INTEGRATED HEALTH SERVICES INC
8-K, 1998-01-14
SKILLED NURSING CARE FACILITIES
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                       SECURITIES AND EXCHANGE COMMISSION
                             WASHINGTON, D.C. 20549


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

                                    FORM 8-K


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


                                 CURRENT REPORT
                     PURSUANT TO SECTION 13 OR 15(D) OF THE
                         SECURITIES EXCHANGE ACT OF 1934


Date of Report (Date of earliest event reported)           December 31, 1997
                                                 ---------------------------


                        INTEGRATED HEALTH SERVICES, INC.
- --------------------------------------------------------------------------------
             (Exact Name of Registrant as Specified in its Charter)


         Delaware                   1-12306                23-2428312
- ----------------------------      -----------           -----------------
(State or Other Jurisdiction      (Commission             (IRS Employer
     of Incorporation)            File Number)          Identification No.)



 10065 Red Run Boulevard, Owings Mills, Maryland                     21117
- --------------------------------------------------                 ----------
(Address of Principal Executive Offices)                           (Zip Code)



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


                                 Not Applicable
- --------------------------------------------------------------------------------
          (Former Name or Former Address, if Changed Since Last Report)



<PAGE>



ITEM 2.  ACQUISITION OR DISPOSITION OF ASSETS.

          On  December  31,  1997,  Integrated  Health  Services,  Inc.  ("IHS")
acquired  from  HEALTHSOUTH  Corporation  ("HEALTHSOUTH")  139 owned,  leased or
managed long-term care facilities,  12 specialty  hospitals,  a contract therapy
business  having over 1,000  contracts and an  institutional  pharmacy  business
serving  approximately  38,000 beds. The businesses  acquired,  which had annual
revenues of approximately  $925 million for the 12 months ended August 31, 1997,
were acquired by HEALTHSOUTH in its recent acquisition of Horizon/CMS Healthcare
Corporation.

         Under the terms of the acquisition agreement, IHS paid $1.15 billion in
cash and assumed  approximately  $100  million in debt.  IHS funded the purchase
price with  available  cash from term loan  borrowings  under its $2.15  billion
revolving  credit  and term  loan  facility  and the  sale of its 9 1/4%  Senior
Subordinated Notes due 2008 and borrowings under the revolving credit portion of
the new  credit  facility.  On a pro  forma  basis  after  giving  effect to the
acquisition of these  business from  HEALTHSOUTH  and the  acquisition of RoTech
Medical Corporation and the lithotripsy division of Coram Healthcare Corporation
in October  1997,  IHS' total debt,  including  current  portion,  accounted for
approximately  74% of its total pro forma  capitalization  as of  September  30,
1997. The transaction will be treated as a purchase for accounting and financial
reporting purposes.

          Donaldson Lufkin & Jenrette Securities  Corporation and Morgan Stanley
Dean  Witter  Discover  &  Co.  acted  as  financial  advisors  to  IHS  in  the
transaction.


ITEM 5.  OTHER EVENTS

         In connection with the  acquisition of the businesses from  HEALTHSOUTH
described in Item 2 above IHS and the lenders  under IHS'  revolving  credit and
term loan  facility  (the  "Credit  Facility")  amended  the Credit  Facility to
provide for an additional $400 million term loan facility (the  "Additional Term
Facility") to finance a portion of the purchase price for the acquisition and to
amend  certain  covenants to permit the  consummation  of the  acquisition.  The
Additional Term Facility,  which was borrowed at the closing of the acquisition,
will mature on December 31, 2005, and will be amortized  beginning  December 31,
1998 as follows:  1998 -- $4 million; each of 1999, 2000, 2001, 2002 and 2003 --
$4 million  (payable  in equal  quarterly  installments);  2004 -- $176  million
(payable in equal quarterly installments);  and 2005 -- $200 million (payable in
equal quarterly installments).  The Additional Term Facility bears interest at a
rate equal to, at the option of IHS, either (i) in the case of Eurodollar loans,
the  sum of  (x)  two  and  one-quarter  percent  or two  and  one-half  percent
(depending  on the ratio of IHS' Debt (as  defined  in the Credit  Facility)  to
earnings before interest, taxes, depreciation,  amortization and rent, pro forma
for  any  acquisitions  or  divestitures  during  the  measurement  period  (the
"Debt/EBITDAR  Ratio")) and (y) the interest rate in the London interbank market
for loans in an amount  substantially  equal to the amount of borrowing  and for
the period of borrowing selected by IHS or (ii) the sum

                                      -2-

<PAGE>


of (a) the higher of (1) Citibank,  N.A.'s base rate or (2) one percent plus the
latest overnight  federal funds rate plus (b) a margin of one percent or one and
one-quarter  percent (depending on the Debt/EBITDAR  Ratio). The Additional Term
Facility can be prepaid at any time in whole or in part without penalty.


ITEM 7.  FINANCIAL STATEMENTS, PRO FORMA FINANCIAL INFORMATION AND EXHIBITS.

         (a)      FINANCIAL STATEMENTS OF BUSINESS ACQUIRED.

                  It is impracticable for IHS to provide the required  financial
                  statements on the date this report is being filed. IHS intends
                  to file the required financial  statements under cover of Form
                  8-K/A as soon as practicable, but not later than 60 days after
                  the date this report must have been filed.

         (b)      PRO FORMA FINANCIAL INFORMATION.

                  It is impracticable  for IHS to provide the required pro forma
                  financial  information on the date this report is being filed.
                  IHS intends to file the required  financial  information under
                  cover of Form 8-K/A as soon as practicable, but not later than
                  60 days after the date this report must have been filed.

         (c)  EXHIBITS.

                  2. Purchase and Sale Agreement, entered into as of November 3,
                  1997, between HEALTHSOUTH Corporation,  Horizon/CMS Healthcare
                  Corporation and Integrated Health Services, Inc. (incorporated
                  herein by reference to Exhibit 2 to Current Report on Form 8-K
                  dated November 3, 1997 of Integrated Health Services, Inc.).

                  10.  Amendment  No. 1 dated as of  December  1,  1997,  to the
                  Revolving  Credit  and Term Loan  Agreement  among  Integrated
                  Health  Services,  Inc.,  the  lenders  parties  to the Credit
                  Agreement and Citibank,  N.A., as administrative agent for the
                  lenders.

                                      -3-

<PAGE>


                                   SIGNATURES


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



                                    INTEGRATED HEALTH SERVICES, INC.



Date: January 14, 1998              By: /s/ Taylor Pickett
                                       ------------------
                                       Name: Taylor Pickett
                                       Title: Executive Vice President--Chief
                                               Financial Officer


                                      -4-

<PAGE>



                                  Exhibit Index

          2. Purchase and Sale  Agreement,  entered into as of November 3, 1997,
          between HEALTHSOUTH  Corporation,  Horizon/CMS  Healthcare Corporation
          and Integrated Health Services, Inc. (incorporated herein by reference
          to Exhibit 2 to Current  Report on Form 8-K dated  November 3, 1997 of
          Integrated Health Services, Inc.).

          10.  Amendment  No. 1 dated as of December 1, 1997,  to the  Revolving
          Credit and Term Loan Agreement among Integrated Health Services, Inc.,
          the lenders  parties to the Credit  Agreement and  Citibank,  N.A., as
          administrative agent for the lenders.

                                      -5-



                  AMENDMENT NO. 1 DATED AS OF DECEMBER 1, 1997, TO THE REVOLVING
CREDIT  AND TERM LOAN  AGREEMENT  among  Integrated  Health  Services,  Inc.,  a
Delaware  corporation  (the  "Borrower"),  the  lenders  parties  to the  Credit
Agreement   referred  to  below  (the   "Lenders")   and   Citibank,   N.A.,  as
administrative agent (the "Agent") for the Lenders.

                  PRELIMINARY STATEMENTS:

                  (1) The Borrower,  the Lenders and the Agent have entered into
a Revolving  Credit and Term Loan Agreement dated as of September 15, 1997 (such
Credit  Agreement,  the "Credit  Agreement").  Capitalized  terms not  otherwise
defined in this  Amendment  have the same  meanings as  specified  in the Credit
Agreement.

                  (2) The Borrower will acquire certain assets from  HEALTHSOUTH
Corporation for  $1,360,000,000 in cash (including the assumption of liabilities
and the payment of related  transaction  fees and  expenses)  (the  "HEALTHSOUTH
Acquisition") pursuant to a Purchase and Sale Agreement entered into on November
3, 1997 (the "Purchase  Agreement").  In connection therewith,  the Borrower has
requested  that the  Lenders  agree  to amend  the  Credit  Agreement  to add an
additional  $400,000,000  of  term  advances  thereunder  and to  amend  certain
covenants  in  Article  V of the  Credit  Agreement  to permit  the  HEALTHSOUTH
Acquisition.

                  (3) The Lenders are, on the terms and conditions stated below,
willing to grant the request of the  Borrower  and the  Borrower and the Lenders
have agreed to amend the Credit Agreement as hereinafter set forth.

                  SECTION  1.  Amendments  to  Credit   Agreement.   The  Credit
Agreement is, effective as of the date hereof and subject to the satisfaction of
the conditions precedent set forth in Section 2, hereby amended as follows:

                  (a) The following definitions are added to Section 1.01 in the
      appropriate alphabetical order:

                "'ACQUIRED ASSETS' means the assets  acquired  from  HEALTHSOUTH
      Corporation  pursuant to the Purchase and Sale  Agreement  entered into on
      November  3,  1997  among  the  Borrower,   HEALTHSOUTH   Corporation  and
      Horizon/CMS Healthcare Corporation.

                  'FIRST  AMENDMENT'  means  Amendment No. 1 to this  Agreement,
      dated as of December 1, 1997.

                  'REQUISITE  TERM LOAN C LENDERS'  means Term Loan C Lenders at
      the time in the  aggregate  holding more than 50.1% of the Term Loan C Pro
      Rata Shares.


<PAGE>
                                       2

                  'TERM LOAN C BORROWING' means the loan made by the Term Loan C
      Lenders pursuant to Section  2.01(a)(iv) hereof in the aggregate principal
      amount of  $400,000,000  and which can bear  interest by  reference to the
      Base Rate or the Eurodollar Rate.

                  'TERM  LOAN C  BORROWING  BASE  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                Margin
                    -------------                ------
                    greater than 5.25            1.25%

                    less than or equal
                          to 5.25                1.00%

                  'TERM LOAN C 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                 Margin
                   -------------                 ------
                    greater than 5.25            2.50%

                   less than or equal
                       to 5.25                   2.25%

                  'TERM  LOAN  C  LENDER'  means  each   financial   institution
      signatory to the First  Amendment to this  Agreement  listed  thereto as a
      Term Loan C Lender which has committed to  participate  in the term credit
      under Section  2.01(a)(iv) hereof as set forth in Schedule I to such First
      Amendment,  and any  financial  institution  that pursuant to Section 8.07
      becomes a party to this Agreement for the purpose of  participating in the
      term credit under Section 2.01(a)(iv) hereof.

                  'TERM  LOAN C PRO RATA  SHARE'  means,  in respect of any Term
      Loan C  Lender,  the  ratio  of (i) on the  Effective  Date  of the  First
      Amendment such Term Loan C Lender's  commitment to participate in the term
      credit under Section  2.01(a)(iv)  hereof and thereafter  the  outstanding
      principal amount of its Advances  hereunder to (ii) on such Effective Date
      the  aggregate  of all such  commitments  by the Term Loan C  Lenders  and
      thereafter  the aggregate  outstanding  amount of the Advances by all Term
      Loan C Lenders hereunder."

                  (b) The following  definitions  in Section 1.01 are amended in
      full to read as follows:

                  "'ADVANCE'  means a revolving  loan or term loan,  as the case
      may  be,  by a  Revolving  Lender,  Term  Lender  or Term  Loan C  Lender,
      respectively,  or a Swing Line  Advance,  in each case pursuant to Article
      II.

<PAGE>
                                       3


                  'BORROWING  DATE' means (i) in the case of the Term Borrowing,
      the  Closing  Date,  (ii) in the  case  of any  Revolving  Borrowing,  any
      subsequent  Business Day on which a Revolving  Borrowing is requested from
      the  Lenders  and  (iii)  in the case of the Term  Loan C  Borrowing,  the
      Effective Date of the First Amendment (as defined therein).

                  '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) Quarter-End  Excess Cash, 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 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;  provided, further, that for the Quarter ending December 31,
      1997, the EBITDAR and Specified  Lease Expense of the Acquired  Assets and
      the indebtedness incurred or assumed (in an aggregate amount not in excess
      of  $1,360,000,000)  to acquire the  Acquired  Assets shall be excluded in
      calculating the Debt/EBITDAR  Ratio, and for the Quarters ending March 31,
      1998,  June 30, 1998 and September 30, 1998,  EBITDAR and Specified  Lease
      Expense of the  Acquired  Assets for the period from the closing  when the
      Borrower  acquired  the  Acquired  Assets  to the  date of  determination,
      annualized for the 12-month  period then ended,  shall be added to EBITDAR
      and Specified Lease Expense,  as the case may be, 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 facility  that was sold or closed 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.


<PAGE>
                                       4



                  'DOMESTIC LENDING OFFICE' means, with respect to any Revolving
      Lender  or Term  Lender,  the  office  of  such  Lender  specified  as its
      "Domestic  Lending Office" opposite its name on Schedule I hereto or, with
      respect to any Term Loan C Lender,  the office of such Lender specified as
      its "Domestic Lending Office" opposite its name on Schedule I to the First
      Amendment or in each case 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.

                  'EURODOLLAR   LENDING  OFFICE'  means,  with  respect  to  any
      Revolving  Lender or Term Lender,  the office of such Lender  specified as
      its "Eurodollar Lending Office" opposite its name on Schedule I hereto or,
      with  respect  to any  Term  Loan C  Lender,  the  office  of such  Lender
      specified as its "Eurodollar Lending Office" opposite its name on Schedule
      I to the First  Amendment or in each case 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.

                  'EURODOLLAR  RATE'  means,  for any  Interest  Period for each
      Eurodollar Rate Advance  comprising part of the same Revolving  Borrowing,
      Term  Borrowing or Term Loan C Borrowing,  as the case may be, an interest
      rate per annum equal to the  displayed  rate at 11:00 AM (London time) two
      Business  Days  before the first day of such  Interest  Period on Telerate
      page 3750 (or such other  page as may  replace  such page on the  Telerate
      Service  for the  purpose  of  displaying  interest  rates  in the  London
      interbank markets) for deposits in U.S. dollars in an amount substantially
      equal  to  such  Revolving  Borrowing,  Term  Borrowing  or  Term  Loan  C
      Borrowing,  as the case may be,  and for a period  equal to such  Interest
      Period.  To the  extent  that such  interest  rate is  unavailable  on the
      Telerate  Service,  the Eurodollar  Rate for any Interest  Period for each
      Eurodollar Rate Advance  comprising part of the same Revolving  Borrowing,
      Term  Borrowing or Term Loan C Borrowing,  as the case may be, shall be 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.

                  'INTEREST  PERIOD'  means,  for each  Eurodollar  Rate Advance
      comprising  part of the same Revolving  Borrowing,  Term Borrowing or Term
      Loan C Borrowing, as the case may be, the period commencing on the date of
      such  Advance



<PAGE>
                                       5

      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 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 in respect
      of any  Revolving  Borrowings  which  ends after the  Maturity  Date or in
      respect of the Term  Borrowing  or Term Loan C Borrowing  which ends after
      the scheduled maturity date therefor;

                  (b) the Borrower may not select any Interest Period which ends
      after any date on which any payment on the respective  Advances (including
      any payment of the Revolving  Borrowing  which may result from a Revolving
      Facility Reduction) is due unless,  after giving effect to such selection,
      the aggregate unpaid principal amount of Base Rate Advances and Eurodollar
      Rate Advances in respect of Revolving  Borrowings,  the Term  Borrowing or
      the Term Loan C Borrowing,  as the case may be,  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 Revolving  Borrowing,  Term Borrowing or Term
      Loan C 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.

                  'LENDER' means each Revolving Lender,  each Term Loan C Lender
      and each Term Lender.

                  'MINIMUM  NET WORTH'  means the sum, as of the last day of any
      Quarter,  of (i)  $1,120,000,000,  less up to $25,000,000 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,  1997,  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 



<PAGE>
                                       6


      Quarter  ended  December 31, 1997 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,  1997 from the sale or
      issuance  of any common or  preferred  stock of the  Borrower  or from the
      conversion of any Convertible Subordinated Debt.

                  'PRO RATA SHARE'  means,  in respect of any Lender on any date
      of determination,  the ratio of (i) in the case of a Term Lender or a Term
      Loan C Lender, the outstanding principal amount of Advances by such Lender
      hereunder  on such  date  and,  in the case of a  Revolving  Lender,  such
      Revolving  Lender's  commitment  hereunder to participate in the revolving
      credit  hereunder as set forth on Schedule I (or if such Revolving  Lender
      has entered into one or more Assignments and Acceptances, in the Register)
      as it may have  been  reduced  as  provided  herein  or if such  Revolving
      Lender's  commitment has terminated,  the outstanding  principal amount of
      Advances by such Revolving Lender hereunder,  as of such date, to (ii) the
      sum of the aggregate  outstanding principal amount of Advances by all Term
      Lenders and Term Loan C Lenders  hereunder on such date and the  aggregate
      of the commitments of all Revolving Lenders as set forth on Schedule I (or
      if any such Revolving  Lender has entered into one or more Assignments and
      Acceptances,  in the  Register)  as they may have been reduced as provided
      herein or if such commitments have terminated,  the aggregate  outstanding
      principal amount of Advances by all Revolving Lenders, as of such date.

                  'TERM  LENDER'  means  each  financial  institution  signatory
      hereto listed as a Term Lender which has committed to  participate  in the
      term credit under Section  2.01(a)(ii)  hereof as set forth in Schedule I,
      and any  financial  institution  that  pursuant to Section  8.07 becomes a
      party to this  Agreement  for the  purpose of  participating  in such term
      credit."

                  (c) Section 2.01 is amended by adding a new subsection (a)(iv)
      to read as follows:

                  "(iv)  Term  Loan C.  Subject  to  the  terms  and  conditions
      herein,  each Term Loan C Lender  severally agrees to lend to the Borrower
      on the  Effective  Date (as defined in the First  Amendment)  an amount in
      Dollars  equal to such Term Loan C Lender's  Term Loan C Pro Rata Share of
      the Term Loan C  Borrowing.  Not later than 11:00 a.m.  New York City time
      (A) three  Business  Days  prior to such  Effective  Date if the  Borrower
      requests  that  the Term  Loan C  Borrowing  initially  bear  interest  by
      reference  to the  Eurodollar  Rate and (B) one Business Day prior to such
      Effective  Date if the  Borrower  requests  that the Term Loan C Borrowing
      initially  bear interest by reference to the Base Rate, the Borrower shall
      deliver a notice to the Agent, which notice shall specify whether the Term
      Loan C  Borrowing  initially  shall  bear  interest  by  reference  to the
      Eurodollar  Rate or the Base  Rate,  and if at the  Eurodollar  Rate,  the
      initial  Interest Period  therefor.  The Agent shall give



<PAGE>
                                       7


      each  Term  Loan C  Lender  prompt  notice  thereof  by  telecopier.  Upon
      fulfillment of the applicable conditions set forth in the First Amendment,
      each Term Loan C Lender shall, before 12:00 noon New York City time on the
      Effective Date of the First  Amendment,  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 Term Loan C Lender's Term Loan C Pro
      Rata Share of the Term Loan C  Borrowing.  After the Agent  receives  such
      funds, the Agent will, not later than 5:00 p.m. New York City time on such
      Effective  Date,  make such funds available to the Borrower at the Agent's
      aforesaid  address.  Unless the Agent  receives  notice from a Term Loan C
      Lender  prior  to such  Effective  Date  that  such  Lender  will not make
      available  to the Agent  such  Lender's  Term Loan C Pro Rata Share of the
      Term Loan C Borrowing  to be made on such  Effective  Date,  the Agent may
      assume that such Lender has made its  respective  share  available  to the
      Agent on such Effective Date in accordance  herewith and the Agent may, in
      reliance  upon such  assumption,  make  available  to the Borrower on such
      Effective  Date a  corresponding  amount.  If and to the extent  that such
      Lender fails to make its  respective  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 (a) in the  case of the
      Borrower,  the interest rate  applicable at the time to such Borrowing and
      (b) 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  Term Loan C
      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 Term Loan C Borrowing for purposes of this  Agreement and the
      Borrower shall thereupon be excused from making the repayment described in
      the preceding sentence.  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 Term Loan C  Borrowing  shall not relieve any
      other Lender of its obligation,  if any,  hereunder to make its Advance as
      part of such Term Loan C Borrowing, but no Lender shall be responsible for
      the failure of any other Lender to make any such Advance on such Effective
      Date."

                  (d)  Section  2.06  is  amended  by  adding  a new  subsection
      (a)(iii) to read as follows:

                  "(iii) The principal amount of the Term Loan C Borrowing shall
      be repaid  quarterly on the last day of each March,  June,  September  and
      December, commencing December 31, 1998, in equal installments in each year
      commencing  in 1999 and with the payment on December  31, 1998 to be equal
      to $4,000,000.  The principal  amount to be repaid in each of 1999,  2000,
      2001, 2002 and 2003 shall be equal to $4,000,000;  the principal amount to
      be repaid in 2004 shall be equal to $176,000,000  and the principal amount
      to be repaid 



<PAGE>
                                       8



      in 2005 shall be equal to $200,000,000 with the aggregate unpaid principal
      amount of the Term Loan C Borrowing to be payable on December 31, 2005."

                  (e) Section 2.07 is amended in full to read as follows:


                  "SECTION 2.07 Interest. The Borrower agrees to pay interest on
      the unpaid principal amount of each Advance made by each Lender comprising
      part of the same  Revolving  Borrowing (or, in the case of an Advance made
      pursuant to Section 2.02(c), by the LC Bank), each Advance comprising part
      of the Term  Borrowing,  each Advance  comprising  part of the Term Loan C
      Borrowing  and each Swing Line Advance 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 Revolving  Borrowing  Base Rate
          Margin,  Term Borrowing Base Rate Margin or Term Loan C Borrowing Base
          Rate Margin,  as the case may be,  determined  for such day  (provided
          that at all times  during the period  commencing  on the Closing  Date
          until the date of the Term Loan C Borrowing,  the Revolving  Borrowing
          Base Rate Margin shall be zero and the Term Borrowing Base Rate Margin
          shall be 0.50%,  during the period  commencing on the date of the Term
          Loan C Borrowing  until the Pricing  Certificate  is delivered for the
          Pricing  Period  ending on May 25, 1998 the Revolving  Borrowing  Base
          Rate  Margin  shall be 0.50% and the Term  Borrowing  Base Rate Margin
          shall  be  0.75%  and  thereafter  shall be  determined  as  otherwise
          provided herein, and that at all times during the period commencing on
          the date of the Term Loan C Borrowing until the Pricing Certificate is
          delivered for the Pricing  Period ending on May 25, 1998 the Term Loan
          C Borrowing  Base Rate margin shall be 1.25% and  thereafter  shall be
          determined  as  otherwise  provided  herein),  with all such  interest
          accrued in any one month payable  monthly on the first day of the next
          following month and, in the case of the Revolving Borrowings, when the
          Revolving  Facility  Amount has been  reduced to zero and all Advances
          comprising Revolving Borrowings are repaid in full, in the case of the
          Term  Borrowing,  when all Advances  comprising the Term Borrowing are
          repaid in full and in the case of the Term Loan C Borrowing,  when all
          Advances  comprising  the Term Loan C  Borrowing  are  repaid in full.
          Interest  shall be paid in cash for any Swing  Line  Advance at a rate
          per  annum  equal on each day to the sum of the Base Rate as in effect
          on such day plus the  Revolving  Borrowing  Base Rate  Margin with all
          such  interest  payable  on the date of  payment  when such Swing Line
          Advance is due.



<PAGE>
                                       9



                  (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 Revolving  Borrowing
          Eurodollar Rate Margin, Term Borrowing  Eurodollar Rate Margin or Term
          Loan  C  Borrowing  Eurodollar  Rate  Margin,  as  the  case  may  be,
          determined  for such day (provided that at all times during the period
          commencing  on the  Closing  Date  until  the date of the Term  Loan C
          Borrowing,  the Revolving  Borrowing  Eurodollar  Rate Margin shall be
          1.25% and the Term  Borrowing  Eurodollar  Rate Margin shall be 1.75%,
          during the period  commencing on the date of the Term Loan C Borrowing
          until the Pricing  Certificate  is  delivered  for the Pricing  Period
          ending on May 25, 1998 the Revolving Borrowing  Eurodollar Rate Margin
          shall be 1.75% and the Term Borrowing  Eurodollar Rate Margin shall be
          2.00% and thereafter shall be determined as otherwise provided herein,
          and that at all times during the period  commencing on the date of the
          Term Loan C Borrowing  until the Pricing  Certificate is delivered for
          the  Pricing  Period  ending on May 25, 1998 the Term Loan C Borrowing
          Eurodollar  Rate  Margin  shall  be  2.50%  and  thereafter  shall  be
          determined as otherwise  provided herein) 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), (c), (d), (e), (f), (g),
          (h),  (i),  (j),  (k),  (l), (m) (with  respect to the Borrower or any
          Material  Subsidiary only) or (n) has occurred and is continuing,  (i)
          the  principal  amount of all  Advances  then  outstanding  shall bear
          interest  payable  upon demand at a rate per annum equal to the sum of
          (A) 2.0% per  annum and (B) the rate  otherwise  payable  pursuant  to
          subsection  (a) or (b)  above,  but not to  exceed  the  maximum  rate
          permitted by applicable  law and (ii) the amount of any interest,  fee
          or other amount  payable  hereunder  which is not paid when due, shall
          bear interest from the date such amount shall be due until such amount
          shall be paid in full,  payable  in  arrears  on the date such  amount
          shall be paid in full and on demand,  at a rate per annum equal at all
          times to 2% per annum  above  the Base Rate as in effect  from time to
          time plus the Revolving Borrowing Base Rate Margin."

                  (f)  Section  2.09(a)  is amended by adding the words "or Term
      Loan C Borrowing" after the words "Term Borrowing" therein.

                  (g)  Section  2.09(d)  is  amended by adding the words "or the
      Requisite  Term  Loan C  Lenders"  after the  words  "Requisite  Revolving
      Lenders" in the second line thereof.



<PAGE>
                                       10


                  (h)  Section  2.10(a)  is  amended by adding the words "or the
      Term Loan C Borrowing"  after the words "Term  Borrowing"  each place such
      words appear therein.

                  (i) The first  sentence of Section 2.11 is amended by deleting
      the word "and" before subclause (iv) therein and adding to the end thereof
      the following provisions;  ", (v) each partial payment is made in the case
      of  the  Term  Loan C  Borrowing,  in an  aggregate  principal  amount  of
      $15,000,000 or an integral multiple of $1,000,000 in excess thereof , (vi)
      each partial payment, in the case of the Term Borrowing or the Term Loan C
      Borrowing,  shall be applied to the respective installments thereof in the
      order of maturity,  and (vii) all partial prepayments hereunder in respect
      of  the  Revolving  Borrowing,  the  Term  Borrowing  or the  Term  Loan C
      Borrowing shall be applied,  in the case of each such prepayment,  ratably
      to the  respective  Advances of the  Lenders and shall be applied  between
      Eurodollar  Advances  and Base  Rate  Advances  in the  case of each  such
      prepayment as directed by the Borrower."

                  (j)  Section  2.12(ii)  is  amended  by adding  the words ", a
      notice  of a Term Loan C  Borrowing"  after  the  words  "Term  Borrowing"
      therein.

                  (k)  Section  5.01(b)  is  amended  by  deleting  in the table
      therein all entries from March 31, 2003 and  thereafter  and  substituting
      therefor the following:

                   "March 31, 2003                                     1.00
                    June 30, 2003                                      1.00
                    September 30, 2003                                 1.00
                    December 31, 2003                                  1.00
                    March 31, 2004                                     1.25
                    June 30, 2004                                      1.25
                    September 30, 2004                                 1.25
                    December 31, 2004                                  1.25
                    March 31, 2005 and
                           each Quarter thereafter                     1.50"

                  (l) Section 5.02(m) is amended in full to read as follows:

                 "(m) Delivery of  Promissory  Note. If requested by any Lender,
      execute  and  deliver a  promissory  note,  in  substantially  the form of
      Exhibit A-1, payable to the order of such Revolving Lender, if applicable,
      in an original  principal amount equal to such Lender's Revolving Pro Rata
      Share of the Revolving Facility Amount,  duly executed by the Borrower,  a
      promissory note, in  substantially  the form of Exhibit A-2 payable to the
      order of such Term Lender, if applicable,  in an original principal amount
      equal to such  Lender's  Term Pro Rata Share of the Term  Borrowing,  duly
      executed by the Borrower, and a promissory note, in substantially the form
      of  Exhibit  A-3,  payable  to


<PAGE>
                                       11


      the  order of such  Term  Loan C Lender,  if  applicable,  in an  original
      principal  amount equal to such Lender's Term Loan C Pro Rata Share of the
      Term Loan C Borrowing, duly executed by the Borrower."

                  (m) Section  5.03(b) is amended by deleting  the  semicolon at
      the end of  subsection  (v) thereof and  substituting  thereof  ";and" and
      adding a new subsection (vi) after such subsection (v) to read as follows:

                 "(vi) the sale of any of the Acquired Assets listed on Schedule
      II to the First  Amendment which is made for fair market value, so long as
      (A) at  least  50% of the  total  consideration  for any 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 any 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  related
      transactions,  either (a) the Retained Interest Criteria shall be met with
      respect to such transactions at the time of consummation  thereof,  or (b)
      the Partial Disposition Limit shall not be exceeded."

                  (n) Section  5.03(c)(viii)  is amended by adding the words "or
      Section 5.03(b)(vi)" at the end of such subsection.

                  (o) Section  5.03(c) is further amended by deleting the period
      at the end of  subsection  (xvi) thereof and replacing it with "; and" and
      adding a new  subsection  (xvii)  after such  subsection  (xvi) to read as
      follows:

                 "(xvii) The acquisition of the Acquired  Assets,  provided that
      (A) at the time of or after giving effect to such acquisition, no Event of
      Default or Potential Default shall exist or result, (B) 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, (C) the total consideration (including assumption of
      liabilities and the payment of related transaction fees and expenses) paid
      by the Borrower for such assets does not exceed $1,360,000,000 and (D) the
      EBITDA (as  hereinafter  defined)  of such assets on a pro forma basis for
      the  twelve-month   period  ending  August  31,  1997  is  not  less  than
      $100,000,000.  'EBITDA'means  the sum of (i) net income  after taxes minus
      any extraordinary  gain and any non-recurring gain on any divestiture plus
      any extraordinary loss and any non-recurring loss on any divestiture; (ii)
      depreciation,   amortization,   and  other  noncash  charges  deducted  in
      determining net income,  (iii) Interest Expense,  and (iv) all charges for
      taxes counted in determining consolidated net income for such period."


<PAGE>
                                       12


                  (p) Section  5.03(d) is amended by deleting  the period at the
      end of subsection (vii) thereof and replacing it with "; and" and adding a
      new subsection (viii) after such subsection (vii) to read as follows:

                 "(viii)  Debt  in  an   aggregate   amount  not  in  excess  of
      $110,000,000  assumed  by the  Borrower  or any  of  its  Subsidiaries  in
      connection with the acquisition provided in subsection 5.03(c)(xvii)."

                   (q) Section 8.01(v) is amended in full to read as follows:

                  (v) Amend the definition of 'Revolving  Facility Amount,' 'Pro
      Rata Share,'  'Requisite  Lenders,' 'Term Pro Rata Share,' 'Requisite Term
      Lenders,' 'Revolving Pro Rata Share,' 'Requisite Revolving Lenders,' 'Term
      Loan C Pro Rata Share' or 'Requisite Term Loan C Lenders.'"

                  (r)  Section  8.01 is further  amended by adding the words "or
      any Term Loan C Lender"  after the words  "Term  Lender"  in the last line
      thereof.

                  (s) A new Exhibit A-3 is added to the Credit  Agreement in the
      form of Exhibit A hereto.

                  (t) Exhibit E-2 to the Credit  Agreement is amended in full to
      read as set forth in Exhibit B hereto.

                  (u) Sections 5.02(e)(C), 5.02(e)(D) and 5.02(e)(E) are amended
      by adding the words ", except such Subsidiaries  listed on Schedule III to
      the First Amendment." at the end of such subsections.

                  SECTION 2. Conditions of  Effectiveness.  This Amendment shall
become  effective as of the date hereof (the  "Effective  Date") if on or before
January  31,  1998 the  Agent  shall  have  received  (i)  counterparts  of this
Amendment  executed by the  Borrower and all of the Lenders or, as to any of the
Lenders,  advice  satisfactory  to the Agent that such Lender has executed  this
Amendment;  (ii) evidence that (a) all fees due under the letter dated  November
7, 1997 between the Agent and the Borrower have been paid,  (b) the Borrower has
paid to the Agent, for the account of the Revolving Lenders and Term Lenders,  a
fee  in an  aggregate  amount  equal  to  0.125%  of the  sum  of the  aggregate
commitments  of the Revolving  Lenders and the aggregate  outstanding  principal
amount of  Advances by the Term  Lenders,  in each case as of the  Business  Day
immediately  prior to the  Effective  Date,  which  amount  will be  distributed
ratably to the Revolving Lenders and the Term Lenders no later then the Business
Day immediately  succeeding the Effective Date and (c) the Borrower has paid all
fees due  under  Section  8.04 of the  Credit  Agreement,  and  (iii) all of the
following  documents,  each such document in form and substance  satisfactory to
the Agent and in sufficient copies for each Lender:



<PAGE>
                                       13


                  (a) Certified  copies of (i) the  resolutions  of the Board of
      Directors of (A) the Borrower  approving  this  Amendment  and the matters
      contemplated  hereby and (B) each other Loan Party evidencing  approval of
      the Consent and the matters  contemplated  thereby and (ii) all  documents
      evidencing other necessary corporate action and governmental approvals, if
      any,  with  respect to this  Amendment  and the  Consent  and the  matters
      contemplated hereby and thereby.


                  (b) A certificate  of the Secretary or an Assistant  Secretary
      of the  Borrower and each other Loan Party  certifying  the names and true
      signatures  of the  officers  of the  Borrower  and such  other Loan Party
      authorized to sign this Amendment and the Consent and the other  documents
      to be delivered hereunder and thereunder.

                  (c)   Counterparts   of  the  Consent   appended  hereto  (the
      "Consent"),  executed  by  each  of  the  Loan  Parties  (other  than  the
      Borrower).

                  (d) An  opinion of  LeBoeuf,  Lamb,  Greene & MacRae,  L.L.P.,
      counsel for the Borrower and the Guarantors,  in substantially the form of
      Exhibit  C  hereto  and  opinions  of  counsel  for  each   Guarantor  not
      incorporated  in  Delaware  as to such  matters as any Lender  through the
      Agent may reasonably request.

                  (e) A certificate  from an Authorized  Officer of the Borrower
      as  to   compliance,   after  giving  effect  to  the  incurrence  of  all
      indebtedness  under the Credit  Agreement with respect to the  HEALTHSOUTH
      Acquisition,  with covenants relating to the incurrence of indebtedness in
      the Subordinated Debt Indentures.

                  (f) A certificate  from an Authorized  Officer of the Borrower
      that all  conditions  precedent to the closing by the  Borrower  under the
      HEALTHSOUTH Acquisition have been satisfied,  the Purchase Agreement is in
      full force and effect, no provision of the Purchase  Agreement  (including
      the schedules and exhibits thereto) has been waived, amended, supplemented
      or otherwise modified in any respect,  and immediately upon receipt of the
      proceeds of the Term Loan C Borrowing the HEALTHSOUTH  Acquisition will be
      consummated.

                  (g) An executed amendment to the Intercreditor  Agreement,  in
      substantially the form of Exhibit D.

                  (h) A  complete,  executed  copy  of  the  Purchase  Agreement
      (including  all  schedules  and exhibits  referred to therein or delivered
      pursuant thereto) and all amendments thereto, waivers relating thereto and
      other  side  letters  or  agreements  affecting  the terms  thereof in any
      respect.

      

<PAGE>
                                       14


                  (i) A certificate  from an Authorized  Officer of the Borrower
      that (i) the representations and warranties contained in Section 3 of this
      Amendment, in Article IV of the Credit Agreement and in Article III of the
      Pledge  and  Security  Agreements  are  correct  on and as of such date as
      though made on and as of such date and (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.

                  SECTION 3. Representations and Warranties of the Borrower. The

Borrower represents and warrants as follows:

                  (a) 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  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) 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 this  Amendment and
      the  Credit  Agreement,  as amended  hereby,  and (iii) to take all action
      necessary to consummate the transactions contemplated under this Amendment
      and the Credit Agreement, as amended hereby.

                  (c) The execution, delivery and performance by each Loan Party
      of this  Amendment,  the  Credit  Agreement,  as amended  hereby,  and the
      Consent, as applicable,  have been duly authorized by all necessary action
      of its  board  of  directors  (or,  in the case of a  partnership,  of its
      governing  authority),  and do  not  contravene  (i)  its  certificate  or
      articles of  incorporation  (or, in the 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) 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 any  Loan  Party  of  this
      Amendment,  the Credit Agreement,  as amended hereby,  or the Consent,  as
      applicable.

                  (e) This Amendment and the Consent have been duly executed and
      delivered  by the  respective  Loan  Party.  This  Amendment,  the  Credit
      Agreement, as amended hereby, and the Consent are legal, valid and binding
      obligations  of  the  respective


<PAGE>
                                       15


      Loan Party,  enforceable  against the respective  Loan Party in accordance
      with their  respective  terms,  subject to laws  generally  affecting  the
      enforcement of creditors' rights.

                  (f)  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 this Amendment,  the
      Credit Agreement, as amended hereby, or the Consent or the consummation of
      any of the transactions contemplated hereby.

                  (g) The execution, delivery and performance of this Amendment,
      the Consent and the Credit  Agreement,  as amended hereby, 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.

                  (h) On the date of the Term Loan C Borrowing,  both before and
      after giving effect thereto and the application of the proceeds therefrom,
      (i) the  representations  and  warranties  contained  in Section 3 of this
      Amendment, in Article IV of the Credit Agreement and in Article III of the
      Pledge  and  Security  Agreements  are  correct  on and as of such date as
      though made on and as of such date and (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.

                  SECTION 4. Reference to and Effect on the Credit Agreement and
the Loan Documents.  (a) On and after the effectiveness of this Amendment,  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  Notes and each of 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 by
this Amendment.

                  (b) The  Credit  Agreement,  as  specifically  amended by this
Amendment, is and shall continue to be in full force and effect and is hereby in
all respects  ratified and  confirmed.  Without  limiting the  generality of the
foregoing,  the Collateral Documents and all of the Collateral described therein
do and shall  continue  to secure  the  payment of all  Obligations  of the Loan
Parties under the Loan Documents, in each case as amended by this Amendment.



<PAGE>
                                       16



                  (c)  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  the  Credit
Agreement, nor constitute a waiver of any provision of the Credit Agreement.

                  SECTION 5. Costs,  Expenses and Taxes.  The Borrower agrees to
pay on demand all reasonable  and documented  costs and expenses of the Agent in
connection  with  the  preparation,   execution,  delivery  and  administration,
modification  and  amendment of this  Amendment  and the other  instruments  and
documents  to  be  delivered  hereunder  (including,   without  limitation,  the
reasonable  and  documented  fees and  expenses  of  counsel  for the  Agent) in
accordance with the terms of Section 8.04 of the Credit Agreement.  In addition,
the Borrower  shall pay any and all stamp and other taxes  payable or determined
to be payable in connection  with the  execution and delivery of this  Amendment
and the other instruments and documents to be delivered hereunder, and agrees to
save the Agent and each Lender harmless from and against any and all liabilities
with  respect to or  resulting  from any delay in paying or omission to pay such
taxes.

                  SECTION 6.  Execution in  Counterparts.  This Amendment 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 but one and the same
agreement.  Delivery of an  executed  counterpart  of a  signature  page to this
Amendment by  telecopier  shall be effective as delivery of a manually  executed
counterpart of this Amendment.

                  SECTION 7. Governing Law. This Amendment shall be governed by,
and construed in accordance with, the laws of the State of New York.

<PAGE>
                                       17





                  IN WITNESS  WHEREOF,  the  parties  hereto  have  caused  this
Amendment 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:




<PAGE>
                                       18







                                     CITIBANK, N.A.,
                                         as Administrative Agent and as a Lender


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


                                   CITIBANK, N.A.,
                                     as Administrative Agent an as a Term Loan C
                                                         


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



<PAGE>
                                       19







                                     TORONTO DOMINION (NEW YORK), INC.
                                       as a Lender


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


<PAGE>
                                       20







                                     BANK OF AMERICA N.T. & S.A.
                                       as a Lender

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



                                     BANK OF AMERICA N.T. & S.A.
                                       as a Term Loan C Lender

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



<PAGE>
                                       21







                                     CREDIT LYONNAIS,
                                       NEW YORK BRANCH,
                                       as a Lender

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



<PAGE>
                                       22







                                     FIRST UNION NATIONAL BANK,
                                       as a Lender


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


                                     FIRST UNION NATIONAL BANK,
                                       as a Term Loan C Lender


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



<PAGE>
                                       23







                                     NATIONSBANK, N.A.,
                                       as a Lender


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




<PAGE>
                                       24







                                     THE BANK OF NOVA SCOTIA,
                                       as LC Bank and a Lender


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





<PAGE>
                                       25







                                     CORESTATES BANK, N.A.,
                                       as a Lender


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

<PAGE>
                                       26







                                     DEUTSCHE BANK, A.G., NEW YORK
                                     AND/OR CAYMAN ISLANDS BRANCH,
                                       as a Lender


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


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


                                     DEUTSCHE BANK, A.G., NEW YORK
                                     AND/OR CAYMAN ISLANDS BRANCH,
                                       as a Term Loan C Lender


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


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


<PAGE>
                                       27







                                     FLEET NATIONAL BANK,
                                       as a Lender


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


<PAGE>
                                       28




                                     AMSOUTH BANK,
                                       as a Lender


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



<PAGE>
                                       29



                                     THE BANK OF TOKYO-MITSUBISHI
                                     TRUST COMPANY,
                                       as a Lender


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




<PAGE>
                                       30







                                     CREDITANSTALT BANKVEREIN,
                                       as a Lender



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


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


                                     CREDITANSTALT BANKVEREIN,
                                       as a Term Loan C Lender



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


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



<PAGE>
                                       31







                                     CRESTAR BANK,
                                       as a Lender


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




<PAGE>
                                       32







                                     FIRST AMERICAN NATIONAL BANK,
                                       as a Lender


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




<PAGE>
                                       33







                                     GENERAL ELECTRIC CAPITAL
                                       CORPORATION,
                                       as a Lender


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


                                     GENERAL ELECTRIC CAPITAL
                                       CORPORATION,
                                       as a Term Loan C Lender


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



<PAGE>
                                       34







                                     HIBERNIA NATIONAL BANK,
                                       as a Lender


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




<PAGE>
                                       35







                                     PROVIDENT BANK OF MARYLAND,
                                       as a Lender


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




<PAGE>
                                       36







                                     THE SANWA BANK, LIMITED,
                                     NEW YORK BRANCH
                                       as a Lender


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




<PAGE>
                                       37







                                     SUMMIT BANK,
                                       as a Lender


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




<PAGE>
                                       38







                                     BANK ONE, TEXAS, N.A.,
                                       as a Lender


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




<PAGE>
                                       39







                                     BANKERS TRUST COMPANY
                                       as a Lender


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



<PAGE>
                                       40







                                     CIBC WOOD GUNDY SECURITIES CORP.
                                       as a Lender


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


                                     CIBC, INC.,
                                       as a Lender


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





<PAGE>
                                       41







                                     DAI-ICHI KANGYO BANK, LIMITED, NEW
                                       YORK BRANCH
                                       as a Lender


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



<PAGE>
                                       42







                                     DRESDNER BANK, AG, NEW YORK AND
                                       GRAND CAYMAN BRANCHES,
                                       as a Lender


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


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




<PAGE>
                                       43







                                     SUNTRUST BANK, CENTRAL FLORIDA,
                                       NATIONAL ASSOCIATION,
                                       as a Lender


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




<PAGE>
                                       44







                                     BARNETT BANK, N.A.
                                       as a Lender


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




<PAGE>
                                       45







                                      THE INDUSTRIAL BANK OF JAPAN,
                                        LIMITED
                                        as a Lender


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




<PAGE>
                                       46







                                     COOPERATIEVE CENTRALE
                                     RAIFFEISEN-BOERENLEENBANK B.A.,
                                     "RABOBANK NEDERLAND", NEW YORK
                                     BRANCH,
                                       as a Lender


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


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



<PAGE>
                                       47







                                     THE TOYO TRUST AND BANKING
                                     CO., LTD.,
                                       as a Lender


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





<PAGE>
                                       48







                                     SOCIETE GENERALE,
                                       as a Lender


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


                                     SOCIETE GENERALE,
                                       as a Term Loan C Lender


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


<PAGE>
                                       49







                                     CHIAO TUNG BANK CO. LTD,
                                       as a Lender


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



<PAGE>
                                       50







                                     FIRST COMMERCIAL BANK,
                                       as a Lender


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



<PAGE>
                                       51







                                     THE SUMITOMO BANK, LIMITED,
                                       as a Lender


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


                                     THE SUMITOMO BANK, LIMITED, NEW YORK BRANCH
                                        as a Term Loan C Lender



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


<PAGE>
                                       52







                                     CHASE SECURITIES, INC.,
                                     as agent for The Chase Manahttan Bank,
                                       as a Lender


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


                                     CHASE SECURITIES, INC.,
                                     as agent for The Chase Manahttan Bank,
                                       as a Term Loan C Lender


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



<PAGE>
                                       53







                                     COMMERZBANK AG,
                                       as a Lender


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




<PAGE>
                                       54







                                     ROYAL BANK OF CANADA,
                                       as a Lender


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


                                     ROYAL BANK OF CANADA,
                                       as a Term Loan C Lender


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



<PAGE>
                                       55







                                      ALLSTATE INSURANCE COMPANY,
                                        as a Lender


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


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




<PAGE>
                                       56







                                     PRIME INCOME TRUST,
                                       as a Lender



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


                                     PRIME INCOME TRUST,
                                       as a Term Loan C Lender


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



<PAGE>
                                       57






                                     DEEPROCK & COMPANY
                                     By:  EATON VANCE MANAGEMENT, as
                                        Investment Manager,
                                        as a Lender


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


                                     EATON VANCE PRIME RATE
                                     By:  EATON VANCE MANAGEMENT, as
                                        Investment Advisor,
                                        as a Term Loan C Lender


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



<PAGE>
                                       58







                                     MASSACHUSETTS MUTUAL LIFE
                                     INSURANCE COMPANY,
                                       as a Lender



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


<PAGE>
                                       59






                                     DEBT STRATEGIES FUND, INC.,
                                       as a Lender



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


                                     MERRILL LYNCH DEBT STRATEGIES
                                     PORTFOLIO
                                       as a Lender

                                     by:    MERRILL LYNCH ASSET MANAGEMENT
                                              L.P., as Investment Advisor


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



                                     MERRILL LYNCH PRIME RATE PORTFOLIO,
                                       as a Lender,

                                     by:    MERRILL LYNCH ASSET MANAGEMENT
                                               L.P., as Investment Advisor


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





<PAGE>
                                       60







                                     MERRILL LYNCH SENIOR FLOATING
                                     RATE FUND, INC.
                                       as a Lender



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


                                     SENIOR HIGH INCOME PORTFOLIO, INC.
                                       as a Lender



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




<PAGE>
                                       61







                                     METROPOLITAN LIFE INSURANCE COMPANY,
                                       as a Lender


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


                                     METROPOLITAN LIFE INSURANCE COMPANY,
                                       as a Term Loan C Lender


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



<PAGE>
                                       62







                                     OCTAGON CREDIT INVESTORS LOAN PORTFOLIO (a
                                      unit of The Chase Manhattan Bank),
                                       as a Lender


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


                                     OCTAGON CREDIT INVESTORS LOAN PORTFOLIO (a
                                      unit of The Chase Manhattan Bank),
                                       as a Term Loan C Lender


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


<PAGE>
                                       63







                                     PARIBAS CAPTIAL FUNDING LLC,
                                       as a Lender


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




<PAGE>
                                       64






                                      PILGRIM AMERICA PRIME RATE TRUST,
                                        as a Term Loan C Lender


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



<PAGE>
                                       65







                                      TCW Leveraged Income Trust, L.P.
                                      by: TCW Advisers (Bermuda), Ltd.,
                                      as General Partner,
                                        as a Lender


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


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

                                     TCW Leveraged Income Trust, L.P.
                                     by:  TCW Investment Management Company,
                                     as Investment Adviser,
                                       as a Lender


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



<PAGE>
                                       66







                                     VAN KAMPEN AMERICAN CAPITAL
                                     PRIME RATE INCOME TRUST,
                                       as a Lender


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


                                     VAN KAMPEN AMERICAN CAPITAL
                                     PRIME RATE INCOME TRUST,
                                       as a Term Loan C Lender


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



<PAGE>
                                       67







                                      STOCKSPLUS L.P. SUBFUND B (Acct 400)

                                      By: Pacific Investment Management Company,
                                      as Investment Advisor, acting through
                                      Investors Fiduciary Trust Company in the
                                      Nominee Name of IFTCO.
                                        as a Lender


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

                                     PIMCO TOTAL RETURN FUND (Acct 700)

                                     By:  Pacific Investment Management Company,
                                     as Investment Advisor, acting through
                                     Investors Fiduciary Trust Company in the
                                     Nominee Name of IFTCO.
                                       as a Lender


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


                                     ROYALTON COMPANY

                                     By:  Pacific Investment Management Company,
                                     as Investment Advisor,
                                       as a Term Loan C Lender


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



<PAGE>
                                       68







                                     KZH-CRESCENT CORPORATION,
                                       as a Lender


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


                                     KZH-ING-1 CORPORATION,
                                       as a Lender



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


                                      KZH-SOLEIL CORPORATION,
                                        as a Lender


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


                                     KZH-ING-2 CORPORATION,
                                       as a Lender


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



<PAGE>
                                       69






                                     KZH-SOLEIL CORPORATION,
                                       as a Term Loan C Lender


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


                                     KZH HOLDING CORPORATION III,
                                       as a Term Loan C Lender


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




<PAGE>




                                     ING HIGH INCOME PRINCIPAL
                                     PRESERVATION FUND HOLDINGS, LDC,
                                       as a Lender

                                     By:  ING CAPITAL ADVISORS INC.,
                                           as Investment Advisor

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


<PAGE>





                                     GOLDMAN SACHS CREDIT PARTNERS LP
                                       as a Lender


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




<PAGE>





                                     INDOSUEZ CAPITAL FUNDING III, LIMITED

                                     By:  Indosuez Capital, as portfolio advisor
                                            as Lender


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



<PAGE>





                                     LEHMAN COMMERCIAL PAPER,
                                       as a Lender


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


                                      LEHMAN COMMERCIAL PAPER,
                                        as a Term Loan C Lender


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



<PAGE>





                                     CYPRESSTREE INVESTMENT PARTNERS I, LTD.
                                     By:  CYPRESSTREE INVESTMENT
                                     MANAGEMENT COMPANY, INC., as portfolio
                                     manager,
                                       as a Lender


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



<PAGE>





                                     SENIOR DEBT PORTFOLIO
                                     By:  BOSTON MANAGEMENT AND
                                     RESEARCH, as Investment Advisor,
                                       as a Lender


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



<PAGE>





                                     PFL LIFE INSURANCE COMPANY,
                                       as a Lender


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



                                     PFL LIFE INSURANCE COMPANY,
                                       as a Term Loan C Lender


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



<PAGE>




                                     BANQUE WORMS CAPITAL CORPORATION,
                                       as a Lender


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









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