________________________
 _______________________________________
                                          Title:________________________________
 _______________________________________
Area Code and 
Telephone No.: _________________________  Date:_________________________________

DO NOT SEND  SHARES  WITH THIS FORM.  ACTUAL  SURRENDER  OF SHARES  MUST BE MADE
PURSUANT TO, AND BE ACCOMPANIED  BY, A PROPERLY  COMPLETED AND VALIDLY  EXECUTED
LETTER OF TRANSMITTAL AND ANY OTHER REQUIRED DOCUMENTS.





                           OFFER TO PURCHASE FOR CASH
                     ALL OUTSTANDING SHARES OF COMMON STOCK
                                       OF
                         COMMUNITY CARE OF AMERICA, INC.
                                       AT
                               $4.00 NET PER SHARE
                                       BY
                           IHS ACQUISITION XXVI, INC.
                          A WHOLLY OWNED SUBSIDIARY OF
                        INTEGRATED HEALTH SERVICES, INC.

THE OFFER AND  WITHDRAWAL  RIGHTS WILL EXPIRE AT 12:00  MIDNIGHT,  NEW YORK CITY
TIME, ON THURSDAY,  SEPTEMBER 4, 1997,  UNLESS THE OFFER IS EXTENDED (SUCH DATE,
AS THE SAME MAY BE EXTENDED, THE "EXPIRATION DATE").


To Brokers, Dealers, Commercial Banks, Trust Companies and Other Nominees:


     We  have  been  appointed  by  IHS  Acquisition   XXVI,  Inc.,  a  Delaware
corporation (the "Purchaser") and a wholly owned subsidiary of Integrated Health
Services,  Inc., a Delaware corporation (the "Parent"), to act as Dealer Manager
in  connection  with  the  Purchaser's  offer  to  purchase  for  cash  all  the
outstanding  shares of Common Stock, par value $.0025 per share ( the "Shares"),
of Community Care of America, Inc., a Delaware corporation (the "Company"), at a
purchase  price of $4.00 per Share,  net to the seller in cash without  interest
thereon,  upon the terms and subject to the conditions set forth in the Offer to
Purchase,  dated  August 7, 1997 (the "Offer to  Purchase"),  and in the related
Letter of Transmittal  (which, as amended from time to time, together constitute
the "Offer") enclosed  herewith.  Holders of Shares whose  certificates for such
Shares  are  not  immediately  available  or  who  cannot  deliver  their  Share
certificates  and all other  required  documents to the  Depositary  (as defined
below) prior to the  Expiration  Date (as defined in the Offer to Purchase),  or
who cannot  complete the procedures  for book-entry  transfer on a timely basis,
must tender their Shares  according to the  guaranteed  delivery  procedures set
forth  under "THE  OFFER --  Procedure  for  Accepting  the Offer and  Tendering
Shares" in the Offer to Purchase.  Capitalized terms used herein but not defined
herein shall have the meanings ascribed to such terms in the Offer to Purchase.

     We are  asking  you to  contact  your  clients  for whom  you  hold  Shares
registered in your name or in the name of your nominee. In addition,  we ask you
to contact your clients who, to your knowledge,  hold Shares registered in their
own names. The Purchaser will pay all transfer taxes, if any,  applicable to the
tender of Shares to it, except as otherwise provided in the Offer.


     Enclosed  herewith for your  information and forwarding to your clients are
copies of the following documents:

     1. The Offer to Purchase, dated August 7, 1997;

     2. A Letter of  Transmittal  for your use and for the  information  of your
clients,   together  with  guidelines  of  the  Internal   Revenue  Service  for
Certification of Taxpayer Identification Number on Substitute Form W-9 providing
information relating to backup federal income tax withholding;

     3. A Notice of  Guaranteed  Delivery  to be used to accept the Offer if (i)
the  Shares  and  all  other  required  documents  cannot  be  delivered  to the
Depositary on or prior to the  Expiration  Date or (ii) the required  procedures
for book-entry transfer cannot be completed on or prior to the Expiration Date;

     4. A form of a letter which may be sent to your  clients for whose  account
you  hold  the  Shares  in your  name or in the name of a  nominee,  with  space
provided for obtaining such clients' instructions with regard to the Offer;


<PAGE>




     5. The Company's  Solicitation/Recommendation  Statement on Schedule 14D-9;
and

     6. Return envelope addressed to the Depositary.

     PLEASE  NOTE THAT THE  OFFER AND  WITHDRAWAL  RIGHTS  WILL  EXPIRE AT 12:00
MIDNIGHT,  NEW YORK TIME,  ON THURSDAY,  SEPTEMBER 4, 1997,  UNLESS THE OFFER IS
EXTENDED (SUCH DATE, AS THE SAME MAY BE EXTENDED,  THE  "EXPIRATION  DATE").  WE
URGE YOU TO CONTACT  YOUR  CLIENTS AS  PROMPTLY  AS  POSSIBLE IN ORDER TO OBTAIN
THEIR INSTRUCTIONS.

     The Offer is conditioned upon, among other things,  (i) there being validly
tendered and not withdrawn  prior to the  expiration of the Offer such number of
Shares  which  constitutes  at least a majority of the  outstanding  Shares on a
fully-diluted basis on the date of purchase,  (ii) the expiration or termination
of any waiting period under the Hart-Scott-Rodino  Antitrust Improvements Act of
1976, as amended, and the regulations  thereunder  applicable to the purchase of
Shares pursuant to the Offer and (iii) the  satisfaction of the other conditions
described  under "THE OFFER -- Procedure  for  Accepting the Offer and Tendering
Shares" in the Offer to  Purchase.  The Offer is not  subject  to any  financing
condition.

     At a meeting held on July 31, 1997,  the Board of Directors of the Company,
by unanimous  vote of all  directors  present and voting (with the two directors
who are also  directors of Parent  abstaining  or not  attending),  based on the
recommendation  of the Special  Committee  appointed by the  Company's  Board of
Directors,  determined  that the terms of the Offer and the  Merger are fair to,
and in the best  interests  of, the holders of Shares  (other than  Parent,  the
Purchaser and its  affiliates)  and recommends that holders of Shares accept the
Offer and tender their Shares to the Purchaser.

     The Offer is being made pursuant to an Agreement and Plan of Merger,  dated
as August  1,  1997 (the  "Merger  Agreement"),  by and  among the  Parent,  the
Purchaser and the Company.  The Merger Agreement  provides,  among other things,
that subsequent to the  consummation of the Offer, the Purchaser will merge with
and into the Company (the  "Merger").  At the effective  time of the Merger (the
"Effective  Time"),  each Share issued and outstanding  immediately prior to the
Effective  Time (other than Shares owned by the Company or any subsidiary of the
Company and Shares owned by the Parent, the Purchaser or any other subsidiary of
the Parent,  which shall be  cancelled,  and other than Shares,  if any, held by
stockholders who have properly  exercised  appraisal rights under Section 262 of
the Delaware General  Corporation Law) will, by virtue of the Merger and without
any action on the part of the holders of the Shares, be converted into the right
to receive $4.00 in cash, payable to the holder thereof,  without interest, upon
surrender of the certificate formerly representing such Share, less any required
withholding taxes.

     In order to take  advantage of the Offer,  (i) a duly executed and properly
completed  Letter of Transmittal and any required  signature  guarantees,  or an
Agent's  Message in connection with a book-entry  delivery of Shares,  and other
required   documents  should  be  sent  to  the  Depositary,   and  (ii)  either
certificates  representing  the  tendered  Shares  should  be  delivered  to the
Depositary,  or such Shares should be tendered by  book-entry  transfer into the
Depositary's  account maintained at one of the Book-Entry  Transfer  Facilities,
all in accordance with the  instructions  set forth in the Letter of Transmittal
and the Offer to Purchase.

     If holders of Shares wish to tender,  but it is  impracticable  for them to
forward their Shares or other  required  documents on or prior to the Expiration
Date or to comply with the book-entry  transfer  procedures on a timely basis, a
tender may be effected by following the guaranteed delivery procedures specified
under "THE OFFER -- Procedure for  Accepting the Offer and Tendering  Shares" in
the Offer to Purchase.

     The Purchaser  will not pay any fees or commissions to any broker or dealer
or  other  person  (other  than  the  Dealer  Manager,  the  Depositary  and the
Information Agent, as described in the Offer to Purchase) for soliciting tenders
of the  Shares  pursuant  to the Offer.  You will be  reimbursed  for  customary
mailing  and  handling  expenses  incurred  by you in  forwarding  the  enclosed
materials  to your  clients  as  described  in the Offer to  Purchase  under the
caption "THE OFFER -- Fees and Expenses."



<PAGE>



     Additional  copies  of the  enclosed  materials  may be  obtained  from the
Information  Agent,  at its address and  telephone  number set forth on the back
cover of the enclosed Offer to Purchase.


                                        Very truly yours,




                                        SHATTUCK HAMMOND PARTNERS INC.

NOTHING  CONTAINED  HEREIN OR IN THE ENCLOSED  DOCUMENTS SHALL CONSTITUTE YOU OR
ANY OTHER PERSON AS THE AGENT OF THE PARENT,  THE  PURCHASER,  THE COMPANY,  THE
DEPOSITARY,  THE INFORMATION AGENT OR THE DEALER MANAGER OR AUTHORIZE YOU OR ANY
OTHER PERSON TO MAKE ANY  STATEMENT OR USE ANY DOCUMENT ON BEHALF OF ANY OF THEM
IN  CONNECTION  WITH  THE  OFFER  OTHER  THAN  THE  ENCLOSED  DOCUMENTS  AND THE
STATEMENTS CONTAINED THEREIN.

                              






                           OFFER TO PURCHASE FOR CASH

                     ALL OUTSTANDING SHARES OF COMMON STOCK
                                       OF
                         COMMUNITY CARE OF AMERICA, INC.
                                       AT
                               $4.00 NET PER SHARE
                                       BY
                           IHS ACQUISITION XXVI, INC.
                            A WHOLLY OWNED SUBSIDIARY
                                       OF
                        INTEGRATED HEALTH SERVICES, INC.

THE OFFER AND  WITHDRAWAL  RIGHTS WILL EXPIRE AT 12:00  MIDNIGHT,  NEW YORK CITY
TIME, ON THURSDAY,  SEPTEMBER 4, 1997,  UNLESS THE OFFER IS EXTENDED (SUCH DATE,
AS THE SAME MAY BE EXTENDED, THE "EXPIRATION DATE").


To Our Clients:


     Enclosed for your  consideration  is the Offer to Purchase  dated August 7,
1997 (as the same may be amended or  supplemented  from time to time, the "Offer
to Purchase") and related Letter of Transmittal  and  instructions  thereto (the
"Letter of Transmittal" and,  together with the Offer to Purchase,  the "Offer")
relating to the offer by IHS Acquisition XXVI, Inc., a Delaware corporation (the
"Purchaser") and a wholly owned subsidiary of Integrated Health Services,  Inc.,
a Delaware corporation (the "Parent"), to purchase all of the outstanding shares
of Common Stock, $.0025 par value per share (the "Shares"), of Community Care of
America,  Inc., a Delaware  corporation (the "Company"),  at a purchase price of
$4.00 per Share,  net to the seller in cash without interest  thereon,  upon the
terms and subject to the conditions set forth in the Offer.  Consummation of the
Offer is subject  to  certain  conditions  described  in the Offer to  Purchase.
Capitalized  terms used herein and not defined  herein  shall have the  meanings
ascribed to them in the Offer to Purchase.

     If you wish to tender Shares but (i) certificates  representing such Shares
("Share Certificates") are not immediately available,  (ii) time will not permit
such  Share  Certificates  and all other  documents  required  by the  Letter of
Transmittal  to  reach  Citibank,  N.A.  (the  "Depositary")  on or prior to the
expiration date of the Offer or (iii) the procedure for book-entry transfer,  as
set forth in the Offer to Purchase,  cannot be completed on a timely basis,  you
may  nevertheless  tender  such  Shares  pursuant  to  the  guaranteed  delivery
procedure  described  under "THE OFFER -- Procedure  for Accepting the Offer and
Tendering  Shares" in the Offer to Purchase.  See Instruction 2 of the Letter of
Transmittal. Delivery of documents to a Book-Entry Transfer Facility (as defined
in the Offer to Purchase) in accordance with the Book-Entry  Transfer Facility's
procedures does not constitute delivery to the Depositary.

     THIS  MATERIAL  RELATING  TO THE  OFFER  IS BEING  FORWARDED  TO YOU AS THE
BENEFICIAL  OWNER OF  SHARES  HELD BY US FOR YOUR  ACCOUNT  OR  BENEFIT  BUT NOT
REGISTERED  IN YOUR NAME.  WE ARE THE HOLDER OF RECORD OF SHARES  HELD BY US FOR
YOUR  ACCOUNT.  A TENDER OF ANY SUCH SHARES CAN BE MADE ONLY BY US AS THE RECORD
HOLDER AND PURSUANT TO YOUR INSTRUCTIONS. THE LETTER OF TRANSMITTAL IS FURNISHED
TO YOU FOR YOUR INFORMATION ONLY AND CANNOT BE USED BY YOU TO TENDER SHARES HELD
BY US FOR YOUR ACCOUNT.

     Accordingly,  we request  instructions  as to whether you wish us to tender
any or all such  Shares held by us for your  account,  pursuant to the terms and
conditions  set  forth in the  Offer.  We urge you to read the  Offer  carefully
before instructing us to tender your Shares.

<PAGE>




     Your  instructions  to us should be  forwarded  as  promptly as possible in
order to permit  us to tender  Shares  on your  behalf  in  accordance  with the
provisions of the Offer. The Offer will expire at 12:00 Midnight,  New York City
time, on Thursday,  September 4, 1997, unless extended (the "Expiration  Date").
Shares  tendered  pursuant  to  the  Offer  may  only  be  withdrawn  under  the
circumstances described in the Offer.


Your attention is directed to the following:

     1. The tender  price is $4.00 per Share,  net to the seller in cash without
interest thereon.

     2. The Offer is for all outstanding Shares.

     3. At a  meeting  held on July 31,  1997,  the  Board of  Directors  of the
Company,  by unanimous  vote of all  directors  present and voting (with the two
directors who are also directors of Parent  abstaining or not attending),  based
on the recommendation of the Special Committee  appointed by the Company's Board
of Directors, determined that the terms of the Offer and the Merger are fair to,
and in the best  interests  of, the holders of Shares  (other than  Parent,  the
Purchaser and their affiliates) and recommends that holders of Shares accept the
Offer and tender their Shares to the Purchaser.

     4. The Offer is being made  pursuant  to an  Agreement  and Plan of Merger,
dated as of August 1, 1997 (the  "Merger  Agreement"),  by and among the Parent,
the  Purchaser  and the  Company.  The Merger  Agreement  provides,  among other
things,  that subsequent to the  consummation  of the Offer,  the Purchaser will
merge with and into the Company (the  "Merger").  At the  effective  time of the
Merger (the "Effective  Time"),  each Share issued and  outstanding  immediately
prior to the  Effective  Time  (other  than  Shares  owned by the Company or any
subsidiary  of the Company and Shares owned by the Parent,  the Purchaser or any
other subsidiary of the Parent, which shall be cancelled, and other than Shares,
if any, held by stockholders who have properly exercised  appraisal rights under
Section 262 of the  Delaware  General  Corporation  Law) will,  by virtue of the
Merger and  without  any action on the part of the  holders  of the  Shares,  be
converted  into the  right to  receive  $4.00 in  cash,  payable  to the  holder
thereof,   without  interest,   upon  surrender  of  the  certificate   formerly
representing such Share, less any required withholding taxes.

     5. The Offer and withdrawal rights will expire at 12:00 Midnight,  New York
City time, on Thursday, September 4, 1997, unless the Offer is extended.

     6.  Tendering  stockholders  will not be obligated to pay brokerage fees or
commissions  or,  except  as  set  forth  in  Instruction  6 of  the  Letter  of
Transmittal,  stock  transfer  taxes on the  purchase of Shares  pursuant to the
Offer.

     7. The Offer is  conditioned  upon,  among  other  things,  (i) there being
validly  tendered and not  withdrawn  prior to the  expiration of the Offer such
number of Shares which constitutes at least a majority of the outstanding Shares
on a  fully-diluted  basis  on the date of  purchase,  (ii)  the  expiration  or
termination  of  any  waiting  period  under  the  Hart-Scott-Rodino   Antitrust
Improvements Act of 1976, as amended, and the regulations  thereunder applicable
to the purchase of Shares  pursuant to the Offer and (iii) the  satisfaction  of
the other  conditions  described  under "THE OFFER -- Certain  Conditions of the
Offer"  in the Offer to  Purchase.  The Offer is not  subject  to any  financing
condition.

     The Offer is being made  solely by the Offer to  Purchase  and the  related
Letter of Transmittal and is being made to all holders of Shares.  The Purchaser
is not  aware of any  state  where the  making  of the  Offer is  prohibited  by
administrative  or judicial action  pursuant to any valid state statute.  If the
Purchaser becomes aware of any valid state statute prohibiting the making of the
Offer or the acceptance of Shares  pursuant  thereto,  the Purchaser will make a
good faith  effort to comply with any such state  statute.  If,  after such good
faith effort,  the Purchaser  cannot comply with such state  statute,  the Offer
will not be made to,  nor will  tenders  be  accepted  from or on behalf of, the
holders of Shares in such state. In any jurisdiction where the securities,  blue
sky or other laws  require the Offer to be made by a licensed  broker or dealer,
the Offer  shall be deemed to be made on  behalf of the  Purchaser  by  Shattuck
Hammond  Partners  Inc.,  the  Dealer  Manager  for  the  Offer,  or one or more
registered  brokers  or  dealers  that  are  licensed  under  the  laws  of such
jurisdiction.



<PAGE>




     If you wish to have us tender any or all of the Shares  held by us for your
account, please so instruct us by completing,  executing and returning to us the
instruction form that follows.  If you authorize the tender of your Shares,  all
such Shares will be tendered unless otherwise  specified on the instruction form
contained in this letter.  PLEASE  FORWARD  YOUR  INSTRUCTIONS  TO US AS SOON AS
POSSIBLE  TO  ALLOW US AMPLE  TIME TO  TENDER  SHARES  ON YOUR  BEHALF  PRIOR TO
EXPIRATION OF THE OFFER.




<PAGE>




              INSTRUCTIONS REGARDING THE OFFER TO PURCHASE FOR CASH
                     ALL OUTSTANDING SHARES OF COMMON STOCK
                                       OF
                         COMMUNITY CARE OF AMERICA, INC.
                                       BY
                           IHS ACQUISITION XXVI, INC.

     The undersigned  acknowledge(s)  receipt of your letter enclosing the Offer
to  Purchase  dated  August 7, 1997 (the  "Offer to  Purchase")  and the related
Letter of  Transmittal  pursuant to an offer by IHS  Acquisition  XXVI,  Inc., a
wholly owned  subsidiary of Integrated  Health  Services,  Inc., to purchase all
outstanding  Shares of Common  Stock,  $.0025 par value per share,  of Community
Care of America,  Inc. at a purchase price of $4.00 per Share, net to the seller
in cash, without interest thereon,  upon the terms and subject to the conditions
set forth in the Offer to Purchase and the related Letter of Transmittal.

     This will  instruct  you to tender the Shares  indicated  below (or,  if no
number is indicated  below, all Shares) which are held by you for the account of
the undersigned,  pursuant to the terms of and conditions set forth in the Offer
to Purchase and the related Letter of Transmittal furnished to the undersigned.

Number of Shares to be Tendered (check ONE box):*

[ ] All Shares                         _______________________________________ 
                                                                               
[ ] ____ Shares                        _______________________________________ 
                                       Signature(s)                            
Dated:______________, 1997                                                     
                                       _______________________________________ 
                                                                               
                                       _______________________________________ 
                                       Please print name(s) here               
                                                                               
                                       _______________________________________ 
                                                                               
                                       _______________________________________ 
                                                                               
                                       _______________________________________ 
                                                                               
                                       _______________________________________ 
                                             Please type or print address      
                                       _______________________________________ 
                                             Area Code and Telephone Number    
                                                                               
                                       _______________________________________ 
                                           Taxpayer Identification or Social   
                                                    Security Number            
                                                                               
                                       _______________________________________ 
                                               My Account Number with You      
                                       
- ----------
*UNLESS OTHERWISE  INDICATED,  SIGNATURE(S)  HEREON BY BENEFICIAL OWNER(S) SHALL
CONSTITUTE AN INSTRUCTION TO THE NOMINEE TO TENDER ALL SHARES OF SUCH BENEFICIAL
OWNER(S).


           GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION 
                        NUMBER ON SUBSTITUTE FORM W-9 

GUIDELINES FOR DETERMINING THE PROPER IDENTIFICATION NUMBER TO GIVE THE 
PAYER--Social Security numbers have nine digits separated by two hyphens: 
i.e., 000-00-0000. Employer identification numbers have nine digits separated 
by only one hyphen: i.e., 00-0000000. The table below will help determine the 
type of number to give the payer. 

- --------------------------------------------------------------------------------
                                                  GIVE THE 
                                                  SOCIAL SECURITY 
FOR THIS TYPE OF ACCOUNT:                         NUMBER OF-- 
- --------------------------------------------------------------------------------
 1. ...  Individual                               The individual 

 2.....  Two or more individuals(1)               The actual owner of the 
                                                  (joint) account or, 
                                                  if combined funds, the first 
                                                  individual listed on the 
                                                  account(2) 

 3......  Custodian account of a minor (Uniform   The minor(3) 
          Gift to Minors Act)                     

 4......  a. The usual revocable savings trust    The grantor-trustee(2) 
          (grantor is also trustee)               

          b. So-called trust account that is not 
          a legal or valid trust under State law 

 5......  Sole proprietorship                     The owner(4) 

 6......  Corporate account                       The corporation 

- ----------------------------------------------------------------------------- 
                                                 GIVE THE 
                                                 EMPLOYER IDENTIFICATION 
FOR THIS TYPE OF ACCOUNT:                        NUMBER OF-- 
- ----------------------------------------------------------------------------- 
 7......  Association, club, religious,          The organization 
          charitable, educational or other 
          tax-exempt organization                

 8......  Partnership account                    The partnership 

 9......  A broker or registered nominee         The broker or nominee 

10......  Account with the Department of         The public entity 
          Agriculture in the name of a public 
          entity (such as a state or local 
          government, school district or 
          prison) that receives agricultural 
          program payments                      
 11.....  A valid trust, estate or pension       The legal entity(5) 
          trust                                  


(1)  Includes  husband and wife, and adult and minor.  If adult and minor,  give
     Social  Security  number  of the  adult  or,  if  the  minor  is  the  only
     contributor, the minor.

(2)  List first and circle the name of the person whose number you furnish.

(3)  Circle the minor's name and furnish the minor's social security number.

(4)  Show your  individual  name. You may also enter your business name. You may
     use either your SSN or EIN.

(5)  List first and circle the name of the valid trust,  estate or pension fund.
     (Do not furnish the identifying  number of the personal  representative  or
     trustee unless the legal entity is not designated in the account title.)

NOTE: If no name is circled when there is more than one name, the number will be
considered to be that of the first name listed.
<PAGE>
<TABLE>
<CAPTION>
                                       GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
                                                 NUMBER (TIN) ON SUBSTITUTE FORM W-9
                                        (SECTION REFERENCES ARE TO THE INTERNAL REVENUE CODE)
                                                               PAGE 2
<S>                                                               <C>
NAME 

If you  are an individual,  you must  generally  provide the name  (15) A trust exempt from tax under section 664(c) or described in
shown on your social security card.  However, if you have changed       section 4947(a)(1).                                         
your last name, for instance, due to marriage,  without informing                                                                   
the Social  Security  Administration  of the name change,  please  Payments of dividends generally not subject to backup withholding
enter  your  first  name,  the last  name  shown  on your  social  include the following:                                           
security card, and your new last name.                                                                                              
                                                                        o    Payments to  nonresident  aliens subject to withholding
                                                                             under section 1441.                                    
OBTAINING A NUMBER                                                                                                                  
                                                                        o    Payments  to  partnerships  not  engaged  in a trade or
If you don't have a taxpayer identification number ("TIN"), apply            business in the U.S. that have at least one nonresident
for one immediately.  To apply, obtain Form SS-5, Application for            alien partner.                                         
a Social  Security  Card,  from our local  office  of the  Social                                                                   
Security  Administration,  or Form SS-4, Application for Employer                                                                   
Identification  Number,  from your local Internal Revenue Service       o    Payments made by certain foreign organizations.        
(the "IRS") office.                                                                                                                 
                                                                   Payments of interest  generally not subject to backup withholding
                                                                   include the following:                                           
PAYEES AND PAYMENTS EXEMPT FROM                                                                                                     
 BACKUP WITHHOLDING                                                     o    Payments   of  interest   on   obligations   issued  by
                                                                             individuals.   Note:  You  may  be  subject  to  backup
                                                                             withholding  if this  interest  is $600 or more  and is
The  following is a list of payees  generally  exempt from backup            paid in the course of the payor's trade or business and
withholding  and for which no information  reporting is required.            you have not provided your correct TIN to the payor.   
For interest and  dividends,  all listed payees are exempt except                                                                   
item (9). For broker  transactions,  payees listed in (1) through       o    Payments    of    tax-exempt     interest    (including
(13) and a person registered under the Investment Advisers Act of            exempt-interest dividends under section 852).          
1940 who regularly acts as a broker are exempt.  Payments subject                                                                   
to reporting  under sections 6041 and 6041A are generally  exempt       o    Payments described in section 6049(b)(5) to nonresident
from backup withholding only if made to payees described in items            aliens.                                                
(1)  through  (7),  except  that a  corporation  (except  certain                                                                   
hospitals  described in  Regulations  section  1.6041-3(a))  that       o    Payments on tax-free covenant bonds under section 1451.
provides  medical and  healthcare  services or bills and collects                                                                   
payments for such services is not exempt from backup  withholding       o    Payments made by certain foreign organizations.        
or information reporting.                                                                                                           
                                                                        o    Mortgage interest paid by you.                         
                                                                                                                                    
(1)  A corporation.                                                                                                                 
                                                                   Payments  that  are not  subject  to  information  reporting  are
(2)  An organization  exempt from tax under section 501(a), or an  generally  also not subject to backup  withholding.  For details,
     individual  retirement plan ("IRA"),  or a custodial account  see sections 6041,  6041A(a),  6042,  6044, 6045, 6049, 6050A and
     under  section   403(b)(7)  if  the  account  satisfies  the  6050N, and the regulations under those sections.                 
     requirements of section 401(f)(2).                                                                                             
                                                                   PRIVACY ACT  NOTICE.--Section  6109  requires you to furnish your
(3)  The   United    States   or   any   of   its   agencies   or  correct TIN to persons who must file information returns with the
     instrumentalities.                                            IRS to report interest,  dividends, and certain other income paid
                                                                   to  you,   mortgage   interest  you  paid,  the   acquisition  or
                                                                   abandonment  of  secured  property,   cancellation  of  debt,  or
(4)  A state,  the  District of  Columbia,  a  possession  of the  contributions  you made to an IRA.  The IRS uses the  numbers for
     United States,  or any of their  political  subdivisions  or  identification  purposes  and to help verify the accuracy of your
     instrumentalities.                                            tax  return.  You must  provide  your TIN  whether or not you are
                                                                   required to file a tax return. Payors must generally withhold 31%
                                                                   of taxable  interest,  dividend,  and certain other payments to a
(5)  A foreign  government or any of its political  subdivisions,  payee who does not  furnish a TIN to a payor.  Certain  penalties
     agencies or instrumentalities.                                may also apply.                                                  
                                                                                                                                    
(6)  An  international  organization  or any of its  agencies  or  PENALTIES                                                        
     instrumentalities.                                                                                                             
                                                                   (1) FAILURE TO FURNISH  TIN.--If you fail to furnish your correct
(7)  A foreign central bank of issue.                              TIN to a requester  (the person  asking you to furnish your TIN),
                                                                   you are subject to a penalty of $50 for each such failure  unless
(8)  A dealer in securities or  commodities  required to register  your  failure  is due to  reasonable  cause  and  not to  willful
     in the U.S., the District of Columbia or a possession of the  neglect.                                                         
     U.S.                                                                                                                           
                                                                   (2)  CIVIL  PENALTY  FOR  FALSE   INFORMATION   WITH  RESPECT  TO
(9)  A futures commission  merchant registered with the Commodity  WITHHOLDING.--If  you make a false  statement  with no reasonable
     Futures Trading Commission.                                   basis that results in no backup withholding, you are subject to a
                                                                   $500 penalty.                                                    
(10) A real estate investment trust.                                                                                                
                                                                   (3)  CRIMINAL  PENALTY FOR  FALSIFYING  INFORMATION.  --Willfully
(11) An entity  registered at all times during the tax year under  falsifying  certifications  or  affirmations  may  subject you to
     the Investment Company Act of 1940.                           criminal penalties including fines and/or imprisonment.          
                                                                                                                                    
(12) A common trust fund operated by a bank under section 584(a).  FOR ADDITIONAL INFORMATION CONTACT YOUR TAX CONSULTANT OR THE IRS
                                                                                                                                    
(13) A financial institution.                                      

(14) A middleman  known in the investment  community as a nominee
     or listed in the most  recent  publication  of the  American
     Society of Corporate Secretaries, Inc., Nominee List.
</TABLE>

FOR IMMEDIATE RELEASE:

                                  Contact:   Robert N. Elkins, M.D.
                                  Chairman & CEO
                                  Marc B. Levin
                                  Executive Vice President
                                  Integrated Health Services, Inc.
                                  (410) 998-8400

                                  Anthony J. Russo, Ph.D., ext. 202
                                  Noonan/Russo Communications, Inc.
                                  (212) 696-4455

                                  ---------------------------------------------
                                  Available on the Internet:
                                  http://www.ihs-inc.com
                                  ---------------------------------------------


                      INTEGRATED HEALTH SERVICES TO ACQUIRE
                            COMMUNITY CARE OF AMERICA

         Owings  Mills,  MD, and  Naples,  FL August 1, 1997  Integrated  Health
Services,  Inc. (NYSE: IHS) and Community Care of America,  Inc. (Nasdaq:  CCAI)
today jointly  announced that they have signed a definitive merger agreement for
IHS to acquire all of the outstanding  shares of CCA. Community Care of America,
Inc., based in Naples, FL, is a provider of healthcare services in rural markets
focused on developing  community-based  networks providing a broad range of high
quality,  low-cost  healthcare  services.  The Company's  operations  include 54
long-term  care  facilities,   one  physician   practice,   and  one  outpatient
rehabilitation center.

         Pursuant to the  agreement,  IHS will  commence a tender offer of $4.00
per share in cash for all outstanding shares of Community Care of America common
stock.  Integrated  Health Services expects to commence its cash tender offer on
August 7, 1997.  This  tender  offer will be  followed by a $4.00 per share cash
merger  to  acquire  any  shares  not  previously  tendered.  As a result of the
transaction, Community Care of America would become a wholly-owned subsidiary of
Integrated Health Services.  The transaction was approved by special  committees
of the boards of IHS and CCA,  each of which  were  represented  by  independent
counsel and advised by separate investment banking firms. IHS was the successful
bidder  following an auction process  conducted by the special  committee of the
CCA board in conjunction with its advisors.

         The transaction has been approved by the Boards of Directors of IHS and
CCA.  The cash  tender  offer is  subject  to at least a  majority  of the fully
diluted  shares of CCA being  tendered,  as well as the receipt of the  required
regulatory  approvals.  Stockholders owning  approximately 2.9 million shares of
CCA common  stock have agreed to tender  their  shares.  In  addition,  IHS owns
warrants exercisable for approximately 1.2 million shares. The parties expect to
complete the transaction within 90 days.

         CCA has approximately 7.6 million shares  outstanding and approximately
10.7  million  shares  on  a  fully  diluted  basis.  The  total  value  of  the
transaction,



<PAGE>

including the assumption of CCA's debt by IHS and other  financial  obligations,
will  approximate  $94 million.  IHS expects the  transaction to be accretive to
earnings and earnings per share as a result of the cost  synergies and economies
of scale IHS brings to CCA.

         "The  acquisition  of CCA will broaden our  post-acute  care network to
include  more rural  markets and  complement  our home care  locations  in rural
markets as well as  complementing  our  announced  merger  with  RoTech  Medical
Corporation," said Robert N. Elkins, M.D., Chairman and CEO of IHS. "We view the
rural market as a growth opportunity for our post-acute networks,  with about 62
million people living in rural America."

         Integrated  Health  Services is a highly  diversified  health  services
provider,  offering a broad  spectrum of post-acute  medical and  rehabilitative
services through its nationwide  healthcare  network.  IHS's post-acute services
include home nursing services, home infusion services,  subacute care, inpatient
and outpatient rehabilitation, respiratory therapy, hospice care, and diagnostic
services.  Supporting  the full  continuum of  healthcare  needs,  IHS currently
operates over 1,000  post-acute  service  locations in 45 states  throughout the
U.S.

         Statements  in this press  release  concerning  the Company's and CCA's
business  outlook or future economic  performances,  anticipated  profitability,
revenues,  expenses or other  financial  items,  anticipated  cost synergies and
product or service  line growth,  together  with other  statements  that are not
historical facts, are "forward-looking statements" as that term is defined under
the Federal  Securities  Laws.  Any  forward-looking  statements  are estimates,
reflecting  the best  judgment  of IHS and CCA based  upon  currently  available
information and involve a number of risks, uncertainties and other factors which
could  cause  actual  results to differ  materially  from  those  stated in such
statements.  Risks, uncertainties and factors which could affect the accuracy of
such forward looking statements are identified in the public filings made by the
Company and CCA with the Securities and Exchange Commission, and forward looking
statements  contained in this press release or in other public statements of the
Company and CCA should be considered in light of those factors.  There can be no
assurance  that factors  will not affect the  accuracy of such  forward  looking
statements.

CONTACTS:

Integrated Health Services              Community Care of America

Investors:     Marc Levin               Investors/Media:  Deborah Lau
               IHS - 410/998-8428       Community Care of America
                                        941/435-0085
Media:         Michele Helm
               Noonan/Russo Communications
               212/696-4455 ext. 225


                                      -2-


                                                                  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



<PAGE>


                                       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.

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                                       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

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                                       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

<PAGE>


                                       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

<PAGE>


                                       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

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                                       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

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                                       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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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;

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                                       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,

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                                       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

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                                       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

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                                       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

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                                        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.

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                                       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




                          AGREEMENT AND PLAN OF MERGER



                                      Among



                        INTEGRATED HEALTH SERVICES, INC.,



                           IHS ACQUISITION XXVI, INC.



                                       and



                         COMMUNITY CARE OF AMERICA, INC.



                           Dated as of August 1, 1997





<PAGE>


<TABLE>
<CAPTION>

                                TABLE OF CONTENTS


                                                                                                      Page

<S>                                                                                                    <C>
ARTICLE I The Offer ................................................................................... 2

   SECTION 1.01.  The Offer ........................................................................... 2
   SECTION 1.02.  Company Actions ..................................................................... 4

ARTICLE II The Merger ................................................................................. 6

   SECTION 2.01.  The Merger .......................................................................... 6
   SECTION 2.02.  Closing ............................................................................. 6
   SECTION 2.03.  Effective Time ...................................................................... 6
   SECTION 2.04.  Effects of the Merger ............................................................... 6
   SECTION 2.05.  Certificate of Incorporation and By-laws ............................................ 6
   SECTION 2.06.  Directors ........................................................................... 7
   SECTION 2.07.  Officers ............................................................................ 7

ARTICLE III Effect of the Merger on the Capital Stock of the Constituent Corporations;
                         Exchange of Certificates ..................................................... 7

   SECTION 3.01.  Effect on Capital Stock ............................................................. 7
   SECTION 3.02.  Exchange of Certificates ............................................................ 9

ARTICLE IV Representations and Warranties of the Company ..............................................11

   SECTION 4.01.  Organization ........................................................................11
   SECTION 4.02.  Subsidiaries ........................................................................12
   SECTION 4.03.  Capitalization ......................................................................12
   SECTION 4.04.  Authority ...........................................................................13
   SECTION 4.05.  Consents and Approvals; No Violations................................................13
   SECTION 4.06.  SEC Reports and Financial Statements.................................................14
   SECTION 4.07.  Absence of Certain Changes or Events.................................................15
   SECTION 4.08.  No Undisclosed Liabilities...........................................................16
   SECTION 4.09.  Information Supplied.................................................................16
   SECTION 4.10.  Benefit Plans .......................................................................17
   SECTION 4.11.  Other Compensation Arrangements......................................................19
   SECTION 4.12.  Litigation ..........................................................................19
   SECTION 4.13.  Compliance with Applicable Law.......................................................20
   SECTION 4.14.  Tax Matters .........................................................................20
   SECTION 4.15.  State Takeover Statutes..............................................................22
   SECTION 4.16.  Brokers; Fees and Expenses...........................................................22


                                       i
<PAGE>

   SECTION 4.17.  Opinions of Financial Advisors.......................................................22
   SECTION 4.18.  Intellectual Property................................................................23
   SECTION 4.19.  Labor Matters .......................................................................24
   SECTION 4.20.  Real Property, Leases and Assets.....................................................25
   SECTION 4.21.  Questionnaire .......................................................................25
   SECTION 4.22.  Environmental Matters................................................................25
   SECTION 4.23.  Reimbursement Matters................................................................27
   SECTION 4.24.  Material Contracts...................................................................28
   SECTION 4.25.  Insurance ...........................................................................29

ARTICLE V Representations and Warranties of Parent and Sub.............................................30

   SECTION 5.01.  Organization ........................................................................30
   SECTION 5.02.  Authority ...........................................................................30
   SECTION 5.03.  Consents and Approvals; No Violations................................................31
   SECTION 5.04.  Information Supplied.................................................................31
   SECTION 5.05.  Interim Operations of Sub............................................................32
   SECTION 5.06.  Brokers .............................................................................32
   SECTION 5.07.  Financing ...........................................................................32
   SECTION 5.08.  Section 2.03 ........................................................................32

ARTICLE VI Covenants ..................................................................................33

   SECTION 6.01.  Covenants of the Company.............................................................33
   SECTION 6.02.  No Solicitation .....................................................................36
   SECTION 6.03.  Other Actions .......................................................................38

ARTICLE VII Additional Agreements.......................................................................39

   SECTION 7.01.  Stockholder Approval; Preparation of Proxy Statement..................................39
   SECTION 7.02.  Access to Information.................................................................40
   SECTION 7.03.  Reasonable Efforts....................................................................40
   SECTION 7.04.  Options; Warrants ....................................................................41
   SECTION 7.05.  Directors ............................................................................42
   SECTION 7.06.  Fees and Expenses ....................................................................43
   SECTION 7.07.  Indemnification; Insurance............................................................44
   SECTION 7.08.  Certain Litigation....................................................................44

ARTICLE VIII Conditions ................................................................................44

   SECTION 8.01.  Conditions to Each Party's Obligation To Effect the Merger............................44

ARTICLE IX Termination and Amendment....................................................................45

   SECTION 9.01.  Termination ..........................................................................45


                                       ii
<PAGE>

   SECTION 9.02.  Effect of Termination.................................................................47
   SECTION 9.03.  Amendment ............................................................................47
   SECTION 9.04.  Extension; Waiver ....................................................................48

ARTICLE X Miscellaneous ................................................................................48

   SECTION 10.01.  Nonsurvival of Representations and Warranties........................................48
   SECTION 10.02.  Notices .............................................................................48
   SECTION 10.03.  Interpretation ......................................................................49
   SECTION 10.04.  Counterparts ........................................................................50
   SECTION 10.05.  Entire Agreement; Third Party Beneficiaries..........................................50
   SECTION 10.06.  Governing Law .......................................................................50
   SECTION 10.07.  Publicity ...........................................................................50
   SECTION 10.08.  Assignment ..........................................................................50
   SECTION 10.09.  Enforcement .........................................................................51

Exhibits

Exhibit A - Conditions of the Offer

</TABLE>













                                       iii
<PAGE>



                  AGREEMENT AND PLAN OF MERGER dated as of August 1, 1997, among
INTEGRATED  HEALTH  SERVICES,  INC.,  a  Delaware  corporation  ("Parent"),  IHS
ACQUISITION  XXVI,  INC., a Delaware  corporation  and an indirect  wholly owned
subsidiary of Parent  ("Sub"),  and COMMUNITY CARE OF AMERICA,  INC., a Delaware
corporation (the "Company").

                  WHEREAS the respective Boards of Directors of Parent,  Sub and
the Company have approved the  acquisition of the Company by Parent on the terms
and subject to the conditions set forth in the Agreement;

                  WHEREAS,  in furtherance of such acquisition,  Parent proposes
to cause Sub to make a tender  offer (as it may be amended  from time to time as
permitted  under the  Agreement,  the "Offer") to purchase  all the  outstanding
shares of Common  Stock,  par value  $0.0025  per  share,  of the  Company  (the
"Company Common Stock"; all the outstanding shares of Company Common Stock being
hereinafter  collectively  referred to as the  "Shares") at a purchase  price of
$4.00 per share (the "Offer Price"), net to the seller in cash, without interest
thereon,  upon  the  terms  and  subject  to the  conditions  set  forth  in the
Agreement;  and the Board of  Directors  of the Company has adopted  resolutions
approving  the Offer and the Merger (as defined  below),  recommending  that the
Company's  stockholders accept the Offer and approving the acquisition of Shares
by Sub pursuant to the Offer;

                  WHEREAS the respective Boards of Directors of Parent,  Sub and
the  Company  have  each  approved  the  merger  of Sub  into the  Company  (the
"Merger"),  upon the  terms  and  subject  to the  conditions  set  forth in the
Agreement,  whereby  each share of Company  Common  Stock,  other than shares of
Company  Common Stock owned  directly or indirectly by Parent or the Company and
Dissenting  Shares (as defined in Section  3.01(d)),  will be converted into the
right to receive the Offer Price; and

                  WHEREAS  Parent,  Sub and the Company  desire to make  certain
representations,  warranties,  covenants and  agreements in connection  with the
Offer and the Merger and also to prescribe  various  conditions to the Offer and
the Merger.

                  NOW,  THEREFORE,  in  consideration  of the  foregoing and the
mutual covenants and agreements herein contained,



<PAGE>




and  intending to be legally bound hereby,  Parent,  Sub and the Company  hereby
agree as follows:


                                    ARTICLE I

                                    THE OFFER

                  SECTION 1.01. The Offer.  (a) Subject to the provisions of the
Agreement,  as promptly as practicable  but in no event later than five business
days after the date of the public  announcement by Parent and the Company of the
execution and delivery of this Agreement,  Sub shall, and Parent shall cause Sub
to, commence the Offer. The obligation of Sub to, and of Parent to cause Sub to,
commence  the Offer and accept for  payment,  and pay for,  any Shares  tendered
pursuant to the Offer shall be subject to the  conditions set forth in Exhibit A
(the "Offer  Conditions") and to the terms and conditions of the Agreement.  Sub
expressly  reserves  the right to modify  the terms of the Offer,  except  that,
without  the  consent  of the  Company,  Sub shall not (i)  reduce the number of
Shares subject to the Offer, (ii) reduce the Offer Price, (iii) add to the Offer
Conditions,  (iv) except as provided in the next sentence, extend the Offer, (v)
change the form of consideration payable in the Offer, (vi) amend any other term
of or add any new term to the  Offer in any  manner  materially  adverse  to the
holders  of the  Shares or (vii)  waive the  Minimum  Condition  (as  defined in
Exhibit A).  Notwithstanding the foregoing,  Sub may, without the consent of the
Company,  (A)  Subject to  Section  9.01(b)(i)(Y),  extend the Offer,  if at the
scheduled or extended  expiration date of the Offer any of the Offer  Conditions
shall  not be  satisfied  or  waived,  until  such time as such  conditions  are
satisfied or waived,  (B) extend the Offer for any period  required by any rule,
regulation, interpretation or position of the Securities and Exchange Commission
(the "SEC") or the staff thereof  applicable to the Offer,  (C) extend the Offer
from time to time until two business days after expiration of the waiting period
under the HSR Act (as  defined in Section  4.05  below) and (D) extend the Offer
for a period not to exceed 15 business days, notwithstanding that all conditions
to the  Offer  are  satisfied  as of  such  expiration  date of the  Offer,  if,
immediately  prior to such expiration  date (as it may be extended),  the Shares
tendered  and not  withdrawn  pursuant  to the Offer  equal less than 90% of the
outstanding  Shares  (on a  fully  diluted  basis).  Subject  to the  terms  and
conditions of the Offer and the Agreement, Sub shall, and Parent shall cause Sub
to, accept for payment,


                                      -2-
<PAGE>




and pay for, all Shares validly tendered and not withdrawn pursuant to the Offer
that Sub becomes  obligated to accept for payment,  and pay for, pursuant to the
Offer as soon as practicable after the expiration of the Offer.


                  (b) On the date of commencement  of the Offer,  Parent and Sub
shall  file  with  the SEC a Tender  Offer  Statement  on  Schedule  14D-1  (the
"Schedule  14D-1")  with respect to the Offer,  which shall  contain an offer to
purchase and a related letter of  transmittal  and summary  advertisement  (such
Schedule 14D-1 and the documents  included  therein  pursuant to which the Offer
will be made,  together with any supplements or amendments  thereto,  the "Offer
Documents").  Parent and Sub agree that the Offer  Documents  shall comply as to
form in all material  respects  with the  Securities  Exchange  Act of 1934,  as
amended  (the  "Exchange  Act"),  and  the  rules  and  regulations  promulgated
thereunder and the Offer Documents,  on the date first published,  sent or given
to the  Company's  stockholders,  shall not  contain any untrue  statement  of a
material fact or omit to state any 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,  except  that no
representation  or warranty is made by Parent or Sub with respect to information
supplied by the Company or any of its stockholders specifically for inclusion or
incorporation by reference in the Offer Documents.  Parent,  Sub and the Company
each agrees  promptly to correct any  information  provided by it for use in the
Offer  Documents  if and to the extent that such  information  shall have become
false or misleading in any material respect, and Parent and Sub further agree to
take all steps necessary to cause the Schedule 14D-1 as so corrected to be filed
with the SEC and the other Offer Documents as so corrected to be disseminated to
holders of  Shares,  in each case as and to the extent  required  by  applicable
securities  laws.  The  Company  and  its  counsel  shall  be  given  reasonable
opportunity to review and comment upon the Offer Documents prior to their filing
with the SEC or dissemination to the stockholders of the Company. Parent and Sub
agree to provide the Company and its counsel any comments  Parent,  Sub or their
counsel  may  receive  from  the SEC or its  staff  with  respect  to the  Offer
Documents promptly after the receipt of such comments.

                  (c) Parent  shall  provide or cause to be provided to Sub on a
timely basis the funds necessary to accept for


                                      -3-
<PAGE>




payment,  and pay for,  any  Shares  that Sub  becomes  obligated  to accept for
payment, and pay for, pursuant to the Offer.


                  SECTION 1.02. Company Actions. (a) The Company hereby approves
of and consents to the Offer and  represents  that the Special  Committee of the
Board of  Directors  of the  Company,  at a meeting  duly called and held,  duly
adopted  resolutions  approving  the  Agreement,   the  Offer  and  the  Merger,
determining  that the terms of the Offer and the  Merger are fair to, and in the
best  interests  of,  the  Company's  stockholders,  and the Board of  Directors
ratified such action and recommended that the Company's  stockholders accept the
Offer,  tender  their  shares  pursuant  to the Offer and  approve and adopt the
Agreement. The Company represents that such approval constitutes approval of the
Offer, the Agreement and the  transactions  contemplated  hereby,  including the
Merger, for purposes of Section 203 of the Delaware General  Corporation Law, as
amended  (the  "DGCL"),  such that,  assuming the truth and  correctness  of the
representation  in Section  5.08,  Section 203 of the DGCL will not apply to the
transactions  contemplated  by the Agreement.  The Company  represents  that its
Board of  Directors  has  received  the  opinions of Smith  Barney Inc.  ("Smith
Barney") and Wheat, First Securities,  Inc. ("Wheat First"), each dated the date
of this Agreement,  to the effect that, as of such date, the cash  consideration
to be received by the holders of Shares  (other than Parent and its  affiliates)
pursuant  to the Offer and the Merger is fair to such  holders  from a financial
point of view,  and complete and correct  signed copies of such opinions will be
included in the Company's  Schedule  14D-9 (as defined  below) and such opinions
may be referenced by Parent in the Schedule 14D-1.

                  (b) At the time the Offer  Documents  are filed  with the SEC,
the Company shall file with the SEC a  Solicitation/Recommendation  Statement on
Schedule 14D-9 with respect to the Offer (such Schedule  14D-9,  as amended from
time to time, the "Schedule 14D-9") containing the  recommendation  described in
paragraph  (a) and shall  mail the  Schedule  14D-9 to the  stockholders  of the
Company.  The Schedule  14D-9 shall  comply as to form in all material  respects
with  the  requirements  of the  Exchange  Act and  the  rules  and  regulations
promulgated thereunder and, on the date filed with the SEC and on the date first
published,  sent or given to the Company's  stockholders,  shall not contain any
untrue  statement of a material fact or omit to state any material fact required
to be stated  therein or necessary in order to make the statements  therein,  in
light


                                      -4-
<PAGE>




of the circumstances under which they were made, not misleading,  except that no
representation  or warranty is made by the Company with  respect to  information
supplied by Parent or Sub specifically for inclusion in the Schedule 14D-9. Each
of the  Company,  Parent and Sub agrees  promptly  to  correct  any  information
provided  by it for use in the  Schedule  14D-9 if and to the  extent  that such
information shall have become false or misleading in any material  respect,  and
the Company  further  agrees to take all steps  necessary to amend or supplement
the Schedule 14D-9 and to cause the Schedule 14D-9 as so amended or supplemented
to be filed with the SEC and disseminated to the Company's stockholders, in each
case as and to the extent required by applicable Federal securities laws. Parent
and its counsel shall be given reasonable opportunity to review and comment upon
the  Schedule  14D-9  prior  to its  filing  with  the SEC or  dissemination  to
stockholders  of the  Company.  The  Company  agrees to  provide  Parent and its
counsel any  comments the Company or its counsel may receive from the SEC or its
staff with  respect to the  Schedule  14D-9  promptly  after the receipt of such
comments.


                  (c) In connection  with the Offer and the Merger,  the Company
shall  furnish or cause its transfer  agent to furnish Sub promptly with mailing
labels  containing the names and addresses of the record holders of Shares as of
a recent date and of those persons  becoming  record holders  subsequent to such
date,  together  with  copies of all lists of  stockholders,  security  position
listings  and  computer  files  and  all  other  information  in  the  Company's
possession  or control  regarding  the  beneficial  owners of Shares,  and shall
furnish to Sub such  information  and  assistance  (including  updated  lists of
stockholders,  security  position  listings  and  computer  files) as Parent may
reasonably  request in  communicating  the Offer to the Company's  stockholders.
Subject to the  requirements of applicable law, and except for such steps as are
necessary to disseminate the Offer  Documents and any other documents  necessary
to  consummate  the  Merger,  Parent  and Sub and  their  agents  shall  hold in
confidence  the  information  contained in any such labels,  listings and files,
will use such  information only in connection with the Offer and the Merger and,
if the Agreement shall be terminated,  will, upon request, deliver, and will use
their best efforts to cause their  agents to deliver,  to the Company all copies
of such information then in their possession or control.


                                      -5-
<PAGE>



                                   ARTICLE II

                                   THE MERGER

                  SECTION  2.01.  The Merger.  Upon the terms and subject to the
conditions  set forth in the  Agreement,  and in  accordance  with the  Delaware
General  Corporation Law, as amended (the "DGCL"),  Sub shall be merged with and
into the Company at the Effective Time (as defined in Section  2.03).  Following
the Effective Time, the separate corporate  existence of Sub shall cease and the
Company  shall   continue  as  the   surviving   corporation   (the   "Surviving
Corporation")  and shall succeed to and assume all the rights and obligations of
Sub in accordance with the DGCL.

                  SECTION  2.02.  Closing.   The  closing  of  the  Merger  (the
"Closing")  will take place at 10:00  a.m.  (New York City time) on a date to be
specified by Parent or Sub, which shall be no later than the second business day
after  satisfaction  or waiver of the  conditions set forth in Article VIII (the
"Closing Date"), at the offices of Chadbourne & Parke LLP, 30 Rockefeller Plaza,
New York,  New York 10112,  unless  another date,  time or place is agreed to in
writing by the parties hereto.

                  SECTION 2.03. Effective Time. Subject to the provisions of the
Agreement,  as soon as  practicable  on or after the Closing  Date,  the parties
shall file a certificate of merger or other  appropriate  documents (in any such
case,  the  "Certificate  of Merger")  executed in accordance  with the relevant
provisions of the DGCL and shall make all other  filings or recordings  required
under  the  DGCL.  The  Merger  shall  become  effective  at  such  time  as the
Certificate of Merger is duly filed with the Delaware  Secretary of State, or at
such other time as Sub and the Company  shall agree  should be  specified in the
Certificate of Merger (the time the Merger becomes  effective being  hereinafter
referred to as the "Effective Time").

                  SECTION 2.04. Effects of the Merger. The Merger shall have the
effects set forth in Section 259 of the DGCL.

                  SECTION 2.05.  Certificate of Incorporation  and By-laws.  (a)
The  Restated  Certificate  of  Incorporation  of  the  Company,  as  in  effect
immediately  prior to the Effective  Time,  shall be amended as of the Effective
Time so that ARTICLE FOURTH of such  certificate of  incorporation  reads in its
entirety as follows: "The total number of shares of all


                                      -6-
<PAGE>




classes of stock which the  Corporation  shall have  authority  to issue is 1000
shares of Common Stock,  par value  $0.0025 per share" and, as so amended,  such
certificate of  incorporation  shall be the certificate of  incorporation of the
Surviving Corporation until thereafter changed or amended as provided therein or
by applicable law.


                  (b) The by-laws of the Company as in effect  immediately prior
to the Effective Time shall be the by-laws of the Surviving  Corporation,  until
thereafter changed or amended as provided therein or by applicable law.

                  SECTION  2.06.  Directors.  The  directors of Sub  immediately
prior to the Effective Time shall be the directors of the Surviving Corporation,
until the  earlier of their  resignation  or removal or until  their  respective
successors are duly elected and  qualified,  as the case may be, and the Company
shall procure,  prior to and as a condition to the Closing,  the  resignation of
each of its directors effective as of the Closing.

                  SECTION   2.07.   Officers.   The   officers  of  the  Company
immediately  prior to the Effective  Time shall be the officers of the Surviving
Corporation,  until the earlier of their  resignation  or removal or until their
respective successors are duly elected and qualified, as the case may be.

                                   ARTICLE III

                EFFECT OF THE MERGER ON THE CAPITAL STOCK OF THE
               CONSTITUENT CORPORATIONS; EXCHANGE OF CERTIFICATES

                  SECTION  3.01.  Effect on Capital  Stock.  As of the Effective
Time,  by virtue of the Merger and  without any action on the part of the holder
of any Shares or any shares of capital stock of Sub:

                  (a) Capital Stock of Sub. Each issued and outstanding share of
capital  stock of Sub shall be  converted  into and  become  1000 fully paid and
nonassessable  shares of Common  Stock,  par value  $0.0025  per  share,  of the
Surviving Corporation.

                  (b)  Cancellation  of Treasury  Stock and Parent  Owned Stock.
Each  share of  Company  Common  Stock  that is owned by the  Company  or by any
subsidiary  of the  Company  and each Share that is owned by Parent,  Sub or any
other


                                      -7-
<PAGE>




subsidiary of Parent shall automatically be canceled and retired and shall cease
to exist, and no consideration shall be delivered in exchange therefor.


                  (c)  Conversion of Company  Common  Stock.  Subject to Section
3.01(d),  each Share issued and outstanding (other than Shares to be canceled in
accordance  with Section  3.01(b))  shall be converted into the right to receive
from the Surviving  Corporation in cash, without interest,  the Offer Price (the
"Merger  Consideration").  As of the  Effective  Time,  all such Shares shall no
longer be outstanding and shall  automatically be canceled and retired and shall
cease to exist,  and each holder of a certificate  representing  any such Shares
shall cease to have any rights with respect thereto, except the right to receive
the Merger Consideration, without interest.

                  (d)  Shares  of   Dissenting   Stockholders.   Notwithstanding
anything in the Agreement to the  contrary,  any issued and  outstanding  Shares
held  by a  person  (a  "Dissenting  Stockholder")  who  complies  with  all the
provisions  of Delaware law  concerning  the right of holders of Company  Common
Stock  to  dissent  from the  Merger  and  require  appraisal  of  their  Shares
("Dissenting Shares") shall not be converted as described in Section 3.01(c) but
shall become the right to receive such  consideration as may be determined to be
due to  such  Dissenting  Stockholder  pursuant  to the  laws  of the  State  of
Delaware.  If, after the Effective Time, such Dissenting  Stockholder  withdraws
his demand for  appraisal  or fails to perfect or  otherwise  loses his right of
appraisal,  in any case  pursuant to the DGCL,  his Shares shall be deemed to be
converted  as of the  Effective  Time  into the  right  to  receive  the  Merger
Consideration.  The Company  shall give Parent (i) prompt  notice of any demands
for  appraisal  of Shares  received by the Company and (ii) the  opportunity  to
participate in and direct all  negotiations  and proceedings with respect to any
such  demands.  The  Company  shall not,  without the prior  written  consent of
Parent,  make any  payment  with  respect  to,  or  settle,  offer to  settle or
otherwise negotiate, any such demands.

                  (e)  Withholding  Tax.  Parent shall be entitled to deduct and
withhold from the consideration  otherwise payable pursuant to this Agreement to
any  holder  of  shares of Common  Stock  outstanding  immediately  prior to the
Effective  Time such amounts as may be required to be deducted and withheld with
respect to the making of such payment under the


                                      -8-
<PAGE>




Internal  Revenue Code of 1986,  as amended (the  "Code"),  or any  provision of
state,  local or foreign tax law. To the extent  that  amounts are so  withheld,
such  withheld  amounts  shall be treated for all purposes of this  Agreement as
having  been paid to the  holder  of the  shares  of  Common  Stock  outstanding
immediately  prior to the Effective  Time in respect of which such deduction and
withholding was made.


                  SECTION 3.02.  Exchange of Certificates.

                  (a) Paying Agent.  Prior to the Effective  Time,  Parent shall
designate  a bank or trust  company to act as paying  agent in the  Merger  (the
"Paying  Agent"),  and,  from time to time on,  prior to or after the  Effective
Time,  Parent shall make available,  or cause the Surviving  Corporation to make
available,  to the Paying Agent funds in amounts and at the times  necessary for
the  payment  of  the  Merger   Consideration  upon  surrender  of  certificates
representing  Shares as part of the Merger  pursuant  to Section  3.01 (it being
understood  that any and all  interest  earned on funds  made  available  to the
Paying Agent pursuant to the Agreement shall be turned over to Parent).

                  (b)  Exchange  Procedure.  As soon as  reasonably  practicable
after the Effective  Time,  the Paying Agent shall mail to each holder of record
of a certificate or certificates  which  immediately prior to the Effective Time
represented  Shares (the  "Certificates"),  (i) a letter of  transmittal  (which
shall specify that delivery shall be effected, and risk of loss and title to the
Certificates  shall pass,  only upon delivery of the  Certificates to the Paying
Agent and  shall be in a form and have  such  other  provisions  as  Parent  may
reasonably  specify) and (ii) instructions for use in effecting the surrender of
the Certificates in exchange for the Merger  Consideration.  Upon surrender of a
Certificate  for  cancellation  to the Paying  Agent or to such  other  agent or
agents as may be appointed by Parent,  together with such letter of transmittal,
duly  executed,  and such other  documents as may  reasonably be required by the
Paying  Agent,  the holder of such  Certificate  shall be entitled to receive in
exchange  therefor  the  amount  of  cash  into  which  the  Shares  theretofore
represented by such  Certificate  shall have been converted  pursuant to Section
3.01, and the  Certificate so surrendered  shall  forthwith be canceled.  In the
event of a  transfer  of  ownership  of  Shares  that is not  registered  in the
transfer records of the Company,  payment may be made to a person other than the
person in whose name the Certificate so


                                      -9-
<PAGE>




surrendered is registered,  if such  Certificate  shall be properly  endorsed or
otherwise be in proper form for transfer and the person  requesting such payment
shall pay any  transfer  or other  taxes  required by reason of the payment to a
person other than the registered  holder of such Certificate or establish to the
satisfaction of the Surviving  Corporation that such tax has been paid or is not
applicable.  Until  surrendered  as  contemplated  by this  Section  3.02,  each
Certificate  shall be deemed at any time after the  Effective  Time to represent
only the  right to  receive  upon such  surrender  the  amount of cash,  without
interest,  into which the Shares  theretofore  represented  by such  Certificate
shall have been converted  pursuant to Section 3.01. No interest will be paid or
will accrue on the cash payable upon the surrender of any Certificate.


                  (c) No Further  Ownership  Rights in Company Common Stock. All
cash paid upon the surrender of  Certificates  in  accordance  with the terms of
this Article III shall be deemed to have been paid in full  satisfaction  of all
rights pertaining to the Shares theretofore represented by such Certificates. At
the Effective Time, the stock transfer books of the Company shall be closed, and
there shall be no further  registration of transfers on the stock transfer books
of the Surviving  Corporation  of the Shares that were  outstanding  immediately
prior to the Effective  Time.  If, after the Effective  Time,  Certificates  are
presented to the Surviving  Corporation or the Paying Agent for any reason, they
shall be canceled and exchanged as provided in this Article III.

                  (d)  Termination of Fund; No Liability.  At any time following
four  months  after the  Effective  Time,  the  Surviving  Corporation  shall be
entitled to require the Paying Agent to deliver to it any funds  (including  any
interest  received with respect  thereto)  which had been made  available to the
Paying Agent and which have not been disbursed to holders of Certificates, shall
be repaid to the Surviving  Corporation,  and  thereafter  such holders shall be
entitled to look to the Surviving  Corporation  (subject to abandoned  property,
escheat or other similar laws) only as general creditors thereof with respect to
the Merger  Consideration  payable  upon due  surrender  of their  Certificates,
without  any  interest  thereon.  Notwithstanding  the  foregoing,  neither  the
Surviving  Corporation  nor the Paying  Agent shall be liable to any holder of a
Certificate for Merger Consideration delivered to a public official


                                      -10-
<PAGE>




pursuant to any applicable abandoned property, escheat or similar law.


                                   ARTICLE IV

                  REPRESENTATIONS AND WARRANTIES OF THE COMPANY

                  Except as specifically  set forth in the schedule  attached to
this Agreement  corresponding  to the sections of this  Agreement  setting forth
exceptions to the Company's representations and warranties set forth herein (the
"Company  Disclosure  Schedule"),  the Company represents and warrants to Parent
and Sub as set forth below. The Company Disclosure  Schedule will be arranged in
sections  corresponding  to  sections of this  Agreement  to be modified by such
disclosure  schedule.  Nothing  in the  Schedules  shall be deemed  adequate  to
disclose an exception to a  representation  or warranty made herein,  unless the
Schedule  identifies the exception with reasonable  particularity  and describes
the relevant facts in reasonable detail.  Without limiting the generality of the
foregoing, the mere listing (or inclusion of a copy) of a document or other item
shall not be deemed  adequate to disclose an  exception to a  representation  or
warranty made herein (unless the  representation  or warranty has to do with the
existence of the document or other item itself).

                  SECTION  4.01.  Organization.  The  Company  and  each  of its
subsidiaries  is a  corporation  duly  organized,  validly  existing and in good
standing under the laws of the  jurisdiction  of its  incorporation  and has all
requisite  corporate  power and  authority to carry on its business as now being
conducted,  except  where the failure to be so  organized,  existing and in good
standing or to have such power and authority  would not have a material  adverse
effect (as defined in Section 10.03) on the Company. The Company and each of its
subsidiaries  is duly  qualified or licensed to do business and in good standing
in each  jurisdiction in which the property  owned,  leased or operated by it or
the nature of the business conducted by it makes such qualification or licensing
necessary,  except  in  such  jurisdictions  where  the  failure  to be so  duly
qualified or licensed  and in good  standing  would not have a material  adverse
effect on the Company.  The Company has made  available  to Parent  complete and
correct  copies of its Amended and Restated  Certificate  of  Incorporation  and
By-laws  and  the  certificates  of   incorporation   and  by-laws  (or  similar
organizational documents) of its subsidiaries.


                                      -11-
<PAGE>







                  SECTION 4.02.  Subsidiaries.  The  subsidiaries of the Company
are as set forth on Schedule 4.02. All the  outstanding  shares of capital stock
of each such  subsidiary,  are owned by the  Company,  by another  wholly  owned
subsidiary of the Company or by the Company and another wholly owned  subsidiary
of  the  Company,  free  and  clear  of all  pledges,  claims,  liens,  charges,
encumbrances   and  security   interests  of  any  kind  or  nature   whatsoever
(collectively,  "Liens"),  except as  indicated on Schedule  4.02,  and are duly
authorized, validly issued, fully paid and nonassessable. Except for the capital
stock of its subsidiaries, the Company does not own, directly or indirectly, any
capital stock or other ownership interest in any corporation, partnership, joint
venture or other entity.

                  SECTION 4.03. Capitalization.  The authorized capital stock of
the Company consists of 15,000,000  shares of Company Common Stock and 1,000,000
shares of  preferred  stock,  par value  $0.0025 per share  ("Company  Preferred
Stock").  At the close of business on July 28,  1997,  (i)  7,597,801  shares of
Company  Common  Stock  were  issued and  outstanding,  (ii) 0 shares of Company
Common Stock were held by the Company in its treasury,  (iii) 399,094  shares of
Company  Common Stock were reserved for issuance  upon  exercise of  outstanding
Options (as defined in Section 7.04),  and (iv) a maximum of 2,661,341 shares of
Company  Common Stock were  issuable  upon the  exercise of certain  outstanding
warrants,  all as set forth on  Schedule  4.03.  Except  as set forth  above and
except for Shares issued upon the exercise of Options since July 28, 1997, as of
the date of the Agreement, no shares of capital stock or other voting securities
of  the  Company  were  issued,  reserved  for  issuance  or  outstanding.   All
outstanding shares of capital stock of the Company are, and all shares which may
be issued will be, when issued, duly authorized,  validly issued, fully paid and
nonassessable  and  not  subject  to  preemptive  rights.  There  are no  bonds,
debentures,  notes or other indebtedness of the Company having the right to vote
(or convertible into, or exchangeable for,  securities having the right to vote)
on any matters on which  stockholders  of the  Company  may vote.  Except as set
forth above or as set forth on Schedule  4.03, as of the date of the  Agreement,
there  are  no  securities,   options,  warrants,  calls,  rights,  commitments,
agreements, arrangements or undertakings of any kind to which the Company or any
of its  subsidiaries is a party or by which any of them is bound  obligating the
Company or any of its  subsidiaries  to issue,  deliver or sell,  or cause to be
issued, delivered or sold, additional shares of capital


                                      -12-
<PAGE>




stock or other voting securities of the Company or of any of its subsidiaries or
obligating the Company or any of its  subsidiaries  to issue,  grant,  extend or
enter  into  any  such  security,  option,  warrant,  call,  right,  commitment,
agreement,  arrangement or undertaking.  As of the date of the Agreement,  there
are not any outstanding contractual obligations (i) of the Company or any of its
subsidiaries  to repurchase,  redeem or otherwise  acquire any shares of capital
stock of the  Company or (ii) of the Company to vote or to dispose of any shares
of the capital stock of any of its subsidiaries.


                  SECTION  4.04.  Authority.   The  Company  has  the  requisite
corporate  power and  authority  to execute  and deliver  the  Agreement  and to
consummate the transactions contemplated hereby (other than, with respect to the
Merger,  the approval and adoption of the terms of the  Agreement by the holders
of  a  majority  of  the  Shares  (the  "Company  Stockholder  Approval")).  The
execution, delivery and performance of the Agreement and the consummation by the
Company of the Merger and of the other  transactions  contemplated  hereby  have
been  duly  authorized  by all  necessary  corporate  action  on the part of the
Company  and no  other  corporate  proceedings  on the part of the  Company  are
necessary to  authorize  the  Agreement or to  consummate  the  transactions  so
contemplated (in each case, other than, with respect to the Merger,  the Company
Stockholder Approval). The Agreement has been duly executed and delivered by the
Company  and,  constitutes  a  valid  and  binding  obligation  of  the  Company
enforceable against the Company in accordance with its terms.

                  SECTION 4.05.  Consents and Approvals;  No Violations.  Except
for filings, permits, authorizations,  consents and approvals as may be required
under,  and other  applicable  requirements  of, the Exchange Act (including the
filing with the SEC of the Schedule 14D-9 and a proxy statement  relating to any
required  approval by the Company's  stockholders  of the Agreement  (the "Proxy
Statement")),  the  Hart-Scott-Rodino  Antitrust  Improvements  Act of 1976,  as
amended (the "HSR Act"), the DGCL, the laws of other states in which the Company
is qualified to do or is doing  business,  state takeover laws and foreign laws,
neither the  execution,  delivery or performance of the Agreement by the Company
nor the consummation by the Company of the transactions contemplated hereby will
(i)  conflict  with or result in any breach of any  provision of the Amended and
Restated Certificate of Incorporation or By-laws of the


                                      -13-
<PAGE>




Company or of the similar  organizational  documents of any of its subsidiaries,
(ii) require any filing with, or permit, authorization,  consent or approval of,
any Federal,  state or local government or any court,  tribunal,  administrative
agency or  commission or other  governmental  or other  regulatory  authority or
agency,  domestic,  foreign or supranational (a  "Governmental  Entity"),  (iii)
violate  any  order,  writ,  injunction,  decree,  statute,  rule or  regulation
applicable to the Company, any of its subsidiaries or any of their properties or
assets,  or (iv) except as set forth on Schedule 4.05,  result in a violation or
breach of, or constitute (with or without due notice or lapse of time or both) a
default (or give rise to any right of  termination,  amendment,  cancellation or
acceleration)  under,  any of the terms,  conditions  or provisions of any note,
bond,  mortgage,   indenture,  lease,  license,  contract,  agreement  or  other
instrument or obligation  to which the Company or any of its  subsidiaries  is a
party or by which any of them or any of their  properties or assets may be bound
that is described or referenced in Section 4.24.


                  SECTION  4.06.  SEC  Reports  and  Financial  Statements.  The
Company has filed with the SEC, and has heretofore made available to Parent true
and complete  copies of, all forms,  reports,  schedules,  statements  and other
documents required to be filed by it since December 31, 1994, under the Exchange
Act or the Securities Act of 1933 (the "Securities  Act") (such forms,  reports,
schedules, statements and other documents, including any financial statements or
schedules included therein, are referred to as the "Company SEC Documents"). The
Company  SEC  Documents,  at the time  filed,  (a) did not  contain  any  untrue
statement  of a material  fact or omit 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 and (b) complied in
all material  respects with the applicable  requirements of the Exchange Act and
the Securities Act, as the case may be, and the applicable rules and regulations
of the  SEC  thereunder.  Except  to  the  extent  revised  or  superseded  by a
subsequently  filed  Company  Filed SEC Document (as defined in Section 4.07) (a
copy of which has been made  available to Parent prior to the date hereof),  the
Company SEC Documents, considered as a whole as of their date, do not contain an
untrue statement of a material fact or omit to state a material fact required to
be stated or incorporated by reference therein or necessary in order to make the
statements therein, in light of the circumstances under


                                      -14-
<PAGE>




which they were made,  not misleading  (it being  understood  that the foregoing
does not cover future events resulting from public announcement of the Offer and
the Merger). The financial statements of the Company included in the Company SEC
Documents comply as to form in all material respects with applicable  accounting
requirements  and with  the  published  rules  and  regulations  of the SEC with
respect  thereto,  have been  prepared in  accordance  with  generally  accepted
accounting  principles applied on a consistent basis during the periods involved
(except  as may be  indicated  in the  notes  thereto  or,  in the  case  of the
unaudited statements,  as permitted by Forms 10-Q and 8-K of the SEC) and fairly
present (subject, in the case of the unaudited statements,  to normal, recurring
audit  adjustments) the consolidated  financial  position of the Company and its
consolidated  subsidiaries as at the dates thereof and the consolidated  results
of their operations and cash flows for the periods then ended.


                  SECTION 4.07. Absence of Certain Changes or Events.  Except as
disclosed in the Company SEC Documents filed and publicly available prior to the
date of the  Agreement  (the  "Company  Filed  SEC  Documents"),  and  except as
contemplated  by  Section  7.04,  since  March 31,  1997,  the  Company  and its
subsidiaries  have conducted  their  respective  businesses only in the ordinary
course,  and there has not been any  material  adverse  change  (as  defined  in
Section  10.03) with respect to the Company.  Except as disclosed in the Company
Filed SEC Documents or Schedule 4.07 , since March 31, 1997,  there has not been
(i)  any  declaration,  setting  aside  or  payment  of any  dividend  or  other
distribution  with respect to its capital stock or any  redemption,  purchase or
other  acquisition of any of its capital stock,  (ii) any split,  combination or
reclassification   of  any  of  its  capital   stock  or  any  issuance  or  the
authorization  of any issuance of any other securities in respect of, in lieu of
or in  substitution  for shares of its capital stock,  (iii) (w) any granting by
the Company or any of its  subsidiaries  to any officer of the Company or any of
its  subsidiaries  of any  increase  in  compensation,  (x) any  granting by the
Company  or any of its  subsidiaries  to any such  officer  of any  increase  in
severance or termination pay, (y) except employment arrangements in the ordinary
course of business  consistent  with past practice with employees other than any
executive  officer  of the  Company,  any  entry  by the  Company  or any of its
subsidiaries  into any employment,  severance or termination  agreement with any
such employee or executive officer or (z) except as contemplated


                                      -15-
<PAGE>




by Section 7.04, any creation of or increase in or  establishment  of any bonus,
insurance,  deferred compensation,  pension, retirement,  profit-sharing,  stock
option  (including the granting of stock  options,  stock  appreciation  rights,
performance  awards or restricted  stock awards or the amendment of any existing
stock options, stock appreciation rights, performance awards or restricted stock
awards),  stock  purchase  or  other  employee  benefit  plan  or  agreement  or
arrangement,  (iv) any damage,  destruction  or loss,  whether or not covered by
insurance,  that has or reasonably  could be expected to have a material adverse
effect on the Company, (v) any revaluation by the Company of any of its material
assets,  or (vi) any  material  change  in  accounting  methods,  principles  or
practices by the Company.


                  SECTION 4.08. No Undisclosed Liabilities. Except as and to the
extent  set  forth  in  the  Company's  financial  statements  contained  in its
Quarterly  Report  on Form 10-Q for March  31,  1997 (the  "Company's  Financial
Statements"),  as of  March  31,  1997,  neither  the  Company  nor  any  of its
subsidiaries  had any  liabilities or obligations of any nature,  whether or not
accrued,  contingent  or  otherwise,  and whether or not  required by  generally
accepted accounting  principles to be reflected on a consolidated  balance sheet
of the Company and its subsidiaries  (including the notes thereto).  Since March
31,  1997,  except  as and to the  extent  set  forth in the  Company  Filed SEC
Documents or as set forth on Schedule  4.08,  neither the Company nor any of its
subsidiaries has incurred any liabilities or obligations of any nature,  whether
or not  accrued,  contingent  or  otherwise,  and  whether  or not  required  by
generally  accepted  accounting  principles  to be reflected  on a  consolidated
balance sheet of the Company and its subsidiaries (including the notes thereto),
except for liabilities incurred in the ordinary course of business.  The Company
and its subsidiaries do not have consolidated indebtedness for borrowed money in
excess of $70,000,000.

                  SECTION 4.09.  Information  Supplied.  None of the information
supplied  or to be  supplied  by  the  Company  specifically  for  inclusion  or
incorporation by reference in (i) the Offer Documents,  (ii) the Schedule 14D-9,
(iii) the  information  to be filed by the Company in connection  with the Offer
pursuant to Rule 14f-1  promulgated  under the  Exchange  Act (the  "Information
Statement")  or (iv)  the  Proxy  Statement,  will,  in the  case  of the  Offer
Documents,  the Schedule 14D-9 and the Information Statement,  at the respective
times the Offer Documents, the Schedule 14D-9 and


                                      -16-
<PAGE>




the  Information  Statement are filed with the SEC or first  published,  sent or
given to the Company's stockholders,  or, in the case of the Proxy Statement, at
the time the Proxy Statement is first mailed to the Company's stockholders or at
the time of the Stockholders  Meeting (as defined in Section 7.01),  contain any
untrue  statement of a material fact or omit to state any material fact required
to be stated  therein or necessary in order to make the statements  therein,  in
light of the  circumstances  under  which  they are made,  not  misleading.  The
Schedule 14D-9, the Information Statement and the Proxy Statement will comply as
to form in all material  respects with the  requirements of the Exchange Act and
the rules and regulations thereunder,  except that no representation or warranty
is made by the  Company  with  respect to  statements  made or  incorporated  by
reference  therein based on information  supplied by Parent or Sub  specifically
for inclusion or incorporation by reference therein.


                  SECTION  4.10.  Benefit  Plans.  (a)  Each  "employee  pension
benefit  plan" (as defined in Section  3(2) of the  Employee  Retirement  Income
Security  Act of 1974,  as amended  ("ERISA"))  (a  "Pension  Plan"),  "employee
welfare  benefit plan" (as defined in Section 3(1) of ERISA) (a "Welfare  Plan")
and each other plan,  binding  pensions  arrangement or policy (written or oral)
relating to stock options, stock purchases, compensation, deferred compensation,
bonuses,  severance,  fringe benefits or other employee  benefits,  in each case
maintained or contributed to, or required to be maintained or contributed to, by
the  Company  or its  subsidiaries  for the  benefit  of any  present  or former
employee, officer or director (each of the foregoing, a "Benefit Plan") has been
administered in all material  respects in accordance with its terms. The Company
and its subsidiaries and all the Benefit Plans are in compliance in all material
respects with the applicable provisions of ERISA, the Code, all other applicable
laws.

                  (b) Schedule 4.10  attached  hereto sets forth a complete list
of  each  Benefit  Plan  as well as  each  bonus,  employment,  termination  and
severance agreement,  contract,  binding arrangement and understanding  (whether
written or oral) with employees of the Company and its subsidiaries.

                  (c) None of the Pension  Plans is subject to Title IV of ERISA
or Section 412 of the Code and none of the Company or any other person or entity
that, together with the Company, is treated as a single employer under Section


                                      -17-
<PAGE>




414 (b), (c), (m) or (o) of the Code (each,  including the Company,  a "Commonly
Controlled Entity"): (i) currently contributes to, or during any time during the
last six years had an  obligation  to  contribute  to, a Pension Plan subject to
Title IV of ERISA or Section 412 of the Code, or (ii) has incurred any liability
to the Pension Benefit Guaranty  Corporation (other than for payment of premiums
not yet due),  which  liability has not been fully paid. All  contributions  and
other  payments  required  to be made by the  Company to any  Pension  Plan with
respect to any period  ending before the Closing Date have been made or reserves
adequate for such contributions or other payments have been or will be set aside
therefor and have been or will be reflected in financial statements.


                  (d) Neither the Company nor any Commonly  Controlled Entity is
required  to  contribute  to any  "multiemployer  plan" (as  defined  in Section
4001(a)(3) of ERISA) or has  withdrawn  from any  multiemployer  plan where such
withdrawal has resulted or would result in any  "withdrawal  liability"  (within
the meaning of Section 4201 of ERISA) or "mass withdrawal  liability" within the
meaning of PBGC Regulation 4219.2 that has not been fully paid.

                  (e) Each Benefit Plan that is a Welfare Plan may be amended or
terminated,  upon thirty (30) days' notice, at any time after the Effective Time
without material liability to the Company or its subsidiaries.

                  (f) Except as set forth in  Schedule  4.10(f),  or as required
under  Section  4980B of the Code,  the Company does not have any  obligation to
provide post-retirement health benefits.

                  (g) The Company has heretofore delivered to Parent correct and
complete copies of each of the following:

                         (1) All written,  and descriptions of all binding oral,
          employment,   termination   and   severance   agreements,   contracts,
          arrangements and understandings listed on Schedule 4.10;

                         (2) Each Benefit Plan and all amendments  thereto;  the
          trust instrument and/or insurance contracts, if any, forming a part of
          such Benefit Plan and all amendments thereto;


                                      -18-
<PAGE>







                         (3) The most  recent  IRS Form  5500 and all  schedules
          thereto, if any;

                         (4) The most recent  determination letter issued by the
          IRS regarding the qualified status of each such Pension Plan;

                         (5) The most recent accountant's report, if any; and

                         (6) The most recent summary plan description, if any.

                  SECTION  4.11.  Other  Compensation  Arrangements.  Except  as
disclosed on Schedule  4.11, or except as provided in the  Agreement,  as of the
date of the  Agreement,  neither the Company  nor any of its  subsidiaries  is a
party to any binding oral or written (i) consulting  agreement not terminable on
not more than 60  calendar  days notice and  involving  the payment of more than
$50,000  per  annum,  (ii)  agreement  with any  executive  officer or other key
employee of the Company or any of its subsidiaries (x) the benefits of which are
contingent, or the terms of which are materially altered, upon the occurrence of
a transaction  involving the Company of the nature contemplated by the Agreement
or (y) providing any term of employment or compensation  guarantee extending for
a period  longer than one year or the payment of more than $100,000 per annum or
(iii)  agreement or plan,  including any stock option plan,  stock  appreciation
right plan, restricted stock plan or stock purchase plan, any of the benefits of
which  will be  increased,  or the  vesting  of the  benefits  of which  will be
accelerated,  by the occurrence of any of the  transactions  contemplated by the
Agreement or the value of any of the benefits of which will be calculated on the
basis of any of the transactions contemplated by the Agreement.

                  SECTION 4.12.  Litigation.  Except as disclosed in the Company
Filed SEC  Documents  or on  Schedule  4.12,  there is no suit,  claim,  action,
proceeding or investigation  pending before any  Governmental  Entity or, to the
best  knowledge  of the  Company,  threatened  against the Company or any of its
subsidiaries that could reasonably be expected to have a material adverse effect
on the Company.  Neither the Company nor any of its  subsidiaries  is subject to
any  outstanding  order,  writ,  injunction  or decree that could  reasonably be
expected to have a material adverse effect on the Company.


                                      -19-
<PAGE>







                  SECTION 4.13.  Compliance with Applicable Law. The Company and
its subsidiaries hold all material  permits,  licenses,  variances,  exemptions,
orders and  approvals  of all  Governmental  Entities  necessary  for the lawful
conduct of their respective businesses (the "Company Permits").  The Company and
its subsidiaries are in compliance with the terms of the Company Permits, except
where the failure to so comply would not have a material  adverse  effect on the
Company. Except as disclosed in the Company Filed SEC Documents,  the businesses
of the Company and its  subsidiaries are not being conducted in violation of any
law,  ordinance or regulation of any  Governmental  Entity,  except for possible
violations  that would not have a material  adverse  effect on the  Company.  No
investigation or review by any  Governmental  Entity with respect to the Company
or any of its  subsidiaries is pending or, to the best knowledge of the Company,
threatened,  nor has any  Governmental  Entity indicated an intention to conduct
any such investigation or review.

                  SECTION  4.14.  Tax  Matters.  Except as set forth in Schedule
4.14:

                  (a) The Company and each of its  subsidiaries has timely filed
all Federal  income tax returns and all other  material  tax returns and reports
required  to be filed by it. All such  returns are  complete  and correct in all
material  respects  (except to the extent a reserve has been  established on the
financial statements contained in the Company Filed SEC Documents).  Each of the
Company  and its  subsidiaries  (i) has  paid  (or the  Company  has paid on its
subsidiaries'  behalf) to the  appropriate  authorities all taxes required to be
paid by it (without  regard to whether a tax return is  required),  except taxes
for which an adequate reserve has been  established on the financial  statements
contained in the Company Filed SEC Documents,  and (ii) has withheld and paid to
the  appropriate  authorities  all  material  withholding  taxes  required to be
withheld by it. The most recent  financial  statements  contained in the Company
Filed SEC  Documents  reflect an adequate  reserve for all taxes  payable by the
Company and its  subsidiaries  for all  taxable  periods  and  portions  thereof
through the date of such financial statements.

                  (b) No Federal  income tax return or other material tax return
of the Company or any of its  subsidiaries  is under audit or examination by any
taxing authority, and no written or unwritten notice of such an


                                      -20-
<PAGE>




audit  or  examination   has  been  received  by  the  Company  or  any  of  its
subsidiaries.  Each material deficiency  resulting from any audit or examination
relating to taxes by any taxing authority has been paid, except for deficiencies
being  contested in good faith. No material issues relating to taxes were raised
in  writing  by  the  relevant  taxing  authority  in  any  completed  audit  or
examination  that can reasonably be expected to recur in a later taxable period.
The Federal  income tax returns of the Company and each of its  subsidiaries  do
not contain any positions  that could give rise to a substantial  understatement
penalty within the meaning of Section 6662 of the Code.


                  (c) There is no  agreement  or other  document  extending,  or
having the effect of  extending,  the period of  assessment or collection of any
taxes and no power of attorney  with  respect to any taxes has been  executed or
filed with any taxing authority.

                  (d) No  material  liens for taxes  exist  with  respect to any
assets or properties of the Company or any of its subsidiaries, except for liens
for taxes not yet due.

                  (e) None of the Company or any of its  subsidiaries is a party
to or is bound by any tax sharing agreement, tax indemnity obligation or similar
agreement,  arrangement or practice with respect to taxes (including any advance
pricing  agreement,  closing agreement or other agreement relating to taxes with
any taxing authority).

                  (f) None of the  Company or any of its  subsidiaries  shall be
required to include in a taxable  period ending after the Effective Time taxable
income attributable to income that accrued in a prior taxable period but was not
recognized in any prior taxable period as a result of the installment  method of
accounting,  the completed contract method of accounting, the long-term contract
method of  accounting,  the cash method of accounting or Section 481 of the Code
or comparable provisions of state, local or foreign tax law.

                  (g) Neither the Company nor any of its  subsidiaries  (i) is a
party to a safe  harbor  lease  within the meaning of Section  168(f)(8)  of the
Internal  Revenue  Code of 1954,  as amended and in effect prior to amendment by
the Tax Equity  and Fiscal  Responsibility  Act of 1982,  (ii) is a  "consenting
corporation"  under Section 341(f) of the Code, (iii) has agreed or is obligated
to make any payments


                                      -21-
<PAGE>




for  services  which would not be  deductible  pursuant  to Sections  162(a)(1),
162(m) or 280G of the Code, (iv) has participated in an international boycott as
defined in Section 999 of the Code,  or (v) is  required to make any  adjustment
under Section  481(a) of the Code by reason of a change in accounting  method or
otherwise.


                  (h) As  used  in the  Agreement,  "taxes"  shall  include  all
Federal, state, local and foreign income, property,  sales, excise,  withholding
and other taxes, tariffs or governmental charges of any nature whatsoever.

                  SECTION  4.15.  State  Takeover   Statutes67.   The  Board  of
Directors of the Company has approved the Offer,  the Merger,  the Agreement and
the  acquisition of Shares by Sub pursuant to the Offer and,  assuming the truth
and  correctness  of the  representation  in  Section  5.08,  such  approval  is
sufficient to render  inapplicable to the Offer,  the Merger,  the Agreement and
the transactions  contemplated by the Agreement the provisions of Section 203 of
the DGCL.  Other than the  consents  listed on  Schedule  4.15,  no other  state
takeover  statute or similar statute or regulation  applies or purports to apply
to the Offer, the Merger, the Agreement, or any of the transactions contemplated
by the Agreement.

                  SECTION  4.16.   Brokers;   Fees  and  Expenses.   No  broker,
investment banker,  financial advisor or other person,  other than Smith Barney,
as financial  advisor to the Company,  and Wheat First, the fees and expenses of
which  will be paid by the  Company,  is  entitled  to any  broker's,  finder's,
financial  advisor's or other similar fee or  commission in connection  with the
transactions contemplated by the Agreement based upon arrangements made by or on
behalf of the Company.

                  SECTION 4.17. Opinions of Financial Advisors.  The Company has
received the  opinions of Smith  Barney and Wheat First,  each dated the date of
this Agreement,  to the effect that, as of such date, the cash  consideration to
be  received  in the Offer and the Merger by the  holders of Shares  (other than
Parent and its  affiliates)  is fair to such holders  from a financial  point of
view,  and such  opinions  have not been  withdrawn  or modified in any material
respect.  Complete and correct  signed copies of such opinions will be delivered
to Parent after receipt thereof by the Company.


                                      -22-
<PAGE>







                  SECTION 4.18.  Intellectual  Property. (a) Except as listed on
Schedule  4.18, the Company has made available to Parent true and correct copies
of all material license  agreements  relating to Intellectual  Property to which
the Company and its subsidiaries are a party.

                  (b)  Except as listed on Schedule 4.18:

                           (1) the Company and each of its subsidiaries owns, or
         is licensed or otherwise  has the right to use (in each case,  clear of
         any liens or  encumbrances  of any  kind),  all  Intellectual  Property
         material to the conduct of its business as currently conducted;

                           (2) no  material  claims are  pending or, to the best
         knowledge  of the  Company,  threatened  that the Company or any of its
         subsidiaries is infringing on or otherwise  violating the rights of any
         person  with  regard  to any  Intellectual  Property  owned  by  and/or
         licensed to the Company or its subsidiaries; and

                           (3) to the best  knowledge of the Company,  no person
         is infringing on or otherwise violating any right of the Company or any
         of its subsidiaries with respect to any Intellectual  Property owned by
         and/or licensed to the Company or its subsidiaries;

                  (c) For  purposes of the  Agreement,  "Intellectual  Property"
shall mean trademarks (registered or unregistered),  service marks, brand names,
certification   marks,  trade  dress,  assumed  names,  trade  names  and  other
indications  of  origin,   the  goodwill   associated  with  the  foregoing  and
registrations  in any  jurisdiction  of, and applications in any jurisdiction to
register, the foregoing, including any extension, modification or renewal of any
such  registration or application;  inventions,  discoveries and ideas,  whether
patented, patentable or not in any jurisdiction;  trade secrets and confidential
information  and  rights  in any  jurisdiction  to limit  the use or  disclosure
thereof  by  any  person;   writings  and  other  works,   whether  copyrighted,
copyrightable  or not in any  jurisdiction;  registration  or  applications  for
registration of copyrights in any  jurisdiction,  and any renewals or extensions
thereof;  any similar  intellectual  property or proprietary rights and computer
programs and software  (including source code, object code and data);  licenses,
immunities, covenants not to sue and the like relating to the foregoing; and any


                                      -23-
<PAGE>




claims or causes of action  arising  out of or  related to any  infringement  or
misappropriation of any of the foregoing.


                  SECTION  4.19.  Labor  Matters.  (a)  Except  as set  forth in
Schedule 4.19, neither the Company nor any of its subsidiaries is a party to any
employment,   labor  or  collective   bargaining  agreement  and  there  are  no
employment, labor or collective bargaining agreements which pertain to employees
of the Company or its subsidiaries.

                  (b) No labor organization or group of employees of the Company
or its  subsidiaries  has made a pending demand for recognition or certification
to  the  Company  or  its  subsidiaries  and  there  are  no  representation  or
certification  proceedings  or  petitions  seeking a  representation  proceeding
presently  pending or threatened to be brought or filed with the National  Labor
Relations Board or any other labor relations  tribunal or authority  relating to
the Company or its subsidiaries. To the knowledge of the Company, after diligent
inquiry  there  are  no  organizing  activities  involving  the  Company  or its
subsidiaries  pending with any labor  organization  or group of employees of the
Company or its subsidiaries.

                  (c) There are no unfair labor practice charges,  grievances or
complaints pending or, to the knowledge of the Company, threatened in writing by
or on  behalf  of any  employee  or group of  employees  of the  Company  or its
subsidiaries.

                  (d) There are no  complaints,  charges,  or claims against the
Company or its subsidiaries  pending,  or threatened in writing to be brought or
filed,  with any Governmental  Entity or arbitrator based on, arising out of, in
connection  with,  or otherwise  relating to the  employment or  termination  of
employment of any individual by the Company or its subsidiaries.

                  (e) The Company and its  subsidiaries  are in compliance  with
all laws and regulations governing the employment of labor,  including,  but not
limited to, all such laws and regulations  relating to wages, hours,  collective
bargaining,   discrimination,   civil  rights,   safety  and  health,   workers'
compensation  and the  collection  and  payment  of  withholding  and/or  Social
Security taxes and similar taxes except where  noncompliance  individually or in
the aggregate will not have a material adverse effect.


                                      -24-
<PAGE>







                  SECTION  4.20.  Real  Property,  Leases and Assets.  . (a) The
Company  has  sufficient  title or  valid  leasehold  interests  to all its real
properties  and assets to conduct its  business  as  currently  conducted  or as
contemplated to be conducted.

                  (b)  Each  parcel  of real  property  owned or  leased  by the
Company  (i) except as set forth in Schedule  4.20,  is owned or leased free and
clear of all mortgages,  pledges,  liens,  security  interests,  conditional and
installment  sale  agreements,  encumbrances,  charges or other  claims of third
parties of any kind  (collectively,  "Liens"),  other than (A) Liens for current
taxes  and   assessments   not  yet  past  due,  (B)  inchoate   mechanics'  and
materialmen's  Liens for construction in progress,  (C) workmen's,  repairmen's,
warehousemen's and carriers' Liens arising in the ordinary course of business of
the Company consistent with past practice,  and (D) all matters of record, Liens
and other imperfections of title and encumbrances which,  individually or in the
aggregate,  would not have a material adverse effect  (collectively,  "Permitted
Liens"),  and (ii) is neither subject to any governmental  decree or order to be
sold nor is being  condemned,  expropriated  or  otherwise  taken by any  public
authority  with  or  without  payment  of  compensation  therefor,  nor,  to the
knowledge of the Company,  has any such  condemnation,  expropriation  or taking
been proposed.

                  (c) All leases of real property  leased for the use or benefit
of the  Company  to  which  the  Company  is a  party  and  all  amendments  and
modifications thereto are in full force and effect and have not been modified or
amended,  and  there  exists no  material  default  under any such  lease by the
Company,  nor any  event  which  with  notice  or  lapse  of time or both  would
constitute a material default thereunder by the Company.

                  SECTION 4.21. Questionnaire.  The healthcare law questionnaire
heretofore delivered to the Company (the "Questionnaire") and attached hereto as
Exhibit B, has been fully and  accurately  completed  and does not  contain  any
material  misstatement of any fact and does not omit any fact that would have to
be stated in order not to render any  response to the  Questionnaire  materially
misleading.

                  SECTION 4.22.  Environmental Matters. (a) For purposes of this
Agreement,   the  following  terms  shall  have  the  following  meanings:   (i)
"Environmental Claims" means any


                                      -25-
<PAGE>




and all actions,  suits,  demands,  demand letters,  claims,  liens,  notices of
non-compliance  or  violation,  notices of  liability  or  potential  liability,
proceedings,  consent  orders or consent  agreements  relating in any way to any
Environmental  Law, any Environmental  Permit or any Hazardous  Materials;  (ii)
"Environmental Law" means any statute,  law, rule,  ordinance or code, in effect
now or any  time  prior  to the  Closing,  and any  judicial  or  administrative
interpretation thereof,  including any judicial or administrative order, consent
decree or  judgment,  relating to pollution or  protection  of the  environment,
health,  safety  or  natural  resources,  including  without  limitation,  those
relating to the use, handling,  transportation,  treatment,  storage,  disposal,
release or discharge of Hazardous Materials;  (iii) "Environmental Permit" means
any permit,  approval,  identification  number,  license or other  authorization
required under any applicable  Environmental Law; (iv) "Governmental  Authority"
means any  United  States  federal,  state or local or any  foreign  government,
governmental,  regulatory or administrative  authority,  agency or commission or
any court,  tribunal,  or judicial or arbitral body;  (v) "Hazardous  Materials"
means (A) petroleum and petroleum  products,  by products or breakdown products,
radioactive   materials,   asbestos-containing   materials  and  polychlorinated
biphenyls,  and (B) any other  chemicals,  materials  or  substances  defined or
regulated as toxic or hazardous or as a pollutant or  contaminant  or as a waste
under any applicable  Environmental  Law; and (vi) "leased property" and "leased
properties"  means the real property  which the Company has the right to control
pursuant to its lease and not any  property  which the Company does not have the
right to control.


                  (b) Except as  described  in Schedule  4.22 of the  Disclosure
Schedule:  (i) the  Company  is and has  been in  material  compliance  with all
applicable  Environmental  Laws;  (ii) the Company has  obtained  all  necessary
Environmental  Permits  and is and has been in  material  compliance  with their
requirements; (iii) to the knowledge of the Company, there are no underground or
aboveground storage tanks or any surface impoundments, septic tanks, pits, sumps
or lagoons in which Hazardous  Materials are being or have been treated,  stored
or disposed of on any of the owned or leased  properties  or with respect to the
period of the Company's ownership, tenancy or operation of such property, on any
real property  formerly  owned,  leased or occupied by the Company;  (iv) to the
best  knowledge of the Company,  no owned or leased  properties  or any property
adjoining any owned or


                                      -26-
<PAGE>




leased  properties is listed or proposed for listing on the National  Priorities
List under the Comprehensive Environmental Response,  Compensation and Liability
Act of 1980,  as  amended  through  the  date  hereof,  or on the  Comprehensive
Environmental  Response,  Compensation  and  Liability  Information  System,  as
updated through the date hereof,  or any analogous state list of sites requiring
investigation  or cleanup;  (v) to the  knowledge  of the  Company,  there is no
asbestos  or  asbestos-containing  material  on  any  of  the  owned  or  leased
properties;  (vi) the  Company has not  released,  discharged  or  disposed  any
Hazardous  Materials  on any of the  owned or leased  properties  or on any real
property  formerly  owned,  leased or  occupied  by the Company in any manner or
quantity that can give rise to a material  adverse effect;  (vii) the Company is
not undertaking, has not completed, and, to the knowledge of the Company, is not
required to conduct,  any  investigation  or  assessment or remedial or response
action relating to any release,  discharge or disposal of or contamination  with
Hazardous  Materials at any site,  location or operation,  either voluntarily or
pursuant to the order of any  Governmental  Authority or the requirements of any
Environmental Law; and (viii) there are no past, pending or, to the knowledge of
the Company,  threatened  Environmental Claims against the Company or any of its
properties,  and, to the knowledge of the Company,  there are no facts which can
form the basis of any such  Environmental  Claim,  including without  limitation
with respect to any off-site disposal location presently or formerly used by the
Company or any of its predecessors.


                  SECTION  4.23.  Reimbursement  Matters.  The  Company and each
subsidiary  thereof,  to  the  extent  necessary  to  conduct  their  respective
businesses  in a manner  consistent  with the past  practices,  is qualified for
participation  in the  Medicare and  Medicaid  programs.  Except as disclosed on
Schedule 4.23 and in Company Filed SEC Documents,  (a) neither the Company,  nor
any subsidiary  thereof,  nor any nursing home,  hospital or other facility with
respect to which the Company or any subsidiary  thereof provides  services,  has
received  any  notice of denial or  recoupment  from the  Medicare  or  Medicaid
programs,  or any other third party  reimbursement  source (inclusive or managed
care organizations) with respect to products or services provided by the Company
or any subsidiary  thereof;  (b) there is no basis for the assertion of any such
denial or  recoupment  claim;  and (c) neither the Company,  nor any  subsidiary
thereof, nor any nursing home, hospital or other facility


                                      -27-
<PAGE>




with respect to which the Company or any subsidiary thereof provides products or
services, has received notice from any Medicare or Medicaid program or any other
third party  reimbursement  source (inclusive of managed care  organizations) of
any pending or threatened investigation or survey with respect to or arising out
of  products or services  provided by the Company or any  subsidiary  thereof or
otherwise  and,  to the best  knowledge,  no such  investigation  or  survey  is
pending, threatened or imminent.


                  SECTION 4.24.  Material Contracts.

                  (a) Each  contract,  agreement or other document or instrument
to which the Company or any of its  subsidiaries is a party that was required to
be filed as an exhibit to the Company's  annual report on Form 10-K for the year
ended  December  31, 1996 was so filed and,  from and after  December  31, 1996,
neither the Company nor any of its  subsidiaries  has entered into any contract,
agreement or other document or instrument  (other than this  Agreement)  that is
required  to be filed  with the SEC that has not been so filed on or before  the
date of this  Agreement  or any  amendment,  modification  or  waiver  under any
contract,  agreement or other  document or  instrument  that was  previously  so
filed, which amendment, modification or waiver is required to be so filed.

                  (b)  Schedule 4.24 lists:

                  (i) any agreement concerning a partnership or joint venture;

                  (ii)   any    agreement    concerning    confidentiality    or
non-competition;

                  (iii) any agreement under which the  consequences of a default
or termination  could have a material adverse effect on the business,  financial
condition, operations, results of operations, or future prospects of the Company
or any subsidiary; or

                  (iv) any other agreement (or group of related  agreements) the
performance of which involves consideration in excess of $100,000.

                  The Company  has  delivered  to Parent a correct and  complete
copy of each written  agreement listed in Schedule 4.24 (as amended to date) and
a written summary


                                      -28-
<PAGE>




setting  forth the terms and  conditions of each oral  agreement  referred to in
Schedule  4.24.  With  respect  to each such  agreement  referred  to in Section
4.24(a) and listed on Schedule 4.24: (A) the agreement is legal, valid, binding,
enforceable, and in full force and effect, (B) the agreement will continue to be
legal, valid,  binding,  enforceable,  and in full force and effect on identical
terms following the consummation of the transactions contemplated hereby; (C) no
party is in breach or default,  and no event has occurred which, with notice, or
lapse of  time,  or both  would  constitute  a  breach  or  default,  or  permit
termination,  modification,  or  acceleration,  under the agreement;  and (D) no
party has repudiated any provision of the agreement.


                  SECTION  4.25.   Insurance.   Schedule  4.25  sets  forth  the
following  information with respect to each insurance policy (including policies
providing property, casualty,  liability, and workers' compensation coverage and
bond and surety  arrangements) to which the Company or any subsidiary thereof is
currently a party, a named insured, or otherwise the beneficiary of coverage:

                  (i) the name, address, and telephone number of the agent;

                  (ii) the name of the  insurer,  the name of the  policyholder,
and the name of each covered insured;

                  (iii) the policy number and the period of coverage;

                  (iv)  the  scope  (including  an  indication  of  whether  the
coverage is on a claims made, occurrence,  or other basis) and amount (including
a description  of how  deductibles  and ceilings are  calculated and operate) of
coverage  and a  description  of each of the claims made  against  the  policies
during the last two years; and

                  (v) a description of any  retroactive  premium  adjustments or
other loss-sharing arrangements.

                  With respect to each such insurance policy:  (A) the policy is
legal,  valid,  binding,  enforceable,  and in full  force and  effect;  (B) the
policy,  or substitute  policies  therefor,  will  continue to be legal,  valid,
binding,  enforceable,  and in full force and effect on materially similar terms
on the Effective Date; (C) neither the Company nor any subsidiary  thereof,  nor
any other party


                                      -29-
<PAGE>




to the policy is in breach or default  (including with respect to the payment of
premiums  or the  giving to  notices),  and no event has  occurred  which,  with
notice,  or the lapse of time,  would  constitute  such a breach or default,  or
permit termination,  modification, or acceleration, under the policy; and (D) no
party to the policy has repudiated any provision  thereof.  The Company and each
of its  subsidiaries  has been covered during the past two years by insurance in
scope and amount  customary and  reasonable  for the  businesses in which it has
engaged  during  the   aforementioned   period.   Schedule  4.25  describes  any
self-insurance arrangements affecting the Company and any subsidiary thereof.


                                    ARTICLE V

                REPRESENTATIONS AND WARRANTIES OF PARENT AND SUB

                  Parent  and  Sub  represent  and  warrant  to the  Company  as
follows:

                  SECTION  5.01.  Organization.  Each  of  Parent  and  Sub is a
corporation duly organized, validly existing and in good standing under the laws
of the jurisdiction of its incorporation  and has all requisite  corporate power
and authority to carry on its business as now being conducted,  except where the
failure to be so organized,  existing and in good standing or to have such power
and authority  would not be reasonably  expected to prevent or materially  delay
the consummation of the Offer and/or the Merger.

                  SECTION  5.02.  Authority.   Parent  and  Sub  have  requisite
corporate  power and  authority  to execute  and deliver  the  Agreement  and to
consummate the transactions  contemplated  hereby.  The execution,  delivery and
performance  of  the  Agreement  and  the   consummation  of  the   transactions
contemplated  hereby have been duly authorized by all necessary corporate action
on the part of Parent and Sub and no other corporate  proceedings on the part of
Parent and Sub are necessary to authorize  the  Agreement or to consummate  such
transactions.  No vote  of  Parent  shareholders  is  required  to  approve  the
Agreement or the transactions  contemplated  hereby. The Agreement has been duly
executed and delivered by Parent and Sub, as the case may be, and,  assuming the
Agreement constitutes a valid and binding obligation of the Company, constitutes
a valid and binding  obligation  of each of Parent and Sub  enforceable  against
them in accordance with its terms, except (i) as


                                      -30-
<PAGE>




limited by applicable  bankruptcy,  insolvency,  reorganization,  moratorium and
other laws of general  application  affecting  enforcement of creditors'  rights
generally and (ii) as limited by laws relating to the  availability  of specific
performance, injunctive relief or other equitable remedies.


                  SECTION 5.03.  Consents and Approvals;  No Violations.  Except
for filings, permits, authorizations,  consents and approvals as may be required
under,  and other  applicable  requirements  of, the Exchange Act (including the
filing with the SEC of the Offer  Documents),  the HSR Act, the DGCL, and as set
forth on Schedule  5.03 the laws of other states in which Parent is qualified to
do or is doing  business,  state  takeover  laws and foreign  laws,  neither the
execution,  delivery or  performance  of the Agreement by Parent and Sub nor the
consummation by Parent and Sub of the transactions  contemplated hereby will (i)
conflict  with or  result  in any  breach  of any  provision  of the  respective
certificate  of  incorporation  or by-laws of Parent and Sub,  (ii)  require any
filing with, or permit, authorization,  consent or approval of, any Governmental
Entity  (except  where the  failure  to  obtain  such  permits,  authorizations,
consents or approvals or to make such filings would not be  reasonably  expected
to prevent or materially delay the consummation of the Offer and/or the Merger),
(iii) violate any order, writ, injunction,  decree,  statute, rule or regulation
applicable  to Parent,  any of its  subsidiaries  or any of their  properties or
assets,  or (iv)  result in a  violation  or breach of, or  constitute  (with or
without  due  notice  or lapse of time or both) a  default  (or give rise to any
right of termination, amendment, cancellation or acceleration) under, any of the
terms, conditions or provisions of any note, bond, mortgage, indenture, license,
lease, contract,  agreement or other instrument or obligation to which Parent or
any of its  subsidiaries  is a party  or by  which  any of them or any of  their
properties  or assets may be bound or,  except in the case of clauses  (iii) and
(iv) for  violations,  breaches or defaults which would not,  individually or in
the  aggregate,  be  reasonably  expected  to  prevent or  materially  delay the
consummation of the Offer and/or the Merger.

                  SECTION 5.04.  Information  Supplied.  None of the information
supplied  or to be  supplied  by Parent or Sub  specifically  for  inclusion  or
incorporation by reference in (i) the Offer Documents,  (ii) the Schedule 14D-9,
(iii) the Information Statement or (iv) the Proxy Statement will, in


                                      -31-
<PAGE>




the  case of the  Offer  Documents,  the  Schedule  14D-9  and  the  Information
Statement,  at the respective times the Offer Documents,  the Schedule 14D-9 and
the  Information  Statement are filed with the SEC or first  published,  sent or
given to the Company's stockholders,  or, in the case of the Proxy Statement, at
the time the Proxy Statement is first mailed to the Company's stockholders or at
the time of the Stockholders Meeting, contain any untrue statement of a material
fact or omit to state  any  material  fact  required  to be  stated  therein  or
necessary in order to make the statements therein, in light of the circumstances
under which they are made, not misleading. The Offer Documents will comply as to
form in all material  respects with the requirements of the Exchange Act and the
rules and regulations  thereunder,  except that no representation or warranty is
made by  Parent  or Sub with  respect  to  statements  made or  incorporated  by
reference therein based on information  supplied by the Company specifically for
inclusion or incorporation by reference therein.


                  SECTION 5.05. Interim Operations of Sub. Sub was formed solely
for the purpose of engaging in the transactions contemplated hereby, has engaged
in no  other  business  activities  and has  conducted  its  operations  only as
contemplated hereby.

                  SECTION 5.06. Brokers. No broker, investment banker, financial
advisor or other person, other than Shattuck Hammond Partners Inc., the fees and
expenses of which will be paid by Parent, is entitled to any broker's, finder's,
financial  advisor's or other similar fee or  commission in connection  with the
transactions contemplated by the Agreement based upon arrangements made by or on
behalf of Parent or Sub.

                  SECTION 5.07. Financing. Parent has sufficient funds available
to purchase,  or to cause Sub to purchase,  all the Shares pursuant to the Offer
and the Merger  and to pay all fees and  expenses  related  to the  transactions
contemplated by the Agreement.

                  SECTION 5.08.  Section 2.0367.  Parent has been an "Interested
Stockholder" (as such term is defined in Section 203 of the DGCL) of the Company
for at least 3 years.  Sub was formed  following  the  approval  of the Board of
Directors of the Company described in Section 4.15.


                                      -32-
<PAGE>







                                   ARTICLE VI

                                    COVENANTS

                  SECTION  6.01.  Covenants of the  Company.  Until such time as
Parent's  designees  shall  constitute a majority of the members of the Board of
Directors of the Company,  the Company agrees as to itself and its  subsidiaries
that (except as expressly contemplated or permitted by the Agreement,  or to the
extent that Parent shall otherwise consent in writing):

                  (a) Ordinary  Course.  The Company shall,  and shall cause its
subsidiaries to, carry on their respective  businesses in the usual, regular and
ordinary  course in  substantially  the same manner as heretofore  conducted and
shall use all  reasonable  efforts to preserve  intact  their  present  business
organizations,  and preserve  their  relationships  with  customers,  suppliers,
employees  and  others  having  business  dealings  with  the  Company  and  its
subsidiaries.

                  (b)  Dividends;  Changes in Stock.  The Company shall not, and
shall not permit any of its subsidiaries to, (i) declare or pay any dividends on
or make other  distributions in respect of any of its capital stock,  except for
dividends by a direct or indirect wholly owned  subsidiary of the Company,  (ii)
split,  combine or reclassify  any of its capital stock or issue or authorize or
propose  the  issuance of any other  securities  in respect of, in lieu of or in
substitution  for shares of its  capital  stock or (iii)  repurchase,  redeem or
otherwise acquire any shares of capital stock of the Company or its subsidiaries
or any other  securities  thereof  except  pursuant to contracts  referred to in
Section 4.24 or listed on Schedule 4.24.

                  (c) Issuance of  Securities.  The Company shall not, and shall
not permit any of its subsidiaries to, issue, deliver, sell, pledge or encumber,
or authorize or propose the issuance,  delivery, sale, pledge or encumbrance of,
any shares of its capital stock of any class or any securities convertible into,
or any rights,  warrants,  calls,  subscriptions or options to acquire, any such
shares or convertible  securities,  or any other ownership  interest  (including
stock  appreciation  rights or phantom  stock)  other than (i) the  issuance  of
shares of Company  Common Stock upon the exercise of Options  outstanding on the
date of the Agreement and in accordance with the terms of such Options,


                                      -33-
<PAGE>




and (ii) the  issuance of shares of Company  Common  Stock upon the  exercise of
warrants  outstanding  on the date of the Agreement  and in accordance  with the
terms of such warrants as of the date of the Agreement.


                  (d) Governing Documents.  The Company shall not, and shall not
permit any of its  subsidiaries to, amend or propose to amend its certificate of
incorporation or by-laws (or similar organizational documents).

                  (e) No  Acquisitions.  The  Company  shall not,  and shall not
permit any of its subsidiaries to, acquire or agree to acquire (i) by merging or
consolidating  with,  or by  purchasing  an equity  interest in or a substantial
portion  of  the  assets  of,  or by  any  other  manner,  any  business  or any
corporation,   partnership,   joint  venture,   association  or  other  business
organization   or  division   thereof;   (ii)  any  assets  that  are  material,
individually or in the aggregate, to the Company and its subsidiaries taken as a
whole,  except  purchases  of  inventory  in the  ordinary  course  of  business
consistent with past practice or enter into any management  agreement for any of
its assets.

                  (f) No Dispositions.  Except as set forth in Schedule 6.01(f),
the Company  shall not, and shall not permit any of its  subsidiaries  to, sell,
lease,  license,  encumber or  otherwise  dispose  of, or agree to sell,  lease,
license,  encumber or  otherwise  dispose of, any of its assets,  except for the
disposition of equipment in the ordinary course of business consistent with past
practice.

                  (g) Indebtedness.  The Company shall not, and shall not permit
any of its  subsidiaries  to,  (i) incur  (which  shall not be deemed to include
entering into credit  agreements,  lines of credit or similar  agreements  until
borrowings are made under such  agreements) any  indebtedness for borrowed money
or  guarantee  any such  indebtedness  or issue or sell any debt  securities  or
warrants or rights to acquire any debt  securities  of the Company or any of its
subsidiaries,   guarantee  any  debt  securities  of  others,   enter  into  any
"keep-well" or other agreement to maintain any financial  statement condition of
another person or enter into any  arrangement  having the economic effect of any
of the foregoing,  except for working  capital  borrowings  consistent with past
practice,  or (ii) make any  loans,  advances  or capital  contributions  to, or
investments in, any other person, other than, with respect to both clause (i)


                                      -34-
<PAGE>




and (ii) above any loan from the  Company to a direct or indirect  wholly  owned
subsidiary of the Company.


                  (h) Advice of Filings.  The Company shall promptly  provide to
Parent (or its  counsel)  copies of all  filings  made by the  Company  with any
Governmental  Entity  in  connection  with the  Agreement  and the  transactions
contemplated hereby.

                  (i)  Tax   Matters.   Neither  the  Company  nor  any  of  its
subsidiaries  shall make any tax election  that would have a material  effect on
the tax  liability  of the  Company  or any of its  subsidiaries  or  settle  or
compromise  any  material  income  tax  liability  of the  Company or any of its
subsidiaries.  The  Company  shall,  before  filing or  causing  to be filed any
material  tax return of the  Company or any of its  subsidiaries,  consult  with
Parent and its advisors as to the positions  and elections  that may be taken or
made with  respect to such  return,  and shall take such  positions or make such
elections as the Company and Parent shall jointly agree.

                  (j) Discharge of Liabilities. The Company shall not, and shall
not permit any of its  subsidiaries  to, pay,  discharge,  settle or satisfy any
claims,  liabilities or obligations (absolute,  accrued, asserted or unasserted,
contingent  or  otherwise),  other than the payment,  discharge,  settlement  or
satisfaction,  in the ordinary course of business  consistent with past practice
or in accordance with their terms, of (i) liabilities recognized or disclosed in
the Company Financial Statements, or (ii) liabilities incurred since the date of
such financial  statements in the ordinary  course of business  consistent  with
past practice.

                  (k)  Material  Contracts.  Except  in the  ordinary  course of
business,  neither  the Company  nor any of its  subsidiaries  shall (i) modify,
amend or terminate  any  material  contract or agreement to which the Company or
such subsidiary is a party or (ii) waive, release or assign any rights or claims
under any such  contract,  including  any  contract  listed on Schedule  4.24 or
referred to in Section 4.24.

                  (l) Compensation of Company  Employees.  Except as provided in
Section  7.04,  the Company  and its  subsidiaries  will not,  without the prior
written  consent of Parent,  except as may be required  by law,  (i) enter into,
adopt, amend or terminate any Company Benefit Plan or other


                                      -35-
<PAGE>




employee  benefit  plan or any  agreement,  arrangement,  plan or policy for the
benefit of any director, officer or current or former employee, (ii) increase in
any  manner the  compensation  or fringe  benefits  of, or pay any bonus to, any
director, executive officer or (iii) pay any benefit not required by any plan or
arrangement  as in effect as of the date  hereof  (including  the  granting  of,
acceleration  of   exercisability   of  or  vesting  of  stock  options,   stock
appreciation rights or restricted stock).


                  SECTION  6.02.  No  Solicitation.  (a)  The  Company  and  its
officers,  directors,  employees,  representatives  and agents shall immediately
cease any discussions or negotiations  with any parties that may be ongoing with
respect to a Takeover Proposal (as hereinafter defined).  The Company shall not,
nor shall it permit any of its  subsidiaries  to, authorize or permit any of its
officers,  directors or employees or any investment  banker,  financial advisor,
attorney,  accountant  or  other  representative  retained  by it or  any of its
subsidiaries  to,  directly or  indirectly,  (i) solicit,  initiate or encourage
(including  by way of  furnishing  information),  or take any  other  action  to
facilitate,  any inquiries or the making of any proposal which  constitutes,  or
may reasonably be expected to lead to, any Takeover Proposal or (ii) participate
in any discussions or negotiations  regarding any Takeover  Proposal;  provided,
however,  that if, at any time  prior to the  acceptance  for  payment of Shares
pursuant to the Offer, the Board of Directors of the Company  determines in good
faith, after consultation with outside counsel, that it is necessary to do so in
order to comply with its fiduciary  duties to the Company's  stockholders  under
applicable  law,  the  Company  may,  in  response  to an  unsolicited  Takeover
Proposal,   and  subject  to  compliance  with  Section  6.02(c),   (x)  furnish
information   with  respect  to  the  Company  to  any  person   pursuant  to  a
confidentiality  agreement and (y)  participate in  negotiations  regarding such
Takeover Proposal. For purposes of the Agreement,  "Takeover Proposal" means any
inquiry,  proposal  or offer from any person  relating to any direct or indirect
acquisition  or  purchase  of 20% or more of the assets of the  Company  and its
subsidiaries or 20% or more of any class of equity  securities of the Company or
any of its subsidiaries,  any tender offer or exchange offer that if consummated
would  result  in any  person  beneficially  owning  20% or more of any class of
equity  securities  of the  Company  or any of  its  subsidiaries,  any  merger,
consolidation,  business  combination,  sale of  substantially  all the  assets,
recapitalization, liquidation, dissolution


                                      -36-
<PAGE>




or similar transaction  involving the Company or any of its subsidiaries,  other
than the transactions  contemplated by the Agreement,  or any other  transaction
the  consummation  of which could  reasonably  be expected to impede,  interfere
with,  prevent or  materially  delay the Offer  and/or the Merger or which would
reasonably  be  expected  to dilute  materially  the  benefits  to Parent of the
transactions contemplated hereby.


                  (b)  Except as set forth in this  Section  6.02,  neither  the
Board of Directors of the Company nor any  committee  thereof shall (i) withdraw
or modify, or propose to withdraw or modify, in a manner adverse to Parent,  the
approval or  recommendation  by such Board of Directors or such committee of the
Offer,  the Agreement or the Merger,  (ii) approve or  recommend,  or propose to
approve or recommend,  any Takeover Proposal or (iii) cause the Company to enter
into any agreement with respect to any Takeover  Proposal.  Notwithstanding  the
foregoing,  in the event  that  prior to the  acceptance  for  payment of Shares
pursuant to the Offer the Board of Directors of the Company  determines  in good
faith, after consultation with outside counsel, that it is necessary to do so in
order to comply with its fiduciary  duties to the Company's  stockholders  under
applicable  law, the Board of Directors of the Company may (subject to the other
provisions of Section 6.02) withdraw or modify its approval or recommendation of
the  Offer,  the  Agreement  and the  Merger,  approve or  recommend  a Superior
Proposal (as defined  below),  cause the Company to enter into an agreement with
respect to a Superior Proposal or terminate the Agreement, but in each case only
at a time that is after the first  business day  following  Parent's  receipt of
written notice (a "Notice of Superior  Proposal") advising Parent that the Board
of  Directors of the Company has received a Superior  Proposal,  specifying  the
material  terms and  conditions of such Superior  Proposal and  identifying  the
person  making such  Superior  Proposal.  In the event that a Notice of Superior
Proposal  is  delivered  and any  material  term or  condition  of the  Superior
Proposal described therein is subsequently  changed, the Company shall deliver a
supplemental Notice of Superior Proposal describing such change and may withdraw
or modify its approval or  recommendation  of the Offer,  the  Agreement and the
Merger, approve or recommend the modified Superior Proposal or cause the Company
to enter into an agreement with respect to the modified  Superior  Proposal only
at a time that is after the first business day following Parent's receipt of the
supplemental Notice of Superior Proposal. In


                                      -37-
<PAGE>




addition, if the Company proposes to enter into an agreement with respect to any
Takeover Proposal,  it shall concurrently with entering into such agreement pay,
or cause to be paid, to Parent the  Termination  Fee (as such term is defined in
Section 7.06(b)). For purposes of the Agreement, a "Superior Proposal" means any
bona fide proposal made by a third party to acquire, directly or indirectly, for
consideration consisting of cash and/or securities,  more than 50% of the shares
of Company Common Stock then outstanding or all or substantially  all the assets
of the  Company  and  otherwise  on terms  which the Board of  Directors  of the
Company  determines  in its  good  faith  judgment  (based  on the  advice  of a
financial advisor of nationally  recognized  reputation) to be more favorable to
the Company's stockholders than the Offer and the Merger.


                  (c) In addition to the obligations of the Company set forth in
paragraphs  (a) and (b) of this  Section  6.02,  the Company  shall  immediately
advise  Parent  orally and in writing of any request for  information  or of any
Takeover Proposal, the material terms and conditions of such request or Takeover
Proposal  and the  identity  of the  person  making  such  request  or  Takeover
Proposal.  The Company will keep Parent fully informed of the status and details
(including  amendments or proposed  amendments)  of any such request or Takeover
Proposal.

                  (d) Nothing  contained in this Section 6.02 shall prohibit the
Company from taking and disclosing to its  stockholders a position  contemplated
by  Rule  14e-2(a)  promulgated  under  the  Exchange  Act or  from  making  any
disclosure to the Company's  stockholders  if, in the good faith judgment of the
Board of Directors  of the Company,  after  consultation  with outside  counsel,
failure so to disclose would be  inconsistent  with its fiduciary  duties to the
Company's  stockholders  under applicable law;  provided,  however,  neither the
Company nor its Board of Directors nor any committee  thereof  shall,  except as
permitted  by Section  6.02(b),  withdraw  or modify,  or propose to withdraw or
modify,  its position with respect to the Offer,  the Agreement or the Merger or
approve or recommend, or propose to approve or recommend, a Takeover Proposal.

                  SECTION 6.03. Other Actions.  The Company shall not, and shall
not permit any of its subsidiaries to, take any action that would, or that could
reasonably  be  expected  to,  result  in (i)  any of  the  representations  and
warranties of the Company set forth in the Agreement that are qualified


                                      -38-
<PAGE>




as to  materiality  becoming  untrue,  (ii)  any  of  such  representations  and
warranties that are not so qualified  becoming untrue in any material respect or
(iii) any of the Offer Conditions not being satisfied  (subject to the Company's
right to take actions specifically permitted by Section 6.02).


                                   ARTICLE VII

                              ADDITIONAL AGREEMENTS

                  SECTION  7.01.  Stockholder  Approval;  Preparation  of  Proxy
Statement.  (a) If the Company  Stockholder  Approval  is  required by law,  the
Company  will,  at  Parent's  request,  as soon  as  practicable  following  the
acceptance  for payment of, and payment  for,  any Shares by Sub pursuant to the
Offer and the  expiration of the Offer,  duly call,  give notice of, convene and
hold a meeting of its stockholders (the "Stockholders  Meeting") for the purpose
of obtaining the Company  Stockholder  Approval.  The Company will,  through its
Board of Directors,  recommend to its stockholders that the Company  Stockholder
Approval be given. Notwithstanding the foregoing, if Sub or any other subsidiary
of Parent  shall  acquire at least 90% of the  outstanding  Shares,  the parties
shall, at the request of Parent,  take all necessary and  appropriate  action to
cause the Merger to become effective as soon as practicable after the expiration
of the Offer without a  Stockholders  Meeting in accordance  with Section 253 of
the DGCL.  Without limiting the generality of the foregoing,  the Company agrees
that its  obligations  pursuant to the first  sentence of this  Section  7.01(a)
shall  not  be  affected  by  (i)  the  commencement,  public  proposal,  public
disclosure or communication to the Company of any Takeover  Proposal or (ii) the
withdrawal  or  modification  by the Board of  Directors  of the  Company of its
approval or recommendation of the Offer, the Agreement or the Merger.

                  (b) If the  Company  Stockholder  Approval is required by law,
the Company  will, at Parent's  request,  as soon as  practicable  following the
acceptance  for payment of, and payment  for,  any Shares by Sub pursuant to the
Offer and the  expiration  of the Offer,  prepare and file a  preliminary  Proxy
Statement  with the SEC and will use its best efforts to respond to any comments
of the SEC or its staff and to cause  the  Proxy  Statement  to be mailed to the
Company's  stockholders as promptly as practicable  after responding to all such
comments  to the  satisfaction  of the staff.  The Company  will  notify  Parent
promptly of the receipt of any


                                      -39-
<PAGE>




comments  from the SEC or its staff and of any  request  by the SEC or its staff
for  amendments  or  supplements  to  the  Proxy  Statement  or  for  additional
information and will supply Parent with copies of all correspondence between the
Company  or any of its  representatives,  on the  one  hand,  and the SEC or its
staff, on the other hand, with respect to the Proxy Statement or the Merger.  If
at any time prior to the  Stockholders  Meeting there shall occur any event that
should be set forth in an amendment or  supplement to the Proxy  Statement,  the
Company will promptly prepare and mail to its stockholders  such an amendment or
supplement.  The Company will not mail any Proxy Statement,  or any amendment or
supplement thereto, to which Parent reasonably objects.


                  (c) Parent  agrees to cause all Shares  purchased  pursuant to
the Offer and all other Shares owned by Parent or any subsidiary of Parent to be
voted in favor of the Company Stockholder Approval.

                  SECTION 7.02.  Access to  Information.  The Company shall (and
shall cause each of its  subsidiaries  to) furnish promptly to Parent (a) a copy
of each report,  schedule,  registration  statement and other  document filed or
received by it during such period pursuant to the requirements of the Federal or
state  securities  laws or the  Federal  tax laws and (b) all other  information
concerning  its  business,  properties  and  personnel as Parent may  reasonably
request (including the Company's outside accountants' work papers).

                  SECTION 7.03. Reasonable Efforts.  Each of the Company, Parent
and Sub agree to use its reasonable  efforts to take, or cause to be taken,  all
actions  necessary to comply promptly with all legal  requirements  which may be
imposed on itself with respect to the Offer and the Merger (which  actions shall
include furnishing all information required under the HSR Act, and in connection
with  approvals  of or  filings  with any other  Governmental  Entity)  and will
promptly cooperate with and furnish information to each other in connection with
any such requirements  imposed upon any of them or any of their  subsidiaries in
connection  with the Offer and the Merger.  Each of the Company,  Parent and Sub
will, and will cause its subsidiaries to, use its reasonable efforts to take all
reasonable  actions  necessary to obtain (and will  cooperate with each other in
obtaining)  any consent,  authorization,  order or approval of, or any exemption
by, any  Governmental  Entity or other public or private third party required to
be obtained or made by Parent, Sub, the Company or any of their subsidiaries in


                                      -40-
<PAGE>




connection  with  the  Offer  and  the  Merger  or  the  taking  of  any  action
contemplated  thereby or by the  Agreement,  except that no party need waive any
substantial  rights or agree to any substantial  limitation on its operations or
to dispose of any assets.


                  SECTION 7.04. Options;  Warrants.  (a) The Company shall amend
all  Company  plans  ("Option  Plans")  pursuant  to which  there are holders of
options to purchase  Shares  granted by the Company (the  "Options")  to provide
that if the optionees do not exercise  their  unexercised  Options within thirty
(30)  days  of a  notice  that  the  Company  proposes  to  merge  into  another
corporation, to the extent that an optionee does not exercise within thirty (30)
days of the notice the optionee shall receive, in settlement of each Option held
by the optionee,  a "Cash Amount" (less any applicable  withholding  taxes) with
respect to the number of previously  unexercised  Shares  underlying  the Option
immediately  prior to the Effective  Time. Each Option shall terminate as of the
Effective  Time. The Cash Amount payable for each Option shall equal the product
of (i) the Merger  Consideration minus the exercise price per Share of each such
Option and (ii) the number of previously unexercised Shares covered by each such
Option.

                  (b) The Company shall provide  notice to  participants  in the
Company   Option  Plans  that  the  Company   proposes  to  merge  into  another
corporation;  that the  Optionee  under the plans or program  may  exercise  his
Options in full for all shares not  theretofore  purchased by him within  thirty
(30) days after such notice; and that the plans and program have been amended to
provide  that to the extent an optionee  does not exercise  such Options  within
thirty (30) days of the notice the optionee shall receive, in settlement of each
Option held by the optionee,  a "Cash Amount" (less any  applicable  withholding
taxes) with respect to the number of previously  unexercised  Shares  underlying
the Option  immediately prior to the Effective Time. Each Option shall terminate
as of the Effective  Time.  The Cash Amount  payable for each Option shall equal
the product of (i) the Merger  Consideration  minus the exercise price per Share
of each such Option and (ii) the number of previously unexercised Shares covered
by each such Option.

                  (c) Except as may be otherwise  agreed to by Parent or Sub and
the Company, the Company's Option Plans shall terminate as of the Effective Time
and the provisions in any other plan, program or arrangement providing for the


                                      -41-
<PAGE>




issuance or grant of any other  interest in respect of the capital  stock of the
Company or any of its Subsidiaries shall be deleted as of the Effective Time.


                  (d) The Company  shall use its best efforts so that  following
the  Effective  Time no holder of employee  stock options will have any right to
receive Shares upon exercise of an employee stock option.

                  (e) At the Effective Time,  each holder of a then  outstanding
warrant to purchase Shares granted by the Company  ("Warrants"),  whether or not
then exercisable,  shall, in settlement thereof,  receive for each Share subject
to such Warrant an amount  (subject to any applicable  withholding  tax) in cash
equal to the difference between the Offer Price and the per share exercise price
of such Warrant to the extent such difference is a positive number. Prior to the
Effective  Time,  the Company shall use its best efforts to obtain all necessary
consents or releases  from  holders of Warrants,  to the extent  required by the
terms of the agreements  governing such Warrants or pursuant to the terms of any
Warrant  granted  thereunder,  and take all such other  lawful  action as may be
necessary  to give  effect  to the  transactions  contemplated  by this  Section
7.04(f)  (except for such action that may require the approval of the  Company's
stockholders).


                  SECTION  7.05.  Directors.  Promptly upon the  acceptance  for
payment of, and payment for, any Shares by Sub pursuant to the Offer,  Sub shall
be entitled to  designate  such number of directors on the Board of Directors of
the Company as will give Sub,  subject to  compliance  with Section 14(f) of the
Exchange Act, a majority of such directors, and the Company shall, at such time,
cause  Sub's  designees  to be so elected by its  existing  Board of  Directors;
provided,  however,  that in the event that Sub's  designees  are elected to the
Board of  Directors  of the  Company,  until the  Effective  Time such  Board of
Directors shall have at least two directors who are directors on the date of the
Agreement and who are not officers of the Company (the "Independent Directors");
and provided further that, in such event, if the number of Independent Directors
shall be reduced below two for any reason whatsoever,  the remaining Independent
Director shall designate a person to fill such vacancy who shall be deemed to be
an  Independent  Director for purposes of the  Agreement  or, if no  Independent
Directors then remain, the other directors shall designate


                                      -42-
<PAGE>




two persons to fill such  vacancies  who shall not be officers or  affiliates of
the Company or any of its  subsidiaries,  or officers or affiliates of Parent or
any of its  subsidiaries,  and such  persons  shall be deemed to be  Independent
Directors for purposes of the Agreement.  Subject to applicable law, the Company
shall take all action requested by Parent necessary to effect any such election,
including mailing to its stockholders the Information  Statement  containing the
information  required  by  Section  14(f) of the  Exchange  Act and  Rule  14f-1
promulgated  thereunder,  and the Company  agrees to make such  mailing with the
mailing of the  Schedule  14D-9  (provided  that Sub shall have  provided to the
Company  on a timely  basis  all  information  required  to be  included  in the
Information  Statement with respect to Sub's designees).  In connection with the
foregoing,  the Company will promptly,  at the option of Parent, either increase
the size of the Company's  Board of Directors  and/or obtain the  resignation of
such number of its current  directors as is necessary to enable Sub's  designees
to be elected or appointed  to, and to  constitute a majority of, the  Company's
Board of Directors as provided above.


                  SECTION 7.06. Fees and Expenses.  (a) Except as provided below
in this Section  7.06,  all fees and expenses  incurred in  connection  with the
Offer,  the Merger,  the  Agreement  and the  transactions  contemplated  by the
Agreement shall be paid by the party incurring such fees or expenses, whether or
not the Offer or the Merger is consummated.

                  (b) If (w) the Company shall terminate this Agreement pursuant
to Section  9.01(d)(i),  (x) Parent shall  terminate this Agreement  pursuant to
Section  9.01(c)(ii) hereof, or (y) either the Company or Parent terminates this
Agreement  pursuant to Section 9.01(b)(i) and (a) prior thereto there shall have
been  publicly  announced  another  Takeover  Proposal  or an event set forth in
paragraph (d) of Exhibit A shall have occurred and (b) a Takeover Proposal shall
be  consummated  on or prior to March 31, 1998,  the Company shall pay to Parent
one million  ($1,000,000)  Dollars as a termination fee (the "Termination Fee"),
which shall be payable in same day funds. The Termination Fee, together with the
balance of any loans between  Parent or any  Subsidiary  thereof and the Company
shall be paid (1) in the case of  termination's  referenced  in subparts (w) and
(x)  above,  concurrently  with  any  such  termination  and (2) in the  case of
termination  referenced in subpart (y) above,  at the time of  consummation of a
Takeover Proposal as described in subpart (y)(b) above.


                                      -43-
<PAGE>







                  SECTION 7.07.  Indemnification;  Insurance. (a) Parent and Sub
agree that all rights to indemnification  for acts or omissions  occurring prior
to the Effective  Time now existing in favor of the current or former  directors
or officers (the  "Indemnified  Parties") of the Company and its subsidiaries as
provided  in their  respective  certificates  of  incorporation  or by-laws  (or
similar organizational documents) or existing indemnification contracts as filed
with the Company Filed SEC Documents shall survive the Merger and shall continue
in full force and effect in accordance with their terms.  For six years from the
Effective Time, Parent shall, (i) guarantee the indemnification  obligations set
forth in this Section 7.07(a) and (ii) maintain in effect the Company's  current
directors'  and officers'  liability  insurance  covering  those persons who are
currently covered by the Company's  directors' and officers' liability insurance
policy (a copy of which has been heretofore delivered to Parent).

                  (b) This Section 7.07 shall  survive the  consummation  of the
Merger at the Effective  Time, is intended to benefit the Company,  Parent,  the
Surviving  Corporation and the Indemnified  Parties, and shall be binding on all
successors and assigns of Parent and the Surviving Corporation.

                  SECTION 7.08. Certain Litigation2.  The Company agrees that it
will not voluntarily  cooperate with any third party which may hereafter seek to
restrain  or  prohibit  or  otherwise  oppose  the Offer or the  Merger and will
cooperate  with Parent and Sub to resist any such effort to restrain or prohibit
or  otherwise  oppose the Offer or the Merger,  unless the Board of Directors of
the Company  determines in good faith,  after consultation with outside counsel,
that failing so to cooperate with such third party or cooperating with Parent or
Sub, as the case may be,  would  constitute  a breach of the  Board's  fiduciary
duties under applicable law.

                                  ARTICLE VIII

                                   CONDITIONS

                  SECTION 8.01.  Conditions to Each Party's Obligation To Effect
the Merger.  The respective  obligation of each party to effect the Merger shall
be  subject  to the  satisfaction  prior to the  Closing  Date of the  following
conditions:


                                      -44-
<PAGE>







                  (a) Company  Stockholder  Approval.  If required by applicable
law, the Company Stockholder Approval shall have been obtained.

                  (b)  No   Injunctions  or   Restraints.   No  statute,   rule,
regulation, executive order, decree, temporary restraining order, preliminary or
permanent   injunction   or  other  order  issued  by  any  court  of  competent
jurisdiction  or  other   Governmental   Entity  or  other  legal  restraint  or
prohibition  preventing  the  consummation  of the  Merger  shall be in  effect;
provided,  however,  that each of the parties shall have used reasonable efforts
to  prevent  the entry of any such  injunction  or other  order and to appeal as
promptly as possible any injunction or other order that may be entered.

                  (c) Purchase of Shares. Sub shall have previously accepted for
payment and paid for Shares pursuant to the Offer.

                  (d)  Competition  Approvals.  The applicable  waiting  periods
under the HSR Act shall have expired or been terminated.



                                   ARTICLE IX

                            TERMINATION AND AMENDMENT

                  SECTION 9.01. Termination.  The Agreement may be terminated at
any time prior to the Effective  Time,  whether  before or after approval of the
terms of the Agreement by the stockholders of the Company:

                  (a)  by mutual written consent of Parent and the Company;

                  (b)  by either Parent or the Company

                         (i) if (x) as a  result  of the  failure  of any of the
Offer  Conditions the Offer shall have  terminated or expired in accordance with
its terms  without Sub having  accepted  for payment any Shares  pursuant to the
Offer or (y) Sub shall not have accepted for payment any Shares  pursuant to the
Offer prior to November 30, 1997; provided, however, that the right to terminate
the Agreement  pursuant to this Section 9.01(b)(i) shall not be available to any
party whose
                                      -45-
<PAGE>




failure to perform any of its  obligations  under the  Agreement  results in the
failure of any such condition or if the failure of such  condition  results from
facts or circumstances  that constitute a breach of  representation  or warranty
under the Agreement by such party; or


                         (ii) if any  Governmental  Entity  shall have issued an
order,  decree  or  ruling or taken  any  other  action  permanently  enjoining,
restraining or otherwise  prohibiting  the acceptance for payment of, or payment
for, shares of Company Common Stock pursuant to the Offer or the Merger and such
order,   decree  or  ruling  or  other   action  shall  have  become  final  and
nonappealable;

                  (c)  by Parent or Sub

                         (i) prior to the  purchase  of Shares  pursuant  to the
Offer in the event of a breach by the Company of any  representation,  warranty,
covenant or other agreement contained in the Agreement which (i) would give rise
to the failure of a condition set forth in paragraph (e) or (f) of Exhibit A and
(ii) cannot be or has not been cured  within 20 days after the giving of written
notice to the Company;

                         (ii) if either  Parent or Sub is entitled to  terminate
the Offer as a result of the  occurrence of any event set forth in paragraph (d)
of Exhibit A to the Agreement; or

                         (iii) if, due to an occurrence,  not involving a breach
by Parent or Sub of their  obligations  hereunder,  which makes it impossible to
satisfy any of the conditions set forth in Exhibit A hereto,  Parent, Sub or any
of their  affiliates shall have failed to commence the Offer on or prior to five
business  days  following  the date of the initial  public  announcement  of the
Offer;

                  (d)  by the Company

                         (i) in  connection  with  entering  into  a  definitive
agreement in accordance with Section 6.02(b),  provided it has complied with all
provisions thereof,  including the notice provisions therein,  and that it makes
simultaneous payment of the Termination Fee;

                         (ii)  if Sub  or  Parent  shall  have  breached  in any
material respect any of their respective representations,  warranties, covenants
or other agreements


                                      -46-
<PAGE>




contained in the  Agreement,  which breach or failure to perform is incapable of
being  cured or has not been  cured  within 20 days  after the giving of written
notice to Parent or Sub, as applicable,  except,  in any case, such breaches and
failures which are not reasonably  likely to affect adversely  Parent's or Sub's
ability to complete the Offer or the Merger; or


                         (iii) if Parent,  Sub or any of their  affiliates shall
have failed to commence the Offer on or prior to five  business  days  following
the date of the initial public  announcement  of the Offer;  provided,  that the
Company may not terminate the Agreement pursuant to this Section 9.01(d)(iii) if
the  Company is at such time in breach of its  obligations  under the  Agreement
such as to cause a material adverse effect on the Company and its  Subsidiaries,
taken as a whole.

                  SECTION  9.02.  Effect  of  Termination.  In  the  event  of a
termination  of the  Agreement  by either the  Company or Parent as  provided in
Section 9.01, the Agreement  shall  forthwith  become void and there shall be no
liability  or  obligation  on the part of  Parent,  Sub or the  Company or their
respective  officers or  directors,  except with respect to the last sentence of
Section 1.02(c),  Section 4.16, Section 5.06, the last sentence of Section 7.02,
Section 7.06, this Section 9.02 and Article X; provided,  however,  that nothing
herein shall relieve any party for liability for any breach hereof.

                  SECTION 9.03.  Amendment.  The Agreement may be amended by the
parties  hereto,  by action taken or  authorized by their  respective  Boards of
Directors,  at any  time  before  or after  obtaining  the  Company  Stockholder
Approval (if required by law), but, after any such approval,  no amendment shall
be made which by law  requires  further  approval by such  shareholders  without
obtaining such further  approval.  The Agreement may not be amended except by an
instrument in writing signed on behalf of each of the parties hereto.  Following
the election or appointment of the Sub's designees  pursuant to Section 7.05 and
prior  to  the  Effective  Time,  the  affirmative  vote  of a  majority  of the
Independent  Directors  then in office  shall be  required by the Company to (i)
amend or terminate the  Agreement by the Company,  (ii) exercise or waive any of
the  Company's  rights or remedies  under the Agreement or (iii) extend the time
for performance of Parent and Sub's respective obligations under the Agreement.


                                      -47-
<PAGE>







                  SECTION  9.04.  Extension;  Waiver.  At any time  prior to the
Effective  Time,  the parties  hereto,  by action taken or  authorized  by their
respective Boards of Directors,  may, to the extent legally allowed,  (i) extend
the time for the  performance  of any of the  obligations  or other  acts of the
other parties hereto,  (ii) waive any  inaccuracies in the  representations  and
warranties  contained  herein or in any document  delivered  pursuant  hereto or
(iii) subject to the proviso of Section 9.03,  waive  compliance with any of the
agreements or conditions  contained herein. Any agreement on the part of a party
hereto to any such  extension  or waiver  shall be valid  only if set forth in a
written  instrument  signed on behalf of such party. The failure of any party to
the Agreement to assert any of its rights under the Agreement or otherwise shall
not constitute a waiver of those rights.

                                    ARTICLE X

                                  MISCELLANEOUS

                  SECTION 10.01.  Nonsurvival of Representations and Warranties.
The  representations  and  warranties  in the  Agreement  or in  any  instrument
delivered pursuant to the Agreement shall terminate at the Effective Time or, in
the case of the Company, shall terminate upon the acceptance for payment of, and
payment for, Shares by Sub pursuant to the Offer, unless the survival thereof is
provided for by their terms.

                  SECTION 10.02.  Notices.  All notices and other communications
hereunder shall be in writing and shall be deemed given if delivered personally,
telecopied (which is confirmed),  sent by overnight courier  (providing proof of
delivery) or mailed by registered or certified mail (return  receipt  requested)
to the parties at the following  addresses (or at such other address for a party
as shall be specified by like notice):

                  (a)      if to Parent or Sub, to:

                           Integrated Health Services, Inc.
                           10065 Red Run Blvd.
                           Owings Mills, MD  21117
                           Attention:  Beth Kelly
                           Facsimile:  (410) 902-2110

                           with a copy to:


                                      -48-
<PAGE>







                           Integrated Health Services, Inc.
                           10065 Red Run Blvd.
                           Owings Mills, MD  21117
                           Attention:  Marshall Elkins, Esq.
                           Facsimile:  (410) 998-8500

                                    and

                           Calo Agostino
                           27 Warren Street
                           Hackensack, NJ  07601
                           Attention:  Frank Agostino, Esq.
                           Facsimile:  (201) 488-5855

                  (b)      if to the Company, to:

                           Community Care of America, Inc.
                           3050 North Horseshoe Drive, Suite 260
                           Naples, FL  34104
                           Attention:  Deborah Lau
                           Facsimile:  (941) 435-0408

                           with a copy to:

                           Chadbourne & Parke LLP
                           30 Rockefeller Plaza
                           New York, NY  10112
                           Attention:  J. Allen Miller, Esq.
                           Facsimile:  (212) 541-5369

                  SECTION 10.03. Interpretation. When a reference is made in the
Agreement to an Article or a Section, such reference shall be to an Article or a
Section of the Agreement unless otherwise  indicated.  The table of contents and
headings  contained in the Agreement  are for reference  purposes only and shall
not affect in any way the meaning or interpretation  of the Agreement.  Whenever
the words "include",  "includes" or "including" are used in the Agreement,  they
shall be deemed to be followed  by the words  "without  limitation".  The phrase
"made  available" in the Agreement shall mean that the  information  referred to
has been made available if requested by the party to whom such information is to
be made available. As used in the Agreement, the term "subsidiary" of any person
means another person, an amount of the voting securities, other voting ownership
or  voting  partnership  interests  of which is  sufficient  to elect at least a
majority of its Board of Directors or other  governing body (or, if there are no
such


                                      -49-
<PAGE>




voting interests, 50% or more of the equity interests of which is owned directly
or indirectly by such first person). As used in the Agreement, "material adverse
change" or "material  adverse  effect" means,  when used in connection  with the
Company,  any change or effect that,  individually  or in the aggregate with any
such other changes or effects, is materially adverse to the business,  financial
condition or results of operations of the Company and its subsidiaries  taken as
a whole.


                  SECTION 10.04. Counterparts.  The Agreement may be executed in
two or more  counterparts,  all of which  shall be  considered  one and the same
agreement and shall become  effective  when two or more  counterparts  have been
signed by each of the  parties  and  delivered  to the other  parties,  it being
understood that all parties need not sign the same counterpart.

                  SECTION 10.05.  Entire Agreement;  Third Party  Beneficiaries.
The Agreement  (including the documents and the instruments  referred to herein)
(a)  constitute  the entire  agreement and supersede  all prior  agreements  and
understandings,  both  written and oral,  among the parties  with respect to the
subject  matter  hereof,  and (b) except as  provided in Section  7.07,  are not
intended to confer upon any person  other than the parties  hereto any rights or
remedies hereunder.

                  SECTION 10.06.  Governing Law. The Agreement shall be governed
and  construed  in  accordance  with the laws of the  State of New York  without
regard to any applicable  conflicts of law,  except to the extent the DGCL shall
be held to govern the terms of the Merger.

                  SECTION 10.07. Publicity.  Except as otherwise required by law
or the rules of any  exchange to which the Company or Parent is subject,  for so
long as the  Agreement is in effect,  neither the Company nor Parent  shall,  or
shall permit any of its  subsidiaries  to, issue or cause the publication of any
press  release or other public  announcement  with  respect to the  transactions
contemplated  by the  Agreement  without the consent of the other  party,  which
consent shall not be unreasonably withheld.

                  SECTION  10.08.  Assignment.  Neither the Agreement nor any of
the rights,  interests or obligations  hereunder shall be assigned by any of the
parties  hereto  (whether by  operation of law or  otherwise)  without the prior
written


                                      -50-
<PAGE>




consent  of the  other  parties,  except  that  Sub  may  assign,  in  its  sole
discretion, any or all of its rights, interests and obligations hereunder to any
direct or indirect wholly owned subsidiary of Integrated  Health Services,  Inc.
Subject to the preceding sentence,  the Agreement will be binding upon, inure to
the benefit of and be enforceable by the parties and their respective successors
and assigns.


                  SECTION 10.09. Enforcement. The parties agree that irreparable
damage would occur in the event that any of the provisions of the Agreement were
not  performed  in  accordance  with  their  specific  terms  or were  otherwise
breached.  It is  accordingly  agreed that the  parties  shall be entitled to an
injunction or  injunctions  to prevent  breaches of the Agreement and to enforce
specifically  the  terms and  provisions  of the  Agreement  in any court of the
United  States  located in the State of Delaware or in a Delaware  state  court,
this being in addition to any other  remedy to which they are entitled at law or
in equity.  In addition,  each of the parties hereto (i) consents to submit such
party to the personal  jurisdiction of any Federal court located in the State of
Delaware or any Delaware  state court in the event any dispute arises out of the
Agreement or any of the transactions  contemplated hereby, (ii) agrees that such
party will not attempt to deny or defeat such personal jurisdiction by motion or
other  request for leave from any such court,  (iii) agrees that such party will
not  bring any  action  relating  to the  Agreement  or any of the  transactions
contemplated hereby in any court other than a Federal court sitting in the state
of Delaware or a Delaware state court and (iv) waives any right to trial by jury
with  respect  to any  claim or  proceeding  related  to or  arising  out of the
Agreement or any of the transactions contemplated hereby.



                                      -51-
<PAGE>



                  IN WITNESS  WHEREOF,  Parent,  Sub and the Company have caused
the  Agreement  to  be  signed  by  their  respective  officers  thereunto  duly
authorized as of the date first written above.

                                      INTEGRATED HEALTH SERVICES, INC.



                                      By: /s/ Brian K. Davidson
                                         ---------------------------------
                                         Name: Brian K. Davidson
                                         Title: Executive Vice President-
                                                 Development



                                      IHS ACQUISITION XXVI INC.



                                      By: /s/ Brian K. Davidson
                                         ---------------------------------
                                         Name: Brian K. Davidson
                                         Title: Executive Vice President-
                                                 Development



                                      COMMUNITY CARE OF AMERICA, INC.



                                      By: /s/ Deborah A. Lau
                                         ---------------------------------
                                         Name: Deborah A. Lau
                                         Title: Chief  Executive Officer




                                      -52-
<PAGE>



                                    EXHIBIT A

                             Conditions of the Offer

                  Notwithstanding  any other term of the Offer or the Agreement,
and in  addition to (and not in  limitation  of) Sub's right to extend and amend
the Offer at any time in its sole  discretion  (subject to the provisions of the
Agreement),  Sub shall not be  required  to accept for  payment  or,  subject to
applicable  rules and regulations of the SEC,  including Rule 14e-1(c) under the
Exchange Act (relating to Sub's  obligation to pay for or return tendered Shares
after the termination or withdrawal of the Offer), to pay for, and may delay the
acceptance for payment of or, subject to the restriction  referred to above, the
payment  for, any Shares  tendered  pursuant to the Offer unless (i) there shall
have been validly  tendered and not  withdrawn  prior to the  expiration  of the
Offer such number of Shares that would  constitute a majority of the outstanding
Shares  (determined on a fully diluted basis for all  outstanding  stock options
and any other rights to acquire  Shares) (the "Minimum  Condition") and (ii) any
waiting period under the HSR Act  applicable to the purchase of Shares  pursuant
to the Offer shall have expired or been terminated. Furthermore, notwithstanding
any other  term of the Offer or the  Agreement,  Sub  shall not be  required  to
accept  for  payment  or,  subject  as  aforesaid,  to pay  for any  Shares  not
theretofore accepted for payment or paid for, and may terminate the Offer if, at
any time on or after the date of the Agreement and before the acceptance of such
Shares for  payment or the payment  therefor,  any of the  following  conditions
exists:

                  (a) there shall be  threatened,  instituted  or pending by any
person or Governmental Entity any suit, action,  investigation or proceeding (i)
challenging  the  acquisition  by Parent or Sub of any Shares under the Offer or
seeking to restrain or prohibit the making or  consummation  of the Offer or the
Merger or the performance of any of the other  transactions  contemplated by the
Agreement,  or seeking to obtain from the Company, Parent or Sub any damages not
covered by insurance which in the reasonable  judgment of Parent are material in
relation to the Company and its subsidiaries  taken as a whole,  (ii) seeking to
prohibit or impose any  limitations on Parent's or Sub's  ownership or operation
(or that of any of their respective Subsidiaries or affiliates) of the Company's
businesses or assets, or to compel Parent or Sub or their


                                      -53-
<PAGE>




respective  Subsidiaries  and  affiliates  to  dispose of or hold  separate  any
portion of the business or assets of the Company or Parent and their  respective
Subsidiaries,  (iii)  seeking to impose  limitations  on the  ability of Sub, or
render Sub unable, to accept for payment, pay for or purchase some or all of the
Shares pursuant to the Offer and the Merger,  (iv) seeking to impose limitations
on the ability of Sub or Parent effectively to exercise full rights of ownership
of the  Shares,  including,  without  limitation,  the right to vote the  Shares
purchased by it on all matters properly presented to the Company's stockholders,
or (v) which otherwise in the reasonable judgment of Parent are likely to have a
material adverse effect on the Company;


                  (b) there shall be any statute,  rule,  regulation,  judgment,
order or injunction enacted, entered, enforced, promulgated or deemed applicable
to  the  Offer  or the  Merger,  or any  other  action  shall  be  taken  by any
Governmental  Entity or court,  other than the  application  to the Offer or the
Merger of applicable waiting periods under the HSR Act that is in the reasonable
judgment  of Parent  likely to result,  directly  or  indirectly,  in any of the
consequences referred to in clauses (i) through (v) of paragraph (a) above;

                  (c)  there  shall  have  occurred  any  events  that,   either
individually or in the aggregate,  have caused or in the reasonable  judgment of
the Parent are likely to cause a material  adverse  change  with  respect to the
Company;

                  (d)(i) the Board of Directors of the Company or any  committee
thereof  shall have  withdrawn or modified in a manner  adverse to Parent or Sub
its approval or  recommendation  of the Offer,  the Merger or the Agreement,  or
approved or  recommended  any  Takeover  Proposal,  (ii) the Company  shall have
entered into any agreement  with respect to any Superior  Proposal in accordance
with  Section  6.02(b) of the  Agreement  or (iii) the Board of Directors of the
Company  or any  committee  thereof  shall  have  resolved  to  take  any of the
foregoing actions;

                  (e) any of the  representations  and warranties of the Company
set forth in the  Agreement  that are qualified as to  materiality  shall not be
true and  correct or any such  representations  and  warranties  that are not so
qualified shall not be true and correct in any material respect, in each case at
the date of the  Agreement  and at the  scheduled or extended  expiration of the
Offer;


                                      -54-
<PAGE>







                  (f) the  Company  shall have  failed to perform or cure within
the applicable cure period any material  obligation or to comply in any material
respect with any  material  agreement or covenant of the Company to be performed
or complied with by it under the Agreement;

                  (g) the  Agreement  shall have been  terminated  in accordance
with its terms;

                  (h) there shall have occurred (i) any general  suspension  of,
or  limitation  on prices  for,  trading  in  securities  on the New York  Stock
Exchange  or on  NASDAQ,  (ii) a  declaration  of a  banking  moratorium  or any
suspension  of  payments  in  respect  of banks in the  United  States,  (iii) a
commencement  of a war,  armed  hostilities or other  international  or national
calamity  directly  involving  the armed forces of the United  States,  (iv) any
general limitation  (whether or not mandatory) by any governmental  authority on
the extension of credit by banks or other lending  institutions,  and (v) in the
case of any of the  foregoing  existing at the time of the  commencement  of the
Offer, a material acceleration or worsening thereof.

                  (i) The Parent,  Sub and Company  shall not have  procured the
consents described on Schedule A(i).

                  The  foregoing  conditions  are for the sole benefit of Parent
and Sub, may be asserted by Parent or Sub regardless of the circumstances giving
rise to such condition (including any action or inaction by Parent or Sub not in
violation  of the  Agreement)  and may be waived by Parent or Sub in whole or in
part at any time and from time to time in the sole  discretion of Parent or Sub,
subject in each case to the terms of the Agreement. The failure by Parent or Sub
at any time to exercise any of the foregoing rights shall not be deemed a waiver
of any such right and each such right shall be deemed an ongoing right which may
be asserted at any time and from time to time.




                                      -55-
<PAGE>




                                LIST OF SCHEDULES



                 Schedule                           Description
                 --------                           -----------
                    4.02                     Subsidiaries
                    4.03                     Capitalization
                    4.05                     Contractual Consents
                    4.07                     Changes or Events
                    4.08                     Undisclosed Liabilities
                    4.10                     Benefit Plans
                    4.11                     Compensation Arrangements
                    4.12                     Litigation
                    4.14                     Tax Matters
                    4.15                     State Takeover Statutes
                    4.18                     Intellectual Property
                    4.19                     Labor Matters
                    4.20                     Real Property, Leases and Assets
                    4.22                     Environmental Matters
                    4.23                     Reimbursement Matters
                    4.24                     Contracts
                    4.25                     Insurance
                    5.03                     Parent/Sub Consents
                    6.01(f)                  Covenants of the Company
                                                Dispositions
                  Exhibit A                  Conditions of the Offer
                  Exhibit B                  Questionnaire




                                      -56-

                           VOTING AND TENDER AGREEMENT


         THIS VOTING AND TENDER  AGREEMENT (this  "Agreement"),  dated as of the
1st day of August, 1997, by and between ROBERT N. ELKINS (the "Stockholder") and
INTEGRATED  HEALTH  SERVICES,  INC., a Delaware  Corporation  ("Parent") and IHS
ACQUISITION XXVI, INC. ("Merger Subsidiary").

         WHEREAS,  Community Care of America,  Inc., a Delaware Corporation (the
"Company"), Parent and Merger Subsidiary are entering into an Agreement and Plan
of Merger,  dated as of the date hereof (the "Merger  Agreement") which provides
for,  among other things,  an offer to purchase by Merger  Subsidiary all of the
outstanding shares of the Company ("Company Common Stock"),  at a purchase price
of Four and 0/100 ($4.00) Dollars per share, net to the seller in cash,  without
interest  thereon,  followed by the merger of Merger Subsidiary with the Company
(the "Merger"); and

         WHEREAS,  as of the date hereof,  the  Stockholder  owns, of record and
beneficially, 1,600,893 shares of Company Common Stock; and

         WHEREAS,  as a  condition  to the  willingness  of  Parent  and  Merger
Subsidiary  to enter  into the  Merger  Agreement,  each of  Parent  and  Merger
Subsidiary  has  required  that the  Stockholder  agree,  and in order to induce
Parent and Merger Subsidiary to enter into the Merger Agreement, the Stockholder
has  agreed,  to enter  into this  Agreement  with  respect to (a) all shares of
Company  Common  Stock  now  owned,  beneficially  or  otherwise,  and which may
hereafter be acquired by the  Stockholder  (the  "Shares") and (b) certain other
matters as set forth herein.

         NOW  THEREFORE,  in  consideration  of the  foregoing  and  the  mutual
covenants  and  agreements  contained  herein and  intending to be legally bound
hereby, the parties hereto hereby agree as follows:

                                    ARTICLE I


         Section 1.1 Tender Agreement.  (a) The Stockholder  shall,  within five
(5) business days after the  commencement of the Offer (as defined in the Merger
Agreement),  tender,  or cause to be  tendered,  for sale to Merger  Subsidiary,
pursuant to the terms of the Offer, all of the  Stockholder's  Shares then owned
of record or  beneficially  by the  Stockholder;  and (b) except as  provided in
clause (a) above,  during the time this Agreement is in effect,  the Stockholder
shall not otherwise  sell,  give,  dispose of (whether by operation of law or by
agreement  or  otherwise)  or tender any Shares or any right,  title or interest
therein or thereto.

         Section 1.2 Voting Agreement. The Stockholder hereby agrees that during
the time this Agreement is in effect,  at any meeting of the stockholders of the
Company, however called, and in any action by consent of the stockholders of the
Company, the Stockholder shall vote the Shares, or cause the Shares to be voted:
(a) in favor of the



<PAGE>

Merger  pursuant to the Merger  Agreement;  and (b) against any proposal for any
recapitalization,  merger, sale of assets or other business  combination between
the Company and any person or entity (other than Merger Subsidiary or Parent) or
any other  action or agreement  that would  result in a breach of any  covenant,
representation  or warranty or any other  obligation or agreement of the Company
under the Merger  Agreement or which could prevent any of the  conditions to the
Company's  obligations  under the  Merger  Agreement  from being  fulfilled.  If
requested by Parent,  the Stockholder will grant Parent an irrevocable  proxy to
vote the Shares in a manner consistent with this Section 1.2 for so long as this
Agreement is in effect.  The Stockholder will not join in any suit or proceeding
or participate in any action that is inconsistent  with, or designed or intended
to have the effect of discouraging, the completion of the Merger pursuant to the
terms of the Merger Agreement.

         Section 1.3  General  Release.  As an  inducement  for  Parent,  Merger
Subsidiary  and the  Company to enter into the  Merger  Agreement:  (a) upon the
Merger Subsidiary obtaining control of the Company, the Stockholder will remise,
release  and  forever  discharge  the  Company,  and  its  respective  officers,
directors, shareholders, employees, agents, successors and assigns, from any and
all debts,  obligations,  suits, actions,  causes of action, claims, demands, in
law or in equity,  which the  Stockholder  ever had or now has, for, upon, or by
reason of any matter,  cause or thing whatsoever,  however arising; and (b) upon
the Merger Subsidiary obtaining control of the Company, the Company will remise,
release and forever discharge Stockholder and its partners, and their respective
officers,  directors,  shareholders,  employees, agents, successors and assigns,
from any and all debts, obligations,  suits, actions, claims, demands, in law or
in  equity,  which  they ever had or now have,  for,  upon,  or by reason of any
matter,  cause or thing whatsoever,  however arising. In the event any action is
instituted,  the parties  hereto  agree to cause its  immediate  dismissal  with
prejudice.

         Section 1.4 Stockholder Capacity.  The Stockholder makes this Agreement
solely in its capacity as the record and beneficial owner of the Shares. Nothing
in  this  Agreement  shall  prohibit  the  Stockholder  or any of its  officers,
directors,  employees,  representatives  and agents from taking,  or omitting to
take, any action as a director, employee, representative or agent of the Company
permitted to be taken or omitted under the Merger Agreement.

         Section 1.5 Acknowledgment.  The Stockholder  acknowledges  receipt and
review of a copy of the Merger Agreement.

                                   ARTICLE II

                REPRESENTATIONS AND WARRANTIES OF THE STOCKHOLDER

      The Stockholder hereby represents and warrants to Parent as follows:

         Section 2.1 Authority  Relative to This Agreement.  The Stockholder has
all  necessary  power and  authority to execute and deliver this  Agreement,  to
perform  its 


                                      -2-
<PAGE>

obligations  hereunder and to consummate the transactions  contemplated  hereby.
The  execution  and  delivery  of  this  Agreement  by the  Stockholder  and the
consummation by the  Stockholder of the  transactions  contemplated  hereby have
been duly and validly  authorized by the Stockholder and no other proceedings on
the part of the  Stockholder  are  necessary to authorize  this  Agreement or to
consummate such transactions.  This Agreement has been duly and validly executed
and delivered by the Stockholder and, assuming the due authorization,  execution
and delivery by Parent and Merger  Subsidiary,  constitutes  a legal,  valid and
binding  obligation of the Stockholder,  enforceable  against the Stockholder in
accordance with its terms, except to the extent enforceability may be limited by
bankruptcy,  insolvency,  moratorium or other similar laws affecting  creditors'
rights  generally  or  by  general  principles  governing  the  availability  of
equitable remedies.

         Section  2.2 No  Conflict.  (a)  The  execution  and  delivery  of this
Agreement by the  Stockholder  do not, and the  performance of this Agreement by
the  Stockholder  shall not:  (i)  conflict  with or violate the  organizational
documents  of the  Stockholder;  (ii)  conflict  with or violate any law,  rule,
regulation,  order, judgment or decree applicable to the Stockholder or by which
the Shares are bound;  or (iii) result in any breach of or  constitute a default
(or an event  that  with  notice,  or lapse of  time,  or both,  would  become a
default)  under,  or  give to  others  any  rights  of  termination,  amendment,
acceleration  or  cancellation  of,  or  result  in the  creation  of a lien  or
encumbrance on any of the Shares  pursuant to any note,  bond,  mortgage,  other
instrument  or obligation  to which the  Stockholder  is a party or by which the
Stockholder or the Shares are bound or affected,  except in case of clauses (ii)
and (iii),  for any such  conflicts,  violations,  breaches,  defaults  or other
occurrences  which would not prevent or delay the performance by the Stockholder
of its obligations  under this Agreement;  and (b) the execution and delivery of
this Agreement by the  Stockholder do not, and the performance of this Agreement
by the Stockholder  shall not, require any consent,  approval,  authorization or
permit of, or filing with,  or  notification  to, any court or arbitrator or any
governmental body, agency or official,  except for applicable  requirements,  if
any of the  Securities  Exchange Act of 1934,  as amended,  and except where the
failure to obtain such consents, approvals authorizations or permits, or to make
such filings or notifications, would not prevent or delay the performance by the
Stockholder of its obligations under this Agreement.

         Section 2.3 Title to the Shares. As of the date hereof, the Stockholder
is the record  and/or  beneficial  owner of 1,600,893  shares of Company  Common
Stock. Such Shares are all the securities of the Company owned, either of record
or beneficially,  by the Stockholder and the Stockholder owns no other rights or
interests exercisable for or convertible into any securities of the Company. The
Shares  are  owned  free and clear of all  security  interests,  liens,  claims,
pledges,  options,  rights  of first  refusal,  agreements,  limitations  on the
Stockholder's  voting  rights,  charges  and other  encumbrances  of any  nature
whatsoever.  The  Stockholder  has not  appointed  or granted  any proxy,  which
appointment or grant is still effective with respect to the Shares.


                                      -3-
<PAGE>

         Section 2.4 No Fees or  Commissions.  No broker,  financial  advisor or
other intermediary is entitled to any fee or other commission in connection with
the transaction  contemplated by this Agreement based on an arrangement  made by
or on behalf of the Stockholder.

                                   ARTICLE III

                          COVENANTS OF THE STOCKHOLDER


         Section 3.1 No Inconsistent Agreement. The Stockholder hereby covenants
and  agrees  that,  except as  contemplated  by this  Agreement  and the  Merger
Agreement,  the Stockholder  shall not enter into any agreement or grant a proxy
or power of attorney with respect to the Shares which is inconsistent  with this
Agreement.

         Section 3.2 No  Encumbrances.  The  Stockholder  hereby  covenants  and
agrees  that the  Stockholder  shall  not by any  action or  omission  cause any
security interests,  liens, claims,  pledges,  charges,  encumbrances,  options,
rights of first refusals,  agreements or limitations on the Stockholder's voting
rights, to attach to the Shares to be tendered to the Merger Subsidiary pursuant
to Section 1.1 hereof.

                                   ARTICLE IV

                    REPRESENTATIONS AND WARRANTIES OF PARTIES

     Each of the Stockholder, Parent and Merger Subsidiary has full right, power
and authority to enter into and perform this  Agreement  and this  Agreement has
been duly authorized,  executed and delivered by each of the Stockholder, Parent
and  Merger  Subsidiary  and is a valid  and  binding  agreement  of each of the
Stockholder,  Parent  and  Merger  Subsidiary  enforceable  against  each of the
Stockholder, Parent and Merger Subsidiary in accordance with its terms.

                                    ARTICLE V

                                  MISCELLANEOUS


         Section  5.1  Termination.  This  Agreement  shall  terminate  upon the
termination of the Merger  Agreement or if the Shares shall have not theretofore
been sold pursuant to the Offer, on November 30, 1997, whichever is earlier.

         Section  5.2  Specific  Performance.  The  parties  hereto  agree  that
irreparable  damage would occur in the event that any of the  provisions of this
Agreement  were not performed in  accordance  with the terms hereof and that the
parties  shall be entitled  to  specific  performance  of the terms  hereof,  in
addition to any other remedy at law or in equity.


                                      -4-
<PAGE>

         Section 5.3 Entire  Agreement.  This Agreement  constitutes  the entire
agreement  between Parent and the Stockholder with respect to the subject matter
hereof and supersedes all prior agreements and understandings,  both written and
oral,  between  Parent and the  Stockholder  with respect to the subject  matter
hereof.

         Section 5.4 Amendment.  This Agreement may not be amended, except by an
instrument in writing signed by the parties hereto.

         Section  5.5  Severability.  If any  term or  other  provision  of this
Agreement is invalid, illegal or incapable of being enforced by any rule of law,
or public policy,  all other  conditions and provisions of this Agreement  shall
regardless  remain in full  force and  effect so long as the  economic  or legal
substance of this Agreement is not affected in any manner materially  adverse to
any party. Upon such  determination that any term or other provision is invalid,
illegal or incapable of being  enforced,  the parties hereby shall  negotiate in
good faith to modify this  Agreement so as to effect the original  intent of the
parties as closely as possible to the fullest extent permitted by applicable law
in a mutually acceptable manner in order that the terms of this Agreement remain
as originally contemplated.

         Section 5.6  Governing  Law.  This  Agreement  shall be governed by and
construed in accordance with the laws of the State of Delaware regardless of the
laws that might  otherwise  govern under  applicable  principles of conflicts of
law.

         Section 5.7 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.













                                      -5-
<PAGE>

         IN WITNESS WHEREOF, the Stockholder,  Parent and Merger Subsidiary have
caused  this  Agreement  to be duly  executed  as the date and year first  above
written.


                                             /s/ Robert N. Elkins
                                             -----------------------------------
                                                       ROBERT N. ELKINS



                                             INTEGRATED HEALTH SERVICES, INC.

                                             By: /s/ Brian K. Davidson
                                                    ----------------------------
                                             Name:  Brian K. Davidson
                                             Title: Executive Vice President -
                                                       Development


                                             IHS ACQUISITION XXVI, INC.

                                             By: /s/ Brian K. Davidson
                                                    ----------------------------
                                             Name:  Brian K. Davidson
                                             Title: Executive Vice President -
                                                       Development
















                                      -6-

                           VOTING AND TENDER AGREEMENT


         THIS VOTING AND TENDER  AGREEMENT (this  "Agreement"),  dated as of the
1st  day  of  August,  1997,  by  and  between  EQUITY-LINKED  INVESTORS,   L.P.
("Stockholder  I"),   EQUITY-LINKED   INVESTORS-II,   L.P.   ("Stockholder  II")
(Stockholder  I  and  Stockholder  II  collectively  the   "Stockholders")   and
INTEGRATED  HEALTH  SERVICES,  INC., a Delaware  Corporation  ("Parent") and IHS
ACQUISITION XXVI, INC. ("Merger Subsidiary").

         WHEREAS,  Community Care of America,  Inc., a Delaware Corporation (the
"Company"), Parent and Merger Subsidiary are entering into an Agreement and Plan
of Merger,  dated as of the date hereof (the "Merger  Agreement") which provides
for,  among other things,  an offer to purchase by Merger  Subsidiary all of the
outstanding shares of the Company ("Company Common Stock"),  at a purchase price
of Four and 0/100 ($4.00) Dollars per share, net to the seller in cash,  without
interest  thereon,  followed by the merger of Merger Subsidiary with the Company
(the "Merger"); and

         WHEREAS,  as of the date  hereof,  Stockholder  I owns,  of record  and
beneficially, 665,907 shares of Company Common Stock and Stockholder II owns, of
record and beneficially, 665907 shares of Company Common Stock; and

         WHEREAS,  as a  condition  to the  willingness  of  Parent  and  Merger
Subsidiary  to enter  into the  Merger  Agreement,  each of  Parent  and  Merger
Subsidiary  has required  that the  Stockholders  agree,  and in order to induce
Parent  and  Merger  Subsidiary  to  enter  into  the  Merger   Agreement,   the
Stockholders  have agreed,  to enter into this Agreement with respect to (a) all
shares of Company Common Stock now owned,  beneficially or otherwise,  and which
may  hereafter be acquired by the  Stockholders  (the  "Shares") and (b) certain
other matters as set forth herein.

         NOW  THEREFORE,  in  consideration  of the  foregoing  and  the  mutual
covenants  and  agreements  contained  herein and  intending to be legally bound
hereby, the parties hereto hereby agree as follows:

                                    ARTICLE I


         Section 1.1 Tender Agreement.  (a) The Stockholders  shall, within five
(5) business days after the  commencement of the Offer (as defined in the Merger
Agreement),  tender,  or cause to be  tendered,  for sale to Merger  Subsidiary,
pursuant  to the terms of the Offer (as long as the Offer is at least  $4.00 net
to the Stockholders in cash, without interest thereon), all of the Stockholders'
Shares then owned of record or beneficially by the  Stockholder;  and (b) except
as provided in clause (a) above,  during the time this  Agreement  is in effect,
the  Stockholders  shall not  otherwise  sell,  give,  dispose  of  (whether  by
operation  of law or by  agreement  or  otherwise)  or tender  any Shares or any
right, title or interest therein or thereto.

<PAGE>

         Section 1.2 Voting Agreement. The Stockholders hereby agree that during
the time this Agreement is in effect,  at any meeting of the stockholders of the
Company, however called, and in any action by consent of the stockholders of the
Company,  the  Stockholders  shall  vote the  Shares,  or cause the Shares to be
voted:  (a) in favor of the Merger  pursuant  to the Merger  Agreement;  and (b)
against any proposal for any  recapitalization,  merger, sale of assets or other
business  combination  between the Company and any person or entity  (other than
Merger  Subsidiary or Parent) or any other action or agreement that would result
in a breach of any covenant,  representation or warranty or any other obligation
or agreement of the Company  under the Merger  Agreement or which could  prevent
any of the conditions to the Company's  obligations  under the Merger  Agreement
from being fulfilled. If requested by Parent, the Stockholders will grant Parent
an irrevocable proxy to vote the Shares in a manner consistent with this Section
1.2 for so long as this Agreement is in effect.  The Stockholders  will not join
in any suit or  proceeding  or  participate  in any action that is  inconsistent
with, or designed or intended to have the effect of discouraging, the completion
of the Merger pursuant to the terms of the Merger Agreement;  provided, however,
that the Stockholders  hereby reserve any and all rights to defend themselves in
any such suit or proceeding or to take any actions required by applicable law.

         Section 1.3  General  Release.  As an  inducement  for  Parent,  Merger
Subsidiary  and the  Company to enter into the  Merger  Agreement:  (a) upon the
Merger  Subsidiary  obtaining  control of the  Company,  the  Stockholders  will
remise, release and forever discharge Parent, Merger Subsidiary and the Company,
and their  respective  officers,  directors,  shareholders,  employees,  agents,
successors and assigns,  from any and all debts,  obligations,  suits,  actions,
causes of action,  claims,  demands, in law or in equity, which the Stockholders
ever had or now have, for, upon, or by reason of any matter,  cause or thing her
than any  obligations  under  this  Agreement  or under  the  Merger  Agreement,
including,  without limitation, the obligations under Section 7.07 of the Merger
Agreement  respecting  the  continuation  of officers  and  directors  indemnity
obligations and insurance after the consummation of the Merger; and (b) upon the
Merger Subsidiary  obtaining control of the Company,  Parent,  Merger Subsidiary
and the Company will remise,  release and forever discharge the Stockholders and
their  partners,  and  their  respective  officers,   directors,   shareholders,
employees,  agents, successors and assigns, from any and all debts, obligations,
suits, actions, claims, demands, in law or in equity, which they ever had or now
have, for, upon, or by reason of any matter, cause or thing whatsoever,  however
arising.  In the event any action or proceeding covered by the foregoing release
has been filed or  instituted,  the parties  hereto agree to cause its immediate
dismissal with prejudice.

         Section 1.4 Stockholder Capacity.  The Stockholders make this Agreement
solely in their  capacity  as the record and  beneficial  owners of the  Shares.
Nothing  in this  Agreement  shall  prohibit  the  Stockholders  or any of their
partners,  officers,  directors,  employees,  representatives  and  agents  from
taking, or omitting to take, any action as a director, employee,  representative
or agent of the  Company  permitted  to be taken or  omitted  under  the  Merger
Agreement.


                                      -2-
<PAGE>


         Section 1.5  Acknowledgment.  The Stockholders  acknowledge receipt and
review of a copy of the Merger Agreement.

                                    ARTICLE 2

               REPRESENTATIONS AND WARRANTIES OF THE STOCKHOLDERS

       The Stockholders hereby represent and warrant to Parent as follows:


         Section 2.1 Authority Relative to This Agreement. The Stockholders have
all  necessary  power and  authority to execute and deliver this  Agreement,  to
perform  their   obligations   hereunder  and  to  consummate  the  transactions
contemplated  hereby.  The  execution  and  delivery  of this  Agreement  by the
Stockholders  and  the  consummation  by the  Stockholders  of the  transactions
contemplated  hereby have been duly and validly  authorized by the  Stockholders
and no  other  proceedings  on the part of the  Stockholders  are  necessary  to
authorize this Agreement or to consummate such transactions.  This Agreement has
been duly and validly executed and delivered by the Stockholders  and,  assuming
the due  authorization,  execution and delivery by Parent and Merger Subsidiary,
constitutes  a  legal,   valid  and  binding  obligation  of  the  Stockholders,
enforceable against the Stockholders in accordance with its terms, except to the
extent  enforceability may be limited by bankruptcy,  insolvency,  moratorium or
other  similar  laws  affecting   creditors'  rights  generally  or  by  general
principles governing the availability of equitable remedies.

         Section  2.2  No Conflict.  (a)  The  execution  and  delivery  of this
Agreement by the  Stockholders  do not, and the performance of this Agreement by
the  Stockholders  shall not:  (i) conflict  with or violate the  organizational
documents of the  Stockholders;  (ii)  conflict  with or violate any law,  rule,
regulation, order, judgment or decree applicable to the Stockholders or by which
the Shares are bound;  or (iii) result in any breach of or  constitute a default
(or an event  that  with  notice,  or lapse of  time,  or both,  would  become a
default)  under,  or  give to  others  any  rights  of  termination,  amendment,
acceleration  or  cancellation  of,  or  result  in the  creation  of a lien  or
encumbrance  on any of the Shares  pursuant to any note,  bon franchise or other
instrument or obligation  to which either of the  Stockholders  is a party or by
which either of the Stockholders or the Shares are bound or affected,  except in
case of clauses (ii) and (iii),  for any such conflicts,  violations,  breaches,
defaults or other  occurrences  which would not prevent or delay the performance
by the  Stockholders  of their  obligations  under this  Agreement;  and (b) the
execution  and delivery of this  Agreement by the  Stockholders  do not, and the
performance  of this  Agreement  by the  Stockholders  shall  not,  require  any
consent,  approval,  authorization or permit of, or filing with, or notification
to, any court or arbitrator or any governmental body, agency or official, except
for applicable  requirements,  if any of the Securities Exchange Act of 1934, as
amended,  and  except  where the  failure  to obtain  such  consents,  approvals
authorizations or permits,  or to make such filings or notifications,  would not
prevent or delay the performance by the Stockholders of their  obligations under
this Agreement.


                                      -3-
<PAGE>

         Section 2.3  Title to the Shares. As of the date hereof,  Stockholder I
is the record and beneficial owner of 665,907 shares of Company Common Stock and
Stockholder  II is the record  and  beneficial  owner of  665,907  shares of the
Company  Common Stock.  Such Shares are all the securities of the Company owned,
either of record or  beneficially,  by the Stockholders and the Stockholders own
no other rights or interests  exercisable for or convertible into any securities
of the Company.  The Shares are owned free and clear of all security  interests,
liens,  claims,  pledges,   options,   rights  of  first  refusal,   agreements,
limitations on the Stockholders'  voting rights,  charges and other encumbrances
of any nature  whatsoever.  Neither of the Stockholders has appointed or granted
any proxy,  which  appointment  or grant is still  effective with respect to the
Shares.

         Section 2.4 No Fees or  Commissions.  No broker,  financial  advisor or
other intermediary is entitled to any fee or other commission in connection with
the transaction  contemplated by this Agreement based on an arrangement  made by
or on behalf of the Stockholders.

                                   ARTICLE III

                          COVENANTS OF THE STOCKHOLDERS

         Section 3.1 No Inconsistent Agreement. The Stockholders hereby covenant
and  agree  that,  except  as  contemplated  by this  Agreement  and the  Merger
Agreement,  the Stockholders shall not enter into any agreement or grant a proxy
or power of attorney with respect to the Shares which is inconsistent  with this
Agreement.

         Section 3.2 No Encumbrances. The Stockholders hereby covenant and agree
that the  Stockholders  shall not by any action or omission  cause any  security
interests,  liens, claims, pledges,  charges,  encumbrances,  options, rights of
first refusals, agreements or limitations on the Stockholders' voting rights, to
attach to the Shares to be tendered to the Merger Subsidiary pursuant to Section
1.1 hereof.

                                   ARTICLE IV

                    REPRESENTATIONS, WARRANTIES AND COVENANTS
                         OF PARENT AND MERGER SUBSIDIARY

         Section  4.1  Authority.  Parent and Merger  Subsidiary  each have full
right,  power and  authority to enter into and perform this  Agreement  and this
Agreement has been duly authorized,  executed and delivered by Parent and Merger
Subsidiary and is a valid and binding  agreement of Parent and Merger Subsidiary
enforceable against Parent and Merger Subsidiary in accordance with its terms.

         Section  4.2 Offer  Price.  Parent and Merger  Subsidiary  each  hereby
confirms to the  Stockholders  that it has not, in  connection  with the Merger,
purchased, and each agrees with the Stockholders that it hereafter will not buy,
any  shares  of stock of the


                                      -4-
<PAGE>

Company for a price higher than the price to be received by the  Stockholders in
the Offer.


                                    ARTICLE V

                                  MISCELLANEOUS


         Section  5.1   Termination.   It  is  a  condition   precedent  to  the
effectiveness  of this Agreement that the Merger  Agreement shall have been duly
executed and  delivered  and shall be in full force and effect.  This  Agreement
shall automatically terminate: (i) upon the termination of the Merger Agreement;
or (ii) if the  Shares  shall have not  theretofore  been sold  pursuant  to the
Offer,  on November  30, 1997;  or (iii) if the price  contained in the Offer is
reduced below a price of $4.00 per share net in cash,  without interest thereon;
or (iv) if the Board of Directors of the Company changes its  recommendation  to
its stockholders in respect of the Merger,  whichever of the four is the earlier
to occur.

         Section  5.2  Specific  Performance.  The  parties  hereto  agree  that
irreparable  damage would occur in the event that any of the  provisions of this
Agreement  were not performed in  accordance  with the terms hereof and that the
parties  shall be entitled  to  specific  performance  of the terms  hereof,  in
addition to any other remedy at law or in equity.

         Section 5.3 Entire  Agreement.  This Agreement  constitutes  the entire
agreement among Parent,  Merger  Subsidiary and the Stockholders with respect to
the  subject   matter   hereof  and   supersedes   all  prior   agreements   and
understandings,  both written and oral, among Parent,  Merger Subsidiary and the
Stockholders with respect to the subject matter hereof.

         Section 5.4 Amendment.  This Agreement may not be amended, except by an
instrument in writing signed by the parties hereto.

         Section  5.5  Severability.  If any  term or  other  provision  of this
Agreement is invalid, illegal or incapable of being enforced by any rule of law,
or public policy,  all other  conditions and provisions of this Agreement  shall
regardless  remain in full  force and  effect so long as the  economic  or legal
substance of this Agreement is not affected in any manner materially  adverse to
any party. Upon such  determination  that any term orties hereby shall negotiate
in good faith to modify this  Agreement so as to effect the  original  intent of
the parties as closely as possible to the fullest extent permitted by applicable
law in a mutually  acceptable  manner in order that the terms of this  Agreement
remain as originally contemplated.

         Section 5.6  Governing  Law.  This  Agreement  shall be governed by and
construed in accordance with the laws of the State of Delaware regardless of the
laws that might  otherwise  govern under  applicable  principles of conflicts of
law.


                                      -5-
<PAGE>

         Section 5.7 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.

         IN WITNESS WHEREOF, the Stockholders, Parent and Merger Subsidiary have
caused  this  Agreement  to be duly  executed  as the date and year first  above
written.

                                  EQUITY-LINKED INVESTORS, L.P.
                                  BY:    Rohit M. Desai Associates,
                                         --------------------------
                                          General Partner

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


                                  EQUITY-LINKED INVESTORS-II, L.P.
                                  BY: Rohit M. Desai Associates-II,
                                       General Partner

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


                                  INTEGRATED HEALTH SERVICES, INC.

                                  By: /s/ Brian K. Davidson
                                         ----------------------------
                                  Name:  Brian K. Davidson
                                  Title: Executive Vice President -
                                            Development


                                  IHS ACQUISITION XXVI, INC.

                                  By: /s/ Brian K. Davidson
                                         ----------------------------
                                  Name:  Brian K. Davidson
                                  Title: Executive Vice President -
                                            Development











                                      -6-





                                                                EXHIBIT (C)(8)

July 31, 1997


Integrated Health Services, Inc.
10065 Red Run Boulevard
Owings Mills, MD 21117


Re: Acquisition of Community Care of America, Inc.

Ladies and Gentlemen:

   Reference  is made to that certain  Agreement  and Plan of Merger dated as of
August 1, 1997 (the "Agreement") whereby Integrated Health Services Inc. ("IHS")
will acquire all of the  outstanding  shares of Community Care of America,  Inc.
("CCA").  Unless otherwise defined, all capitalized terms shall have the meaning
given to them in the Agreement.  The purpose of this letter is to memorialize my
pledge with respect to the proceeds generated from the sale of my shares of CCA.

   Annexed as Exhibit A to this letter are projections  (the  "Projections")  of
the net income to IHS after the  incorporation  of the CCA's assets described in
the Projections into IHS's operation  ("CCA's Net Income")  prepared by Shattuck
Hammond  Partners Inc. The period covered by the Projections is the one (1) year
ending on the anniversary of the merger of CCA into IHS  Acquisition  XXVI, Inc.
(the "Guaranty  Period").  The net income to IHS reflected in the Projections is
net of certain contemplated extraordinary transactions described on Exhibit B to
this letter.

     In order to induce IHS to enter into the  Agreement,  I agree that,  to the
extent  CCA's Net Income  for the  Guaranty  Period(1)  is less than the CCA Net
Income set forth in the  Projections,  then I will pay to IHS an amount equal to
the  shortfall   subject  to  the  Cap  (hereinafter   defined)  (the  "Guaranty
Payment")(2). Simply  stated,  I am  guaranteeing  the  CCA Net  Income  for the
Guaranty Period (the "Guaranty").(3)

   The  Guaranty  is limited  in amount to the net  proceeds  (after  payment of
applicable taxes) derived by me from the sale of my shares in CCA (the "Cap"); a
computation  of the Cap is attached  to this  letter as Exhibit C. The  Guaranty
Payment shall be payable ninety (90) days after the final computation thereof as
described in note 3 hereof.

   The Guaranty is conditioned on  reimbursement  rates for CCA's  services,  in
general, remaining stable or increasing. If reimbursement rates decrease then my
Guaranty  shall be reduced in  proportion  to the decrease in the  reimbursement
rate decreases.

- ----------

1.   Whenever  the term  calculation  of the CCA Net  Income or words of similar
     content is used herein,  they shall refer to a calculation  thereof made by
     applying the accounting  policies and procedures  presently utilized by IHS
     in preparing IHS's financial  statements,  which are intended to enable the
     calculation to be made in a manner  consistent  with the preparation of the
     Projections.  In the event an extraordinary transaction is not provided for
     in Exhibit B, the  calculation  shall be made in accordance  with generally
     accepted accounting  principles consistent with IHS's accounting practices,
     as both are in effect as of the end of the Guaranty Period.  In all events,
     the calculation of the CCA's Net Income shall disregard any effect of IHS's
     accounting treatment of the extraordinary transactions described on Exhibit
     B.

2.   IHS shall  cause  distinct  accounting  records  to be  maintained  for the
     business of CCA. The CCA Net Income shall  include all income  derived from
     the CCA  facilities  existing at the  beginning of the Guaranty  Period and
     shall also include all ancillary  therapy services  revenue  generated from
     CCA's facilities.  If any CCA facilities  currently included in the CCA Net
     Income calculation are disposed of during the Guaranty Period,  there shall
     be added to the CCA Net Income calculation made by IHS for purposes of this
     Guaranty the net income and ancillary  therapy service revenue  ascribed to
     such facilities in the Projections.

3.   Upon completion of the calculation, IHS will advise Elkins in writing as to
     the amount of the CCA Net Income at the end of the  Guaranty  Period.  Upon
     receipt of such  advice,  Elkins  shall be  entitled  to review the CCA Net
     Income calculations so made by IHS and, within 15 days after receipt, shall
     advise IHS if Elkins  disagrees with the  calculation.  Any disagreement or
     controversy  between  Elkins  and  IHS,  which is not  resolved  by IHS and
     Elkins, as to the calculation of CCA Net Income for the periods in question
     shall be determined by arbitration as follows:  on ten days' written notice
     by either Elkins or IHS, each party shall  designate a firm of  independent
     certified  accountants  of  recognized  national  standing to resolve  such
     disagreement or controversy.  If the two firms cannot agree on a resolution
     within  the two weeks  from the date it is  submitted  to them,  they shall
     jointly  agree on a third  firm of  independent  certified  accountants  of
     recognized  national  standing.  The decision of any two of such accounting
     firms on the correct  calculation of CCA Net Income in accordance  with the
     terms of this Agreement  shall be binding on both Elkins and IHS. If two of
     such firms have not agreed within two weeks  following the  appointment  of
     the third firm,  all of such firms will be  dismissed  and the  controversy
     shall be  settled  by  arbitration  in  accordance  with  the  Rules of the
     American  Arbitration  Association.   The  party  prevailing  in  any  such
     arbitration  proceeding  shall be entitled to recover its costs  (including
     reasonable attorneys' fees) from the other party thereto.



<PAGE>



   This Guaranty  should not be (a) considered as a substitute for due diligence
on the part of IHS and its advisors,  or (b) construed  confirmation or adoption
of any representation or warranty of CCA set forth in the Agreement.

   Any notice or demand  required  or  permitted  to be made or given  hereunder
shall be deemed  sufficiently  given or made if given by personal  service or by
certified or registered mail, return receipt requested. This Guaranty may not be
changed or  terminated  orally,  but only an agreement in writing  signed by the
party against whom enforcement of any change, modification, termination, waiver,
or  discharge  is sought.  This  Guaranty  shall be  construed  and  enforced in
accordance with the laws of New York.

   Please  acknowledge  your  acceptance of the Guaranty be  countersigning  the
enclosed copy of this letter and returning the same to me.


                                        Very truly yours,

                                        /s/ Robert N. Elkins

                                        ROBERT N. ELKINS

ACCEPTED AND AGREED:

INTEGRATED HEALTH SERVICES, INC.

 By /s/ Brian Davidson              
    --------------------------------
    Name: Brian Davidson                         
    Title: Executive Vice President-
           -Development             

<PAGE>

                                   EXHIBIT A



                                   Years ended December 31
                                  -------------------------
                                         Projected
                                  -------------------------
                                     12 mos        FY
                                      1997        1998
                                   ----------  ----------
Patient Service Revenue            $  107,475  $  117,423
Other Oper. Revenue                         0           0
                                   ----------  ----------
Total Revenue                         107,475     117,423

Operating Expense                      87,187      91,874
Gross Income                           20,289      25,549
SG&A                                    2,200       2,507
EBITDAR                                18,089      23,042
Lease/Rent Exp.                         7,430       7,745
EBITDA                                 10,659      15,297
Depreciation                            2,323       2,396
Amortization                              608         608
EBIT                                    7,728      12,293
Investment Income                          80         157
Revolver Expense                            0           0
Interest Expense                       (4,635)     (4,814)
Pretax Income                           3,172       7,636
Income Taxes                            1,205       2,902
Net Inc. Bef. Extra. Item               1,967       4,734
Ex. Item, net of tax (2)                    0           0
Net Income                         $    1,967  $    4,734
                                   ==========  ==========


<PAGE>



                                    EXHIBIT B


                                   ASSUMPTIONS
                                   -----------



o    Financial  analysis is performed on a pro-forma  basis assuming the sale or
     closure of 12 facilities.

o    The 12 month 1997 income statement  represents the 12 month period from the
     date of closure of the transaction.

o    Pre-tax income of $3.172  million for the 12 months  following the close of
     the transaction is calculated based upon routine  Medicare,  Medicaid,  and
     private rate increases, as well as normal expense growth.



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