COMMUNITY CARE OF AMERICA INC
10-Q, 1996-11-14
SKILLED NURSING CARE FACILITIES
Previous: VIATEL INC, 10-Q, 1996-11-14
Next: AMERICAN TIRE CORP, NT 10-Q, 1996-11-14




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



                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549


                                    FORM 10-Q


[X] Quarterly Report Pursuant to Section 13 or 15 (d) of the Securities Exchange
    Act of 1934. For the quarterly period ended September 30, 1996.

[ ] Transition Report Pursuant to Section 13 or 15 (d) of the Securities
    Exchange Act of 1934. for the transition period from ______ to ______ .

                         Commission file number: 0-26502


                         COMMUNITY CARE OF AMERICA, INC.
             (Exact name of registrant as specified in its charter)

                 Delaware                               52-1823411
    (State or other jurisdiction of                   (IRS Employer
     incorporation or organization)                 Identification No.)


           3050 North Horseshoe Drive, Suite 260, Naples, Florida 34104
                     (Address of principal executive offices)

        Registrant's telephone number, including area code: (941) 435-0085


                                       N/A
       (Former name, address and fiscal year, if changed since last report)

Indicate by check mark whether the registrant (1) has filed all reports required
to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during
the  preceding 12 months (or for such  shorter  period that the  registrant  was
required  to file  such  reports),  and  (2) has  been  subject  to such  filing
requirements for the past 90 days. [X] Yes [ ] No

As of October 31, 1996, there were outstanding 7,597,801 shares of common stock,
$.0025 par value, per share.

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



<PAGE>



                                      INDEX

PART I  - FINANCIAL INFORMATION                                     PAGE

Item 1.    Condensed Financial Statements (Unaudited)

              Consolidated Balance Sheets.............................3

              Consolidated Statements of Operations...................4

              Consolidated Statement of Shareholders' Equity..........5

              Consolidated Statements of Cash Flows...................6

              Notes to Consolidated Financial Statements..............7

Item 2.    Management's Discussion and Analysis of Financial
           Condition and Results of Operations.......................15

PART II - OTHER INFORMATION

Item 3.    Defaults Upon Senior Securities...........................26

Item 5.    Other Information.........................................26

Item 6.    Exhibits and Reports on Form 8-K..........................27

                Signatures...........................................29

                Exhibit index........................................30













                                        2


<PAGE>

<TABLE>
<CAPTION>



                         Community Care of America, Inc.
                                and Subsidiaries
                           Consolidated Balance Sheets
<S>                                                     <C>            <C>

                                                         December 31,   September 30,
                                                             1995           1996
                                                         -----------     ----------
                           Assets                                        (Unaudited)

    Current assets:
      Cash and cash equivalents                          $  2,485,000   $  1,545,000
      Accounts receivable net of allowance for
        doubtful accounts and contractual
        adjustments of $1,978,000, and
        $3,248,000 at December 31, 1995
        and September 30, 1996                             12,934,000     16,993,000
      Supplies inventory                                    1,534,000      1,795,000
      Prepaid expenses and other current assets             3,662,000      4,122,000
                                                            ---------      ---------
                  Total current assets                     20,615,000     24,455,000

    Property, plant and equipment, net of
      accumulated depreciation                             54,327,000     65,019,000
    Notes receivable                                        2,533,000         -
    Deposits                                               10,244,000      6,638,000
    Excess of cost over fair value of net
      assets acquired, net of accumulated
      amortization of $139,000 and $337,000
      at December 31, 1995 and September 30, 1996           3,299,000     15,756,000
    Deferred financing costs                                  948,000      2,955,000
    Other assets                                            1,324,000      1,798,000
                                                            ---------      ---------

                                                         $ 93,290,000   $116,621,000
                                                           ==========    ===========


            Liabilities and shareholders' equity Current liabilities:

      Current maturities of long-term debt               $  1,258,000   $  8,303,000
      Accounts payable and accrued expenses                14,869,000     19,801,000
      Put option contracts payable (219,798
        shares outstanding)                                     -          2,181,000
                                                            ---------      ---------

                 Total current liabilities                 16,127,000     40,285,000

    Long-term debt, less current maturities                 4,407,000     41,876,000
    Other liabilities                                           -          1,188,000
    Deferred income taxes                                   9,334,000      5,169,000

    Common stock subject to repurchase, 219,798
      shares issued and outstanding at
      December 31, 1995                                     2,181,000          -

    Shareholders' equity:
      Common stock, $.0025 par value;  authorized  15,000,000 shares; issued and
        outstanding 6,762,991 and 7,597,801 at December 31, 1995
        and September 30, 1996                                 17,000         18,000
      Additional paid-in capital                           31,356,000     36,467,000
      Deficit                                                (132,000)    (8,382,000)
                                                            ----------     ---------

                 Total shareholders' equity                31,241,000     28,103,000
                                                           ----------     ----------
                                                         $ 93,290,000   $116,621,000
                                                           ==========    ===========


          See accompanying notes to consolidated financial statements.


                                        3



</TABLE>

<TABLE>
<CAPTION>


                Community Care of America, Inc. and Subsidiaries
                Unaudited Consolidated Statements of Operations


<S>                                            <C>            <C>            <C>            <C>

                                                  Three Months Ended              Nine Months Ended
                                                      September 30,                 September 30,
                                               --------------------------    --------------------------
                                                   1995           1996           1995             1996
                                               -----------     ----------    -----------   ------------

Operating revenues:
  Net patient service revenues                $ 25,638,000   $ 33,881,000   $ 64,336,000   $ 90,746,000
  Other operating revenues                         595,000        463,000        868,000      4,980,000
                                               -----------     ----------    -----------   ------------

    Total operating revenues                    26,233,000     34,344,000     65,204,000     95,726,000
                                               -----------     ----------    -----------   ------------

Operating expenses:
  Facility operating expenses                   20,566,000     27,459,000     51,559,000     74,890,000
  Corporate administrative and general           1,116,000      1,154,000      3,393,000      3,713,000
  Rent                                           1,853,000      2,188,000      4,458,000      6,041,000
  Depreciation and amortization                    540,000        640,000      1,540,000      1,926,000
  Interest, net of interest income                 895,000      1,360,000      2,666,000      3,280,000
  Unusual charges                                    -              -              -         19,185,000
                                               -----------     ----------    -----------   ------------

   Total operating expenses                     24,970,000     32,801,000     63,616,000    109,035,000
                                               -----------     ----------    -----------   ------------

     Earnings (loss) before income taxes
      and extraordinary item                     1,263,000      1,543,000      1,588,000    (13,309,000)

Provision (benefit) for income taxes               386,000        586,000        476,000     (5,059,000)

                                               -----------     ----------    -----------   ------------
     Earnings (loss) before extraordinary          877,000        957,000      1,112,000     (8,250,000)

Extraordinary item, net of income taxes           (992,000)         -           (992,000)         -
                                               -----------     ----------    -----------   ------------

     Net earnings (loss)                          (115,000)       957,000        120,000     (8,250,000)

Dividends-preferred stock                          (82,000)         -           (408,000)         -
                                               -----------     ----------    -----------   ------------

Net earnings (loss) applicable to common       $  (197,000)    $  957,000    $  (288,000)  $ (8,250,000)
                                               ===========     ==========    ===========   ============

Earnings (loss) per common share:
  Before extraordinary item                    $      .15      $    0.12     $     0.17    $     (1.13)
  Extraordinary item                                (0.19)           -            (0.24)           -
                                               ===========     ==========    ===========   ============
  Net earnings (loss)                          $    (0.04)     $    0.12     $    (0.07)   $     (1.13)
                                               ===========     ==========    ===========   ============

Weighted average number of common and
common equivalent shares outstanding             5,323,281      7,597,801      4,129,354      7,313,144
                                               ===========     ==========    ===========   ============




          See accompanying notes to consolidated financial statements.


                                        4






</TABLE>

<TABLE>
<CAPTION>





                         Community Care of America, Inc.
                                and Subsidiaries
                 Consolidated Statement of Shareholders' Equity

<S>                              <C>           <C>              <C>           <C>

                                   Additional
                                   Common        Paid-In
                                   Stock         Capital        Deficit         Total
                                 ---------    -------------     ----------     ----------

Balance at December 31, 1995     $ 17,000      $31,356,000    $  (132,000)    $ 31,241,000

Issuance of  615,012 shares
  of common stock                   1,000        5,111,000           -           5,112,000

Net loss                              -               -        (8,250,000)      (8,250,000)

                                ===========    ===========    ============    ============
Balance at September 30, 1996
  (unaudited)                    $ 18,000      $36,467,000    $(8,382,000)    $ 28,103,000
                                ===========    ===========    ============    ============






































          See accompanying notes to consolidated financial statements.


                                        5



</TABLE>

<TABLE>
<CAPTION>

                         Community Care of America, Inc.
                                and Subsidiaries
                 Unaudited Consolidated Statements of Cash Flows

<S>                                                    <C>             <C>


                                                           Nine Months Ended
                                                             September 30,
                                                        ==========================
                                                            1995           1996
                                                        -----------   ------------
                                                        (Unaudited)    (Unaudited)


    Net cash provided by (used in)
      operating activities                             $  1,418,000   $ (1,386,000)

    Cash flows from investing activities:
         Property, plant and equipment additions        (4,649,000)     (6,604,000)
         Business acquisitions                          (7,351,000)     (4,985,000)
         Notes receivable                               (2,247,000)        (75,000)
         Deposits                                            -            (519,000)
         Other assets                                   (4,681,000)       (571,000)
                                                         ----------      ----------

    Net cash used in investing activities              (18,928,000)    (12,754,000)
                                                         ----------      ----------

    Cash flows from financing activities:
         Dividends on preferred stock                     (408,000)          -
         Principal reductions of long-term debt        (11,825,000)     (3,327,000)
         Proceeds from long-term debt borrowings        12,271,000      18,505,000
         Redemption of Preferred Stock                  (8,167,000)          -
         Proceeds from issuances of stock               27,630,000         162,000
         Deferred financing costs                         (562,000)     (2,140,000)
                                                         ----------     ----------

    Net cash provided by financing activities           18,939,000      13,200,000
                                                         ----------     ----------

    Increase (decrease) in cash and cash equivalents     1,429,000        (940,000)

    Cash and cash equivalents, beginning of period       3,925,000       2,485,000
                                                         ---------      ----------

    Cash and cash equivalents, end of period           $ 5,354,000     $ 1,545,000
                                                         =========      ==========


    Supplemental disclosures of cash flow information:

    Interest paid                                      $ 2,847,000     $ 3,554,000
    Income taxes paid                                        3,400          32,000
















          See accompanying notes to consolidated financial statements.


                                        6


</TABLE>

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(1)  Basis of presentation

The interim  unaudited  consolidated  financial  statements of Community Care of
America,  Inc.  and  subsidiaries  (the  "Company")  presented  herein have been
prepared in accordance with generally accepted accounting principles for interim
financial  statements and with the instructions to Form 10- Q and Regulation S-X
pertaining to interim financial  statements.  The interim  financial  statements
presented  herein  reflect  all  adjustments  (consisting  of  normal  recurring
adjustments) which, in the opinion of management, are considered necessary for a
fair presentation of the Company's  financial condition as of September 30, 1996
and results of operations for the three and nine months ended September 30, 1996
and 1995. The Company's financial  statements should be read in conjunction with
the Company's audited  consolidated  financial  statements and the notes thereto
included in the Company's Annual Report on Form 10-K for the year ended December
31,  1995.  The  results  of  operations  for the  three and nine  months  ended
September  30, 1996 are not  necessarily  indicative  of the results that may be
expected  for the full year.  Certain 1995  amounts  have been  reclassified  to
conform with the 1996 presentation.

(2)  Recent and Potential Acquisitions

Southern Care Transaction

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

Pursuant to the merger  agreement,  the former  shareholders  of  Southern  Care
received $2.7 million of cash and 568,888 shares of Common Stock of the Company.
In addition,  the  shareholders of Southern Care are entitled to receive,  on or
before March 31, 1997,  up to $2.0 million in Common Stock of the Company  based
on the amount that the annualized  contribution  margin, on a consolidated basis
of the Acquired  Subsidiaries for the year ended December 31, 1996, exceeds $4.4
million.  Based on the current results of operations of the Acquired Facilities,
payment of such additional consideration is believed remote.



                                        7

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996


(2)  Recent and Potential Acquisitions (continued)

Southern Care Transaction (continued)

The merger  agreement  provides  for the Company to file two shelf  registration
statements  under the  Securities  Act of 1933, as amended,  covering the shares
issued  and  issuable  in the  merger  and,  upon  request  of the  holders,  to
"piggyback" such shares in certain registration statements filed by the Company.
On August 19, 1996, the  shareholders of Southern Care demanded that the Company
file a  registration  statement  to  cover  the  shares  issued  to  them in the
acquisition.  The Company has 90 days following  this date to prepare,  file and
use its best efforts to have the registration of these shares declared effective
by the Securities and Exchange Commission.  At this time, the Company intends to
delay the filing of this registration statement until after the due date.

Following the consummation of the transaction, the subsidiaries of Southern Care
acquired the five leased Georgia  facilities and, in turn, sold those facilities
to Health and Retirement  Properties  Trust ("HRPT").  HRPT thereupon leased the
five Georgia  facilities back to the Acquired  Subsidiaries  for an initial term
ending on December 31, 2003 and for up to two  additional  thirteen  year terms,
each at the option of the  Acquired  Subsidiaries.  After the first  lease year,
rent is subject to increase  based on year over year  increases,  if any, in net
patient revenues and non-inpatient revenues, each as defined in the master lease
agreement.  The  Louisiana  facility  will  continue to be leased under the same
terms as the facility was being leased prior to the merger and will  continue to
be accounted for as a capital lease.

The Company's  total cost of the  acquisition  was  approximately  $8.4 million,
including  legal,  consulting and other direct costs.  Such acquisition has been
accounted for by the purchase method and, accordingly, the results of operations
have been included in the Company's  consolidated financial statements since the
date of acquisition.  The purchase price allocation which follows is preliminary
and subject to resolution of certain issues.

<TABLE>
     <S>                                                          <C>

     Accounts receivable, net                                    $    536,000
     Prepaid expenses and other current assets                        217,000
     Property, plant and equipment                                  4,550,000
     Deposits                                                         875,000
     Excess of cost over fair value of net assets acquired         12,456,000
     Accounts payable and accrued expenses                         (3,390,000)
     Long-term debt                                                (5,426,000)
     Deferred income tax liability                                 (1,393,000)
                                                                  -----------

                                                                  $ 8,425,000
                                                                  ===========
</TABLE>

                                        8

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(2)  Recent and Potential Acquisitions (continued)

Southern Care Transaction (continued)

Pursuant to the merger  agreement,  the purchase  price is to be adjusted by the
extent to which current  liabilities less current assets exceed $1,850,000.  The
Company has  calculated  this  difference  as $1.5 million and has recorded such
amount as a current asset as of September 30, 1996.  This  calculation  has been
disputed by the former  shareholders  of Southern  Care.  If the final  purchase
price adjustment differs from the amount calculated by the Company,  the Company
will  record an  adjustment  to the excess of cost over fair value of net assets
acquired related to the acquisition.

The following unaudited pro forma consolidated results of operations assumes the
transaction  described  above  occurred  as of the  beginning  of the nine month
periods  ended  September  30,  1995 and 1996,  after  giving  effect to certain
adjustments,  including  amortization  of  intangibles,  increased rent expense,
elimination  of certain  non-recurring  expenses and related  income tax effects
and,  including  the effect of unusual  charges  recorded  by the Company in the
second quarter of 1996 which were unrelated to the Southern Care acquisition.

<TABLE>
<CAPTION>

                                                Nine Months Ended September 30,
                                                -------------------------------
                                                  1995                 1996
                                                  ----                 ----
 <S>                                             <C>               <C>

  Total operating revenues                       $75,730,000      $102,007,000
  Net income (loss) before extraordinary item        671,000        (8,158,000)
  Net loss                                          (321,000)       (8,158,000)
  Net loss applicable to common stock               (728,000)       (8,158,000)
  Net loss per common share                           (0.16)            (1.08)

</TABLE>

Memorial Transaction

On  April  29,  1996,   the  Company   acquired  (the   "Initial   Acquisition")
substantially all of the business and operations, including substantially all of
the personal property and all of the real property, of a 71-bed hospital located
in Hahira,  Georgia,  d/b/a Smith Hospital from Memorial  Health Care, Inc. (the
"Seller").  The aggregate  purchase  price was $6.1 million,  subject to certain
post-closing  adjustments.  The purchase price for the Initial  Acquisition  was
paid  through the  application  of  payments  aggregating  $2.25  million and an
unsecured $3.85 million  promissory note (the "Smith Note") bearing  interest at
the prime rate in effect at NationsBank of Florida, N.A. ("NationsBank") plus 1%
which  matured on July 1, 1996,  of which $3.0  million  was  outstanding  as of
September 30, 1996 and October 31, 1996. Such outstanding balance is payable, at
the option of the Company, in either shares of Common Stock of the Company or by
the  issuance of another  promissory  note,  in the amount of $3.0  million plus
accrued interest, on terms and conditions acceptable to NationsBank.

                                        9

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(2)  Recent and Potential Acquisitions (continued)

Memorial Transaction (continued)

The Company also entered into a Purchase  Option  Agreement dated April 29, 1996
pursuant to which the Company was granted an option (the  "Option")  exercisable
until July 1, 1996,  which  entitled the Buyer,  for an aggregate  consideration
valued at approximately  $23.2 million, to (1) purchase all the capital stock of
Memorial Hospital of Adel, Inc., ("Adel") which owns a 60-bed hospital, a 95-bed
long-term  care  facility  and a home  healthcare  agency in Adel and  Valdosta,
Georgia, (2) purchase substantially all of the assets, including the real estate
of Telfair  County  Hospital,  Inc.,  comprising  a 60-bed  hospital  in McCrae,
Georgia,  known  as  "Telfair  Hospital"  and  (3)  obtain  an  assignment  of a
management  agreement  (subject to obtaining a  satisfactory  assignment  of the
agreement) for the management of a 45-bed hospital in Cochran, Georgia, known as
"Bleckley Hospital".

The  Company  did not  exercise  the Option on July 1, 1996,  nor did it pay the
Smith Note when due on July 1, 1996.

In September, the parties entered into management agreements,  effective July 1,
1996, (the "Management  Agreements") to manage Adel and Telfair Hospitals and an
assignment  agreement (the "Assignment  Agreement") with respect to the Bleckley
Hospital  management  agreement.  The  Management  Agreements and the Assignment
Agreement also contained an option (the "New Option"), exercisable until October
3, 1996, on substantially  the same terms and conditions as the original Option,
for  option  consideration  of  $180,000  per month for each  month that the New
Option was not exercised.  The New Option expired unexercised on October 3, 1996
and option consideration of $360,000 has not been paid by the Company.

The parties have entered into discussion with respect to an extension of the New
Option, the Management  Agreements and the Assignment Agreement through December
31, 1996 in exchange  for option  consideration  of $180,000  per month for each
month that the New Option is not exercised.  The discussion  includes  extending
the terms of the Smith Note and giving the Sellers the option to repurchase  the
Smith Hospital for the unpaid  balance of the Smith Note.  The  management  fees
from the Management  Agreements  and the Assignment  Agreement are to be paid to
the Company only upon exercise of the New Option, at which time these management
fees will be included in results of operations of the Company.

The  Company  is in various  stages of  negotiation  with  some,  and is holding
discussions  with other,  institutional  lenders towards  securing the necessary
financing to complete the Memorial  transaction (see Note 6). Should the parties
fail to complete the transactions  contemplated above, the Company could incur a
charge to  earnings of  approximately  $5.0  million,  most likely in the fourth
quarter of 1996.

                                       10

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(3)  Unusual Charges and Statement of Financial Accounting Standards No. 121
     (SFAS No. 121)

The Company incurred unusual charges  aggregating $19.2 million (pre-tax) during
the second quarter of 1996 comprised of the following:

The  Company  recorded  a $17.7  million  pre-tax  charge  for  closing  certain
physician  practices,  primary  care  clinics  and  adult day care  centers  and
terminating  the  management  agreements  under which it had been  managing nine
long-term care  facilities in the state of Maine (see note 4). The components of
this charge include:  $5.0 million reserve for potential forfeiture of a deposit
for an option to acquire the Maine  facilities,  $3.4 million for  severance and
personnel  reductions,  $2.9  million  for  closing  clinics  and adult day care
centers and write-off of the related  development  costs,  $1.7 million for real
estate and personal  property lease  terminations  and asset  write-downs,  $4.0
million for uncollected  management fees and other accounts receivables from the
divested  businesses  and  $700,000  for  estimated  other exit costs.  The $3.4
million  charge for  severance  and personnel  reductions  primarily  represents
severance  costs  associated  with the  elimination  of 45 positions,  including
senior management of the Company,  physicians, field development and acquisition
personnel and administrative  personnel. As of September 30, 1996, approximately
$2.4 million of the charge has not been utilized.  The portion of the unutilized
amount  expected  to be expended  by  September  30, 1997 is included in current
liabilities on the Company's consolidated balance sheet as of September 30, 1996
with the remainder included in other liabilities.

During 1996, the Company  closed its Aurora  facility as a result of unfavorable
market  conditions  and,  voluntarily  withdrew  its  Toledo  facility  from the
Medicare  and Medicaid  programs  resulting in a  substantially  idle  facility.
Consequently,  the Company  evaluated  its  long-lived  assets  related to these
facilities for impairment in accordance with SFAS No. 121. The Company estimated
the  undiscounted  net cash flows from these facilities and ascertained that the
carrying value of the long-lived  assets exceeded such  undiscounted cash flows.
Accordingly,  the  Company  compared  the fair value of the assets  based on the
present value of the estimated future cash flows for the facilities  (which were
estimated based on the remaining useful lives of the assets, earnings history, a
discount rate  commensurate  with the risks  involved and market  conditions and
assumptions  reflecting  internal  operating  plans  and  strategies)  with  the
carrying value. Using this analysis,  the Company determined that the fair value
of these facilities were less than the carrying value and, accordingly, recorded
a  loss  on  impairment  of  approximately  $1.5  million  in  the  consolidated
statements of  operations  as part of unusual  charges for the nine months ended
September 30, 1996.



                                       11

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(4)  Events Subsequent to September 30, 1996

On October  27,  1996,  the  Company  reached a  settlement  agreement  with the
entities for whom it had been managing nine long-term  care  facilities in Maine
("Sandy River  Group").  The Company  canceled  these  management  agreements on
August 14, 1996.  Under the terms of the  settlement,  the Company  canceled and
forgave all amounts due to the Company,  including any interest accrued thereon,
from the Sandy River  Group.  The Sandy River Group  forgave and  forfeited  all
contractual rights due under various agreements with the Company.  The effect of
this settlement is reflected on the the Company's  consolidated balance sheet as
of September  30, 1996 and the results of  operations  for the nine month period
then ended.  In  connection  with the  termination,  the Company,  in the second
quarter of 1996,  recorded a pre-tax charge to earnings of $9.7 million which is
included as part of the unusual charges in the statement of operations (see note
3).

In addition,  the terms of the settlement  agreement provide for the exercise of
the put options (the "Put Options") held by the  shareholders of the Sandy River
Group and the former  shareholders  of the Maine Head Trauma  Center,  Inc. (the
"Shareholders"),  which  require the Company to the purchase  219,798  shares of
Common Stock of the Company from the  Shareholders.  The parties agreed that the
Shareholders  may not demand  payment of the $2.181 million put option until the
earlier of February  28, 1997 or the sale of all, or  substantially  all, of the
assets  of the  Company.  Accordingly,  the  liability  associated  with the Put
Options is included in current liabilities on the Company's consolidated balance
sheet as of September 30, 1996.

(5)  Deferred offering costs

On July 30, 1996, the Company's  proposed  public offering of 3.1 million shares
of its Common  Stock was  withdrawn.  The  Company  determined  that it would no
longer  proceed with the offering  because a price  acceptable to the Company or
the  proposed  selling  stockholders  could not be obtained.  In  addition,  the
Company has incurred  costs related to a  subsequently  contemplated  high yield
debt offering.  The Company is still seeking  additional capital and is pursuing
several  different  sources.  Costs of the public  offering and debt offering of
approximately  $2.0  million are  considered  to have future  value in obtaining
alternative  capital financing.  Such costs will be charged against the proceeds
of any equity  capital,  or  deferred  and  amortized  over the term of any debt
financing.  If the  Company is unable to obtain  alternative  financing,  it may
incur a charge to earnings of up to $2.0 million as early as the fourth  quarter
of 1996 related to these costs.



                                       12

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(6)  Compliance With Covenants and Restructuring of Debt Facilities

At  September  30,  1996,  the  Company had a working  capital  deficit of $15.8
million.   To  date,  the  Company's  major   acquisitions  have  been  financed
principally by Health and Retirement  Properties Trust ("HRPT"). As of September
30, 1996, the Company was obligated to HRPT under installment notes with respect
to  17  facilities  having  an  outstanding   aggregate   principal  balance  of
approximately  $35.8 million and as a tenant under three master leases  covering
30 facilities  having an aggregate  minimum rent of  approximately  $202 million
(subject to  increases)  during the  remainder of their  initial terms and first
renewal period.  The master leases require the Company to maintain  consolidated
tangible  net  worth of at least  $5.0  million  and a current  ratio  (ratio of
current  assets  to  current  liabilities)  of at least  one to one.  While  the
Company's  consolidated  tangible  net worth was  approximately  $8.4 million at
September 30, 1996, its consolidated  current ratio was .6 to 1 at September 30,
1996 and, accordingly,  the Company was not in compliance with the current ratio
covenant.  The Company has received a waiver of  compliance  with this  covenant
from HRPT through November 29, 1996. HRPT has orally agreed to extend the waiver
period to  December  27,  1996  provided  at  November  29,  1996 the Company is
otherwise  in  compliance  with its  obligations  to HRPT  including  making the
payments  referred  to below on a timely  basis.  with the  covenants,  HRPT has
agreed to defer the payments of interest,  principal, rent and other charges due
from the Company to HRPT under the installment notes and master lease agreements
on September 1 and October 1, 1996 until November 29, 1996.  Interest accrues on
the amount of all such deferred  payments from the date they were  contractually
due through the date of their  payment at a rate of 18% per annum.  Certain debt
instruments  with HRPT  (aggregating  approximately  $30.9  million in principal
amount) have been  modified to provide that  interest only will be payable until
July 31, 1998, at which time principal will again become payable, with interest,
in  installments.  The notes and leases contain cross default  provisions,  such
that a default under any note or lease would entitle HRPT to accelerate  payment
of all of  such  notes  and  terminate  all of  such  leases  (and,  subject  to
mitigation of damages, to receive future rents).

On August 1, 1996, the Company and NationsBank  amended their  Revolving  Credit
and  Reimbursement  Agreement to provide for termination of the agreement on the
earlier of the  assumption of additional  indebtedness  (as defined) or December
31, 1996. Consequently,  the Company has classified the $14.3 million obligation
as a current  liability as of September  30, 1996.  The Company has  unamortized
deferred  financing costs  associated with this credit facility of approximately
$260,000 as of September 30, 1996. The unamortized deferred costs at the time of
repayment  will be charged to  earnings  in the period  that the  obligation  is
repaid.

On April 29, 1996, in connection  with the  acquisition of Smith  Hospital,  the
Company  executed an unsecured  $3.85 million  promissory  note which matured on
July 1, 1996, bearing interest at the prime rate in effect with NationsBank plus
1%, of which $3.0 million plus accrued  interest was outstanding as of September
30, 1996 and October  31,  1996.  Such  outstanding  balance is payable,  at the
option of the Company, in either shares of Common Stock of the Company or by the
issuance  of  another  $3.0  million  promissory  note on terms  and  conditions
acceptable to NationsBank.

                                       13

<PAGE>



                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                   Notes to Consolidated Financial Statements
                                   (Unaudited)
                               September 30, 1996

(6)  Compliance With Covenants and Restructuring of Debt Facilities (continued)

On April 4, 1996,  the Company  borrowed  $10.0 million from HRPT pursuant to an
11% promissory note to provide  additional  renovation,  acquisition and general
working capital funding.  No principal  payments are required until the maturity
date of December 31, 2008 with interest  payments made  monthly.  However,  this
loan, together with a $2.6 million prepayment premium,  must be prepaid from the
first proceeds of any equity or debt (or any combination  thereof) issued by the
Company  after  August 30,  1996.  The note is secured by all of the  collateral
security which secure the Company's  current  obligations to HRPT and is subject
to cross default with other obligations to HRPT.

On October 9, 1996,  the Company  engaged  Smith  Barney,  Inc. as the Company's
financial  advisor to assist in evaluating  strategic  alternatives  for raising
debt and/or equity capital and otherwise enhancing shareholder value,  including
the  possible  sale of the  Company.  Independently,  the  Company is in various
stages  of  negotiation  with  some,  and is  holding  discussions  with  other,
institutional  lenders towards replacing the NationsBank  credit facility and/or
securing the  necessary  financing to complete  the  Memorial  transaction.  The
Company is seeking to have these  financings  in place by December 25, 1996.  If
the Company is successful in obtaining sufficient financing,  on a timely basis,
it  would  be in  compliance  with  the  working  capital  maintenance  covenant
contained in the master lease  agreements with Health and Retirement  Properties
Trust  (compliance  with which has been waived  through  November  29, 1996) and
default in the payment of the  remaining  $3.0 million  balance due on the $3.85
million  unsecured  promissory  note issued in  connection  with its purchase of
Smith Hospital and otherwise complete the Memorial  transaction.  This paragraph
contains  forward-looking  statements which are subject to a number of known and
unknown  risks  and  uncertainties  that  could  cause  the  achievement  of the
Company's objectives to differ materially from those described or implied in the
forward-looking  statements.  These factors  include,  among other  things,  the
Company's  ability  to reach  agreement  with  financing  sources  and  complete
financing agreements to obtain sufficient financing on a timely and economically
feasible basis,  changes in interest rates,  changes in governmental  healthcare
policies including any changes in Medicaid and Medicare, any actions that may be
taken by third parties prior to the time of achievement  of such  objectives and
changes in other general economic conditions. There can be no assurance that any
necessary  funds will be  available to the Company or, if  available,  the terms
thereof. There can be no assurance that any necessary funds will be available to
the Company or, if available, the terms thereof.

                                       14

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

INTRODUCTION

As of  September  30,  1996  after  giving  effect  to the  consummation  of the
acquisition of Smith Hospital, the termination of its nine management agreements
in Maine and the closing of certain physician  practices,  clinics and adult day
care centers,  the Company  operated 54 licensed  long-term care facilities with
4,426 licensed beds, two rural  hospitals,  three  physician  practices and four
clinics, one child day care center, two home healthcare  agencies,  and assisted
living  with an  aggregate  of 119  units in six of the  communities  which  the
Company serves.

The following  provides a discussion of the Company's  results of operations and
liquidity  and  capital  resources  and should be read in  conjunction  with the
consolidated  financial  statements  of the Company and notes  thereto  included
elsewhere in this report.

RESULTS OF OPERATIONS

Three months ended  September 30, 1996 compared to three months ended  September
30, 1995:

Revenues  increased  by $8.1  million,  or 31%,  to $34.3  million  in the third
quarter of 1996 from $26.2 million in the  comparable  1995 period.  This growth
was primarily  attributable  to the addition of nine long-term care  facilities,
two clinics and a hospital  acquired,  managed or leased subsequent to September
30, 1995 which increased revenues by $6.8 million and an increase in revenue per
patient  day due to an  increased  proportion  of  higher  acuity  patients  and
additional  ancillary services resulting in additional revenues of $3.1 million,
offset by a decrease  in revenue of $1.8  million  resulting  from a decrease in
occupancy in the long-term care facilities.  Long-term care facilities accounted
for 87.1% of total  revenues in the 1996  period,  a decrease  from 93.4% in the
1995 period.

Net operating  revenues per patient day for long-term  care and assisted  living
facilities  increased 9.6% to $91.83 in the third quarter of 1996 from $83.76 in
the third quarter of 1995,  primarily resulting from an increased  proportion of
higher acuity patients.  Medicare days as a percent of total days increased from
4.3% in the third  quarter of 1995 to 4.9% in 1996.  Medicare  revenues from the
long-term care  facilities as a percentage of total  long-term care  facilities'
revenues  also  increased  from 14.9% in 1995 to 19.3% in 1996  primarily due to
additional  ancillary  services for the higher acuity patients.  Occupancy rates
were 86.3% in the third  quarter of 1996  compared to 88.1% in the third quarter
of 1995. Patient days from long-term care facilities  increased 11.4% to 325,785
in 1996 from 292,503 in the third quarter of 1995 due to the facilities acquired
or leased subsequent to September 30, 1995.

Facility  operating  expenses  increased  by $6.9  million,  or 33.5%,  to $27.5
million in 1996 from $20.6 million in the third  quarter of 1995  primarily as a
result of  operations  acquired  subsequent  to  September  30,  1995,  and also
increased  as a percent  of  revenues  to 80.0% in 1996 from  78.4% in the third
quarter of 1995. The 1995 period  included  management fees for 45 days for nine
managed


                                       15

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

RESULTS OF OPERATIONS (continued)

Three months ended  September 30, 1996 compared to three months ended  September
30, 1995:

facilities which  contributed to the Company's higher operating  margins in that
period.  The payroll related component of facility  operating expenses increased
by $4.0  million,  or 29.2%,  to $17.7 million from $13.7 million in 1995 due to
facilities acquired or leased subsequent to September 30, 1995, but decreased as
a  percentage  of revenues  from 52.2% in the third  quarter of 1995 to 51.6% in
1996.

Corporate  administrative and general expenses increased by $38,000, or 3.4%, to
$1.2 million in 1996 from $1.1 million in the third quarter of 1995.  The dollar
increase primarily  resulted from additional  operations,  information  systems,
finance,  accounting and other personnel to support the growth of owned,  leased
and managed  facilities offset, in part, by the elimination of certain personnel
in conjunction with the restructuring of the Company.  Corporate  administrative
and general expenses as a percentage of revenues  decreased to 3.4% in 1996 from
4.3% in the third quarter of 1995.

Rent expense increased by $335,000,  or 18.1%, to $2.2 million in 1996 from $1.9
million in 1995. However,  rent expense as a percentage of revenues decreased to
6.4% in 1996 from 7.1% in 1995.  The dollar  increase was  primarily  due to the
acquisition  of  leasehold  interests in six  facilities  leased  subsequent  to
September 30, 1995,  additional  rental costs  resulting from landlord  financed
renovations  and an  increase  in  contingent  rentals  which are based on gross
revenue of certain leased facilities.

Depreciation  and  amortization  expense  increased  by $100,000,  or 18.5%,  to
$640,000 in 1996 from  $540,000 in 1995,  but  decreased  to 1.9% of revenues in
1996 from 2.1% of revenues  in 1995.  The dollar  increase  was due to a $48,000
increase related to facilities  acquired subsequent to September 30, 1995 and to
renovations of certain owned  facilities.  The percentage  decrease was due to a
lower percentage of owned facilities to total facilities in 1996 than in 1995.

Net interest  expense  increased by $465,000,  or 52.0%,  to $1.4 million in the
third  quarter of 1996 from  $895,000 in the same period in 1995.  Net  interest
expense also  increased as a percentage of revenues to 4.0% in 1996 from 3.4% in
the third quarter of 1995.  The dollar and  percentage  increases were primarily
due to a net increase of $24.5  million of  indebtedness  to provide  additional
renovation, acquisition and working capital funding.

Federal and state income tax expense was $586,000 in the third quarter  computed
using an  annualized  effective  tax rate of 38%. The tax provision for the same
period in 1995 was $386,000  based on an  annualized  effective  tax rate of 30%
which was below the effective federal rate due to the use of loss carryforwards.


                                       16

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

RESULTS OF OPERATIONS (continued)

Three months ended  September 30, 1996 compared to three months ended  September
30, 1995:

The Company had $1.54  million of pre-tax  earnings in the third quarter of 1996
compared to pre-tax  earnings of $1.26 million in the third quarter of 1995. The
Company  reported  net  earnings  of  $957,000,  or $.12 per  share in the third
quarter of 1996 compared to a net loss of $197,000,  or $.04 per share,  for the
same  period  in  1995.  The  loss in the  third  quarter  of 1995  included  an
extraordinary charge of $992,000, net of income tax.

Nine months ended September 30, 1996 compared to nine months ended September 30,
1995:

Unusual Charges During 1996

The Company incurred unusual charges  aggregating $19.2 million (pre-tax) during
the second quarter of 1996 comprised of the following:

The  Company  recorded  a $17.7  million  pre-tax  charge  for  closing  certain
physician  practices,  primary  care  clinics  and  adult day care  centers  and
terminating  the  management  agreements  under which it had been  managing nine
long-term care  facilities in the state of Maine.  The components of this charge
include:  $5.0  million  reserve for  potential  forfeiture  of a deposit for an
option to acquire the Maine facilities, $3.4 million for severance and personnel
reductions,  $2.9  million  for closing  clinics and adult day care  centers and
write-off  of the related  development  costs,  $1.7 million for real estate and
personal  property lease  terminations and asset  write-downs,  $4.0 million for
uncollected  management  fees and other accounts  receivables  from the divested
businesses and $700,000 for estimated other exit costs.  The $3.4 million charge
for severance and personnel  reductions  primarily  represents  severance  costs
associated with the elimination of 45 positions,  including senior management of
the  Company,  physicians,  field  development  and  acquisition  personnel  and
administrative  personnel. As of September 30, 1996,  approximately $2.4 million
of the charge  has not been  utilized.  The  portion  of the  unutilized  amount
expected to be expended by September 30, 1997 is included in current liabilities
on the  Company's  consolidated  balance sheet as of September 30, 1996 with the
remainder included in other liabilities.

During 1996, the Company  closed its Aurora  facility as a result of unfavorable
market  conditions  and,  voluntarily  withdrew  its  Toledo  facility  from the
Medicare  and Medicaid  programs  resulting in a  substantially  idle  facility.
Consequently,  the Company  evaluated  its  long-lived  assets  related to these
facilities for impairment in accordance with SFAS No. 121. The Company estimated
the  undiscounted  net cash flows from these facilities and ascertained that the
carrying value of the long-lived  assets exceeded such  undiscounted cash flows.
Accordingly,  the  Company  compared  the fair value of the assets  based on the
present value of the estimated future cash flows for the facilities  (which were
estimated based on the remaining useful lives of the assets, earnings history, a
discount rate  commensurate  with the risks  involved and market  conditions and
assumptions  reflecting  internal  operating  plans  and  strategies)  with  the
carrying value. Using this analysis, the Company

                                       17

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

RESULTS OF OPERATIONS (continued)

Nine months ended September 30, 1996 compared to nine months ended September 30,
1995:

determined  that the fair value of these  facilities were less than the carrying
value and,  accordingly,  recorded a loss on  impairment of  approximately  $1.5
million in the consolidated  statements of operations as part of unusual charges
for the nine months  ended  September  30,  1996.  Revenues  increased  by $30.5
million, or 46.8%, to $95.7 million in the 1996 period from $65.2 million in the
1995  period.  This  growth  was  primarily  attributable  to  the  addition  of
twenty-four  facilities,  two hospitals and three clinics  acquired or leased at
various times from February 1, 1995 through May 16, 1996 increasing  revenues by
$26.1 million.  The remainder of the increase,  $4.4 million,  resulted from the
management of nine  long-term  care  facilities  (the  agreements for which were
terminated  by the  Company  on August  14,  1996),  consulting  related to nine
long-term care  facilities and five hospitals (the  agreements for which expired
during the second quarter of 1996) and from expanded network services from other
than  long-term  care.  Long-term care  facilities  accounted for 86.1% of total
revenues in 1996, a decrease from 94.4% in 1995.

Net operating  revenues per patient day for long-term  care and assisted  living
facilities  increased  10.9% to $90.52 for the nine months ended  September  30,
1996 from $81.62 in 1995,  primarily  resulting  from an  increase in  ancillary
services for higher  acuity  patients.  Medicare days as a percent of total days
decreased  from 5.0% in 1995 to 4.8% in 1996  primarily  the result a  voluntary
withdrawal from  participating in the Medicare program at the Company's  Toledo,
Iowa facility.  However, Medicare revenues from the long-term care facilities as
a percentage of total long-term care facilities'  revenues  increased from 16.1%
in 1995 to 18.1% in 1996, primarily due to additional ancillary services for the
higher  acuity  patients.  Occupancy  rates were 85.7% for the nine months ended
September 30, 1996  compared to 87.6% for the same period in 1995.  Patient days
from  long-term care  facilities  increased to 910,856,  or 21.1%,  in 1996 from
751,858 in 1995 due to the  facilities  acquired or leased at various times from
April 1, 1995 through May 16, 1996.

Facility  operating  expenses  increased by $23.3  million,  or 45.3%,  to $74.9
million in the 1996 period from $51.6 million in the 1995 period  primarily as a
result of operations  acquired  subsequent to March 31, 1995, but decreased as a
percent of revenues to 78.2% in 1996 from 79.0% in 1995.  The  improved  margins
resulted  primarily from the increase in the number of management  contracts and
consulting  agreements  offset  by a  decrease  in the  margins  from  the  same
community  facilities and certain  facilities  acquired  subsequent to March 31,
1996. The payroll related component of facility  operating expenses increased by
$13.3  million,  or 38.6%,  to $47.7  million  from $34.4  million in 1995,  but
decreased as a percentage of revenues from 52.7% in 1995 to 49.8% in 1996.

Corporate administrative and general expenses increased by $320,000, or 9.4%, to
$3.7  million in 1996 from $3.4  million in 1995 but  decreased  as a percent of
revenues  to 3.8% in 1996  from  5.2% in  1995.  The  dollar  increase  resulted
primarily from additional operations,  information systems, finance,  accounting
and  other  personnel  to  support  the  growth  of owned,  leased  and  managed
facilities.

                                       18

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

RESULTS OF OPERATIONS (continued)

Nine months ended September 30, 1996 compared to nine months ended September 30,
1995:

Rent expense  increased by $1.6 million,  or 35.5%, to $6.0 million in 1996 from
$4.5 million in 1995. Rent expense as a percent of revenues decreased to 6.3% in
1996 from 6.8% in 1995. The dollar increase was primarily due to the acquisition
of leasehold  interests in eleven facilities leased subsequent to June 30, 1995,
additional  rental costs  resulting from landlord  financed  renovations  and an
increase  in  contingent  rentals  which are based on gross  revenues of certain
leased facilities.

Depreciation and amortization  expense increased by $386,000,  or 25.0%, to $1.9
million in 1996 from $1.5 million in 1995,  but decreased to 2.0% of revenues in
1996 from 2.3% of revenues in 1995.  The dollar  increase  was due to a $237,000
increase  related to  facilities  acquired  subsequent  to March 31, 1995 and to
renovations of certain owned  facilities.  The percentage  decrease was due to a
lower percentage of owned facilities to total facilities in 1996 than in 1995.

Net interest  expense  increased by $614,000,  or 23.0%, to $3.3 million in 1996
from $2.7  million  in 1995.  Net  interest  expense  as a percent  of  revenues
decreased to 3.4% in 1996 from 4.1% in 1995.  The dollar  increase was primarily
due to a net increase of $24.5  million of  indebtedness  to provide  additional
renovation, acquisition and working capital funding.

Federal and state  income tax benefit was $5.1 million for the nine months ended
September 30, 1996 due to pre-tax losses of $13.3  million,  using an annualized
effective tax rate of  approximately  38%. The tax provision for the same period
in 1995  was  $476,000  based  on  pre-tax  earnings  of $1.6  million  using an
annualized  effective tax rate of 30% which was below the effective federal rate
due to the utilization of loss carryforwards.

The  early  extinguishment  of $15.4  million  of  long-term  debt  resulted  in
extraordinary  charges to earnings of $992,000,  net of tax benefit of $404,000,
in the 1995  period.  The  extraordinary  charge was  comprised  of  $683,000 of
unamortized  debt  placement  costs and  $713,000 of  prepayment  penalties  and
charges.

The  Company  had a $13.3  million  pre-tax  loss in 1996  compared  to  pre-tax
earnings  of $1.6  million in 1995.  The loss in the 1996  period  included  the
unusual charges of $19.2 million realized during the second quarter of 1996. The
Company  had a $8.3  million net loss for the nine months  ended  September  30,
1996.  For the same nine month period in 1995,  the Company  reported a net loss
applicable to common stock of $288,000.



                                       19

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

Potential Effects of Certain Transactions

Memorial Transaction

On  April  29,  1996,   the  Company   acquired  (the   "Initial   Acquisition")
substantially all of the business and operations, including substantially all of
the personal property and all of the real property, of a 71-bed hospital located
in Hahira,  Georgia,  d/b/a Smith Hospital from Memorial  Health Care, Inc. (the
"Seller").  The aggregate  purchase  price was $6.1 million,  subject to certain
post-closing  adjustments.  The purchase price for the Initial  Acquisition  was
paid  through the  application  of  payments  aggregating  $2.25  million and an
unsecured $3.85 million  promissory note (the "Smith Note") bearing  interest at
the prime rate in effect at NationsBank of Florida, N.A. ("NationsBank") plus 1%
which  matured on July 1, 1996,  of which $3.0  million  was  outstanding  as of
September 30, 1996 and October 31, 1996. Such outstanding balance is payable, at
the option of the Company, in either shares of Common Stock of the Company or by
the issuance of another promissory note, in the principal amount of $3.0 million
plus accrued interest, on terms and conditions acceptable to NationsBank.

The Company also entered into a Purchase  Option  Agreement dated April 29, 1996
pursuant to which the Company was granted an option (the  "Option")  exercisable
until July 1, 1996,  which  entitled the Buyer,  for an aggregate  consideration
valued at approximately  $23.2 million, to (1) purchase all the capital stock of
Memorial Hospital of Adel, Inc., ("Adel") which owns a 60-bed hospital, a 95-bed
long-term  care  facility  and a home  healthcare  agency in Adel and  Valdosta,
Georgia, (2) purchase substantially all of the assets, including the real estate
of Telfair  County  Hospital,  Inc.,  comprising  a 60-bed  hospital  in McCrae,
Georgia,  known  as  "Telfair  Hospital"  and  (3)  obtain  an  assignment  of a
management  agreement  (subject to obtaining a  satisfactory  assignment  of the
agreement) for the management of a 45-bed hospital in Cochran, Georgia, known as
"Bleckley Hospital".

The  Company  did not  exercise  the Option on July 1, 1996,  nor did it pay the
Smith Note when due on July 1, 1996.

In September, the parties entered into management agreements,  effective July 1,
1996, (the "Management  Agreements") to manage Adel and Telfair Hospitals and an
assignment  agreement (the "Assignment  Agreement") with respect to the Bleckley
Hospital  management  agreement.  The  Management  Agreements and the Assignment
Agreement also contained an option (the "New Option"), exercisable until October
3, 1996, on substantially  the same terms and conditions as the original Option,
for  option  consideration  of  $180,000  per month for each  month that the New
Option was not exercised.  The New Option expired unexercised on October 3, 1996
and option consideration of $360,000 has not been paid by the Company.



                                       20

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

Potential Effects of Certain Transactions (continued)

Memorial Transaction (continued)

The parties have entered into discussion with respect to an extension of the New
Option, the Management  Agreements and the Assignment Agreement through December
31, 1996 in exchange  for option  consideration  of $180,000  per month for each
month that the New Option is not exercised.  The discussion  includes  extending
the terms of the Smith Note and giving the Sellers the option to repurchase  the
Smith Hospital for the unpaid  balance of the Smith Note.  The  management  fees
from the Management  Agreements  and the Assignment  Agreement are to be paid to
the Company only upon exercise of the New Option, at which time these management
fees will be included in results of operations of the Company.

The  Company  is in various  stages of  negotiation  with  some,  and is holding
discussions  with other,  institutional  lenders towards  securing the necessary
financing  to complete  the  Memorial  transaction.  Should the parties  fail to
complete the transactions  contemplated  above, the Company could incur a charge
to earnings of approximately $5.0 million,  most likely in the fourth quarter of
1996.

Deferred Offering Costs

On July 30, 1996, the Company's  proposed  public offering of 3.1 million shares
of its Common  Stock was  withdrawn.  The  Company  determined  that it would no
longer  proceed with the offering  because a price  acceptable to the Company or
the  proposed  selling  stockholders  could not be obtained.  In  addition,  the
Company has incurred  costs related to a  subsequently  contemplated  high yield
debt offering.  The Company is still seeking  additional capital and is pursuing
several  different  sources.  Costs of the public  offering and debt offering of
approximately  $2.0  million are  considered  to have future  value in obtaining
alternative  capital financing.  Such costs will be charged against the proceeds
of any equity  capital,  or  deferred  and  amortized  over the term of any debt
financing.  If the  Company is unable to obtain  alternative  financing,  it may
incur a charge to earnings of up to $2.0 million as early as the fourth  quarter
of 1996 related to these costs.

Government Regulation

The Federal  government  and all states in which the Company  operates  regulate
various  aspects of the  Company's  business.  In  particular,  the operation of
long-term care  facilities and the provision of healthcare  services are subject
to Federal,  state and local laws relating to, among other things,  the adequacy
of  medical  care,  distribution  of  pharmaceuticals,   equipment,   personnel,
operating  policies,   fire  prevention  and  compliance  with  building  codes.
Long-term  care   facilities   are  also  subject  to  periodic   inspection  by
governmental and other  authorities to assure continued  compliance with various
standards, their continued licensing under state law and certification under the
Medicare  and  Medicaid  programs.  The failure to obtain or renew any  required
regulatory approvals or licenses could adversely affect the Company's growth and
could prevent it from offering its existing or additional services.


                                       21

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

Government Regulation (continued)

Medicare  certification  is a critical  factor  contributing to the revenues and
profitability of a long-term care facility and, accordingly,  is a key objective
of the Company's facility enhancement program.  Such certification  depends on a
favorable review of the Company's facilities by the Health Standards and Quality
Bureau of the United States  Healthcare  Financing  Administration  (HCFA).  Any
suspension or delay in the  administration  of HCFA's  survey and  certification
program,  as had been  proposed  by HCFA  early in 1995,  could  delay  Medicare
certification of the Company's facilities and adversely effect implementation of
the Company's facility enhancement program.

The Company  believes that all of its facilities  are in substantial  compliance
with the various  Medicare and Medicaid  requirements and all are in substantial
compliance with other regulatory  requirements  applicable to them.  However, in
the  ordinary  course  of  its  business,   the  Company   receives  notices  of
deficiencies for failures to comply with various  regulatory  requirements.  The
Company reviews such notices and seeks to take appropriate corrective action. In
most cases,  the Company and the reviewing  agency have agreed upon the measures
to be  taken  to bring  the  facility  into  compliance.  In some  cases or upon
repeated  violations,  the  reviewing  agency has the authority to impose fines,
temporarily  suspend  admission  of new  patients  to the  facility,  suspend or
decertify  from  participation  in the  Medicare  or Medicaid  programs  and, in
extreme  circumstances,   revoke  a  facility's  license.  These  actions  could
adversely affect a facility's ability to continue to operate, the ability of the
Company  to  provide  certain   services  and  the  facility's   eligibility  to
participate in the Medicare or Medicaid programs.

In March 1996, the Company's  Toledo,  Iowa long-term care facility  voluntarily
withdrew from  participating  in the Medicare and Medicaid  programs rather than
risk being  decertified  from  participating  in those  programs.  The Company's
Council Bluffs North facility,  which had been terminated from  participation in
the Medicare and Medicaid  programs in March 1996, has been resurveyed and found
to be  deficiency-free.  The facility was recertified to participate in both the
Medicaid and Medicare programs on May 18, 1996 and July 17, 1996, respectively.

LIQUIDITY AND CAPITAL RESOURCES

Net cash used in operating  activities  for the nine months ended  September 30,
1996 was $1.4 million compared to $1.4 million provided by operating  activities
for the same  period in 1995.  Net cash  used in  operating  activities  in 1996
resulted  primarily from the Company's net loss ($8.2 million),  net of non-cash
unusual  charges of $11.4  million and  non-cash  charges for  depreciation  and
amortization  of $1.9  million,  a decrease  in  accounts  payable  and  accrued
expenses  ($419,000),   a  net  increase  accounts  receivable  ($6.3  million),
inventories  and  other  assets   ($200,000)  due  primarily  to  the  Company's
expansion.



                                       22

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

LIQUIDITY AND CAPITAL RESOURCES (continued)

The Company used net cash in investing activities totaling $12.8 million for the
nine months ended September 30, 1996 resulted primarily from property, plant and
equipment additions of $6.6 million, a $550,000 security deposit with respect to
a $10  million  promissory  note  issued  in April  1996 (as  discussed  below),
business  acquisitions  of $5.0  million and a net  increase in other  assets of
$600,000.

Net cash provided by financing  activities was $13.2 million for the nine months
ended  September  30,  1996  resulting  from $18.5  million  net  proceeds  from
long-term borrowings and $162,000 from issuance of 46,124 shares of common stock
upon  exercise of stock  options,  offset in part by principal  payments of $3.3
million on long-term  debt and $2.1 million of deferred  financing  and offering
costs.

As of September  30,  1996,  the Company had cash and cash  equivalents  of $1.5
million  and, a working  capital  deficit of $15.8  million  compared to working
capital of $4.5 million at December 31, 1995. The change in working  capital was
primarily  attributable  to the  inclusion  of  the  revolving  credit  facility
discussed below as a current liability ($14.3 million),  the note related to the
Smith Hospital acquisition ($3.0 million), the exercise of the of the put option
rights by the shareholders of the Sandy River Group and the former  shareholders
of the Maine Head Trauma Center, Inc. as part of the settlement  agreement which
resulted in the recognition of a current  liability for the put option contracts
($2.181  million) and the assumption of negative  working  capital in connection
with  the  acquisition  of  Southern  Care  Centers,  Inc.  (approximately  $1.5
million).

On August 1, 1996, the Company and NationsBank of Florida, N.A.  ("NationsBank")
amended  their  Revolving  Credit and  Reimbursement  Agreement  to provide  for
termination  of the  agreement on the earlier of the  assumption  of  additional
indebtedness  (as defined) or December 31, 1996.  Consequently,  the Company has
classified the $14.3 million  obligation as a current  liability as of September
30,  1996.  The Company will need to obtain  funds to repay  NationsBank  ($14.3
million) on or prior to December 31, 1996. The Company has unamortized  deferred
financing costs associated with this credit facility of  approximately  $260,000
as of September  30, 1996,  which will be charged to earnings in the period that
the obligation is repaid.

At  September  30,  1996,  the Company was  obligated  to Health and  Retirement
Properties Trust ("HRPT") under  installment notes with respect to 17 facilities
having an outstanding aggregate principal balance of approximately $35.8 million
and as a tenant  under three  master  leases  covering 30  facilities  having an
aggregate  minimum rent of  approximately  $202 million  (subject to  increases)
during the remainder of their initial terms and first renewal period. The master
leases  require the Company to maintain  consolidated  tangible  net worth of at
least $5.0  million  and a current  ratio  (ratio of  current  assets to current
liabilities) of at least one to one. While the Company's  consolidated  tangible
net worth was approximately $8.4 million at September 30, 1996, its consolidated
current  ratio was .6 to 1 at September 30, 1996 and,  accordingly,  the Company
was

                                       23

<PAGE>


                COMMUNITY CARE OF AMERICA, INC. AND SUBSIDIARIES
                     Management's Discussion and Analysis of
                  Financial Condition and Results of Operations

LIQUIDITY AND CAPITAL RESOURCES (continued)

not in compliance  with the current ratio  covenant.  The Company has received a
waiver of compliance  with this  covenant  from HRPT through  November 29, 1996.
HRPT has orally agreed to extend the waiver period to December 27, 1996 provided
at November 29, 1996 the Company is otherwise in compliance with its obligations
to HRPT including  making the payments  referred to below on a timely basis.  In
addition,  to the waiver of compliance  with the  covenants,  HRPT has agreed to
defer the payments of interest,  principal,  rent and other charges due from the
Company  to HRPT under the  installment  notes and master  lease  agreements  on
September 1 and October 1, 1996 until November 29, 1996. Interest accrues on the
amount  of  all  such  deferred  payments  from  the  date  they  are  currently
contractually  due through the date of their payment at a rate of 18% per annum.
Certain debt instruments with HRPT (aggregating  approximately  $30.9 million in
principal  amount)  have been  modified to provide  that  interest  only will be
payable until July 31, 1998, at which time principal will again become  payable,
with  interest,  in  installments.  The notes and leases  contain  cross default
provisions,  such that a default  under any note or lease would  entitle HRPT to
accelerate  payment of all of such notes and  terminate all of such leases (and,
subject to mitigation of damages, to receive future rents).

On April 4, 1996,  the Company  borrowed  $10.0 million from HRPT pursuant to an
11% promissory note to provide  additional  renovation,  acquisition and general
working capital funding.  No principal  payments are required until the maturity
date of December 31, 2008 with interest  payments made  monthly.  However,  this
loan, together with a $2.6 million prepayment premium,  must be prepaid from the
first proceeds of certain equity or debt (or any combination  thereof) issued by
the Company after August 30, 1996.  The note is secured by all of the collateral
security which secure the Company's  current  obligations to HRPT and is subject
to cross default with other obligations to HRPT.

On April 29, 1996, in connection  with the  acquisition of Smith  Hospital,  the
Company  executed an unsecured  $3.85 million  promissory  note which matured on
July 1, 1996, bearing interest at the prime rate in effect with NationsBank plus
1%, of which $3.0 million plus accrued  interest was outstanding as of September
30, 1996 and October  31,  1996.  Such  outstanding  balance is payable,  at the
option of the Company, in either shares of Common Stock of the Company or by the
issuance  of  another  $3.0  million  promissory  note on terms  and  conditions
acceptable to NationsBank.

The Company has been seeking  additional funds to satisfy its obligations to pay
NationsBank,  meet the put option obligations to shareholders of the Sandy River
Group  and the  former  shareholders  of the Maine  Head  Trauma  Center,  Inc.,
complete the Memorial transaction which includes the repayment of the Smith Note
and satisfy its other working capital obligations  including meeting the working
capital maintenance covenants contained in the master lease agreements with HRPT
from,  among  various  means  including,  borrowings  from  commercial  lenders,
financing  obtained from sale-lease back transactions and the public and private
equity and debt capital  markets.  On October 9, 1996, the Company engaged Smith
Barney,  Inc.  as the  Company's  financial  advisor  to  assist  in  evaluating
strategic  alternatives  for raising debt and/or  equity  capital and  otherwise
enhancing  shareholder  value,  including  the  possible  sale  of the  Company.
Independently, the Company is in various stages of negotiation with some, and is
holding discussions with other, institutional lenders

                                       24
<PAGE>


LIQUIDITY AND CAPITAL RESOURCES (continued)

towards replacing the NationsBank  credit facility and/or securing the necessary
financing to complete the Memorial  transaction.  The Company is seeking to have
these  financings in place by December 25, 1996. If the Company is successful in
obtaining  sufficient  financing,  on a timely basis,  it would be in compliance
with the working  capital  maintenance  covenant  contained  in the master lease
agreements with Health and Retirement  Properties  Trust  (compliance with which
has been waived  through  November  29,  1996) and default in the payment of the
remaining  $3.0 million  balance due on the $3.85 million  unsecured  promissory
note issued in  connection  with its purchase of Smith  Hospital  and  otherwise
complete the  Memorial  transaction.  This  paragraph  contains  forward-looking
statements  which  are  subject  to a number  of known  and  unknown  risks  and
uncertainties  that could cause the  achievement of the Company's  objectives to
differ  materially  from  those  described  or  implied  in the  forward-looking
statements.  These factors include, among other things, the Company's ability to
reach  agreement with  financing  sources and complete  financing  agreements to
obtain sufficient financing on a timely and economically feasible basis, changes
in interest rates,  changes in governmental  healthcare  policies  including any
changes in Medicaid and Medicare, any actions that may be taken by third parties
prior to the time of achievement of such objectives and changes in other general
economic conditions.  There can be no assurance that any necessary funds will be
available to the Company or, if available, the terms thereof.

                                       25
<PAGE>


PART II - OTHER INFORMATION

Item 3. Defaults Upon Senior Securities

Reference  is  made  to  Note  6 of the  Notes  to  the  Consolidated  Financial
Statements  contained in this Report for  information  concerning  the Company's
default with the working capital  maintenance  covenant  contained in the master
lease agreements with Health and Retirement  Properties  Trust  (compliance with
which has been waived  through  November 29, 1996) and default in the payment of
the remaining  $3.0 million  balance due on a $3.85 million  unsecured  promisor
note,  issued in connection  with the Company's  acquisition of Smith  Hospital,
which note matured on July 1, 1996.
Such information is incorporated herein by reference.

Item 5. Other Information

In order to keep the stockholders and the investment  community  informed of the
Company's future plans, the Company and certain officers, directors or employees
of the  Company,  acting  on  behalf  of the  Company  may make  forward-looking
statements  concerning,  among other things, the Company's  revenues,  earnings,
capital  expenditures,  capital  structure and other financial items,  plans and
objectives and economic performance.  Forward-looking  statements may be made in
writing or orally.  The  Company's  ability to do this has been  fostered by the
Private Securities  Litigation Reform Act of 1995 which provides a "safe harbor"
for  forward-looking  statements to encourage  companies to provide  prospective
information so long as those statements are accompanied by meaningful cautionary
statements  identifying  important  factors that could cause  actual  results to
differ materially from those discussed in the statement. The Company believes it
is in the best interests of the Company and its  stockholders  to take advantage
of the "safe harbor"  provisions of that Act. Among the factors that could cause
the Company's  future  actual  results,  performance  or  achievement  to differ
materially  from  those  described  or  implied  in  forward-looking  statements
(including  any that may be contained  in this  Report)  are: (a) the  Company's
ability to obtain,  on a timely and  economically  feasible basis, the financing
required to (1) meet its various obligations (including those discussed in Notes
2, 4 and 6 of the Notes to the Consolidated  Financial  Statements  contained in
this Report),  (2) increase its working capital to eliminate its working capital
deficiencies  ($15.8 million at September 30, 1996) to meet the working  capital
maintenance  covenant  contained in the Company's  master leases with Health and
Retirement  Properties  Trust  (as  discussed  in  Note  6 of the  Notes  to the
Consolidated  Financial  Statements  contained  in this  Report),  (3) avoid the
potential charges to earnings (as discussed in Notes 2 and 5 of the Notes to the
Consolidated  Financial  Statements  contained in this Report), (4) fund capital
improvements  and (5) fund the Memorial  Transaction  (as discussed in Note 2 of
the Notes to the Consolidated Financial Statements contained in this Report) and
any future  acquisitions or other  transactions that the Company may consider to
implement its  strategy;  (b) the Company's  ability to  successfully  integrate
acquisitions  and  effectuate  economies of scale and  otherwise  implement  its
growth strategy; ( c) the Company's ability to retain qualified  personnel;  (d)
the continuation of third party payor programs, including Medicaid and Medicare,
at current benefits levels and reimbursement rates; (e) the Company's ability to
remain in compliance with the requirements for participation in such programs as
well as remain in compliance with the other  government  regulations to which it
is subject;  (f) the level of, and the Company's  ability to meet,  competition;
(g) government climate towards healthcare

  
                                     26


<PAGE>



PART II - OTHER INFORMATION (continued)

Item 5. Other Information (continued)

legislation; and (h) general economic conditions.

Many of these factors are discussed in greater  detail  elsewhere in this Report
and in the Company's Annual Report on Form 10-K for its latest fiscal year.

Item 6. Exhibits and Reports on Form 8-K

     (a)  Exhibits:

           Number                   Description
           ------                   -----------

            4(a)    Amendment  dated  August 30, 1996,  to Revolving  Credit and
                    Reimbursement  Agreement  dated  August  7,  1995  among the
                    Company, various subsidiaries of the Company and NationsBank
                    of Florida, National Association

            4(b)    Third Allonge and Amendment to Promissory Note ($13,600,000)
                    dated July 16, 1996  between ECA  Holdings,  Inc. and Health
                    and Retirement Properties Trust

            4(c)    Third Allonge and Amendment to Promissory Note  ($6,000,000)
                    dated July 16, 1996 between Community Care of Nebraska, Inc.
                    and Health and Retirement Properties Trust

            4(d)    Second Allonge and Amendment to Promissory Note ($2,045,000)
                    dated July 16,  1996  between  Community  Care of  Nebraska,
                    Inc.,  W.S.T.  Care, Inc.,  Quality Care of Lyons,  Inc. and
                    Quality  Care of Columbus,  Inc.  and Health and  Retirement
                    Properties Trust

            4(e)    Allonge and Amendment to Promissory Note ($6,466,700)  dated
                    July 16, 1996  between  ECA  Holdings,  Inc.  and Health and
                    Retirement Properties Trust

            4(f)    Second Allonge and Amendment to Promissory Note ($2,833,300)
                    dated July 16,  1996  between  Community  Care of  Nebraska,
                    Inc.,  W.S.T.  Care, Inc.,  Quality Care of Lyons,  Inc. and
                    Quality  Care of Columbus,  Inc.  and Health and  Retirement
                    Properties Trust



                                       27

<PAGE>



PART II - OTHER INFORMATION (continued)

Item 6. Exhibits and Reports on Form 8-K (continued)

      (a)  Exhibits (continued):

      Number                   Description
      ------                   -----------

       10(a)        Letter  Agreement dated August 30, 1996 between HRPT and the
                    Company.

       10(b         Settlement  Agreement  dated  October  27,  1996  among  the
                    Company,  CCA of Maine, Inc. and, among others, the entities
                    for whom the Company had managed  long-term care  facilities
                    in Maine known as the Sandy River Facilities.

       27           Financial Data Schedule

       (b) Reports on Form 8-K

           During the quarter for which this report is filed,  the Company filed
           one Report on Form 8-K dated (date of earliest  event  reported) July
           10, 1996  reporting  under Item 5 the  termination  of the management
           agreements  with the Sandy River  facilities,  the  completion of the
           required  analysis in  connection  with the  adoption of Statement of
           Financial Accounting Standards No. 121, Accounting for the Impairment
           of  Long-Lived  Assets,  the  closing of certain  existing  physician
           practices,  primary  care  clinics  and adult day care  centers,  the
           corresponding  unusual charges to earnings of $19.2 million,  and the
           delay of the  closing of the  acquisition  of three  hospitals  and a
           skilled nursing facility.



                                       28

<PAGE>



                                   SIGNATURES

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




                         COMMUNITY CARE OF AMERICA, INC.
                                  (Registrant)



Date:   November 14, 1996                   By:      /s/ Gary W. Singleton
                                                     Gary W. Singleton
                                                     President and
                                                     Chief Executive Officer




Date:   November 14, 1996                   By:      /s/ David H. Fater
                                                     David H. Fater
                                                     Executive Vice President
                                                     and Chief Financial Officer



                                       29


<PAGE>



                                  EXHIBIT INDEX

   Exhibit
   Number                        Description                               Page
   ------                        -----------                               ----


    4(a)    Amendment  dated  August 30, 1996,  to Revolving  Credit and
            Reimbursement  Agreement  dated  August  7,  1995  among the
            Company, various subsidiaries of the Company and NationsBank
            of Florida, National Association .... .......................... 31

    4(b)    Third Allonge and Amendment to Promissory Note ($13,600,000)
            dated July 16, 1996  between ECA  Holdings,  Inc. and Health
            and Retirement Properties Trust ................................ 36

    4(c)    Third   Allonge  and   Amendment  to   Promissory   Note
            ($6,000,000)  dated July 16, 1996 between  Community Care of
            Nebraska, Inc. and Health and Retirement Properties Trust ...... 38

    4(d)    Second Allonge and Amendment to Promissory Note ($2,045,000)
            dated July 16,  1996  between  Community  Care of  Nebraska,
            Inc.,  W.S.T.  Care, Inc.,  Quality Care of Lyons,  Inc. and
            Quality  Care of Columbus,  Inc.  and Health and  Retirement
            Properties Trust ............................................... 40

    4(e)    Allonge and Amendment to Promissory Note ($6,466,700)  dated
            July 16, 1996  between  ECA  Holdings,  Inc.  and Health and
            Retirement Properties Trust .................................... 42

    4(f)    Second Allonge and Amendment to Promissory Note ($2,833,300)
            dated July 16,  1996  between  Community  Care of  Nebraska,
            Inc.,  W.S.T.  Care, Inc.,  Quality Care of Lyons,  Inc. and
            Quality  Care of Columbus,  Inc.  and Health and  Retirement
            Properties Trust ............................................... 44

   10(a)    Letter  Agreement dated August 30, 1996 between HRPT and the
            Company. ....................................................... 46

   10(b)    Settlement  Agreement  dated  October  27,  1996  among  the
            Company,  CCA of Maine, Inc. and, among others, the entities
            for whom the Company had managed  long-term care  facilities
            in Maine known as the Sandy River Facilities. .................. 49

   27       Financial Data Schedule


                                       30



                   Further Amendment and Consent Agreement to
                  Revolving Credit and Reimbursement Agreement
                               and Other Documents


     THIS  AMENDMENT  AGREEMENT  is made and entered into as of this 31st day of
July, 1996, by and among COMMUNITY CARE OF AMERICA, INC., a Delaware corporation
("CCA"), the following Subsidiaries of CCA: ECA HOLDINGS,  INC., ECA PROPERTIES,
INC.,  COMMUNITY CARE OF NEBRASKA,  INC., CCA OF MAINE, INC., W.S.T. CARE, INC.,
QUALITY CARE OF LYONS, INC., QUALITY CARE OF COLUMBUS,  INC., CCA ACQUISITION I,
INC.,  GLENWOOD/SCC,  INC.,  MARIETTA/SCC,  INC.,  DUBLIN/SCC,  INC., MACON/SCC,
INC.COLLEGE  PARK/SCC,  INC. AND  LULING/SCC,  INC.  (the "Old  Borrowers")  and
COMMUNITY CARE OF GEORGIA,  INC., a Delaware  corporation  (the "New  Borrower";
together with the Old Borrowers, the "Borrowers"),  COMMUNITY CARE OF AMERICA OF
ALABAMA, INC. and CCA OF MIDWEST, INC., as Guarantors, and NATIONSBANK, NATIONAL
ASSOCIATION   (SOUTH)  (as  successor  to  NationsBank   of  Florida,   National
Association),  as Agent and sole  Lender  ("NationsBank")  under  the  Revolving
Credit and Reimbursement  Agreement dated August 7, 1995 among the Borrowers (as
defined in the Agreement) and NationsBank.

                              W I T N E S S E T H:

     WHEREAS,  the Old Borrowers and NationsBank have entered into the Agreement
pursuant to which  NationsBank as Lender has agreed to make  revolving  loans to
the Old Borrowers in the principal  amount of up to  $15,000,000 as evidenced by
the Notes (as defined in the Agreement); and

     WHEREAS,  as a condition to the making of the revolving  loans  pursuant to
the Agreement the Lenders have required that all  Subsidiaries  of CCA which are
not Borrowers guaranty payment of all Obligations of the Borrowers arising under
the Agreement; and

     WHEREAS,  the New Borrower  desires to obtain working  capital  directly or
indirectly  with the  proceeds  of Loans  under the Loan  Documents,  which will
materially and directly benefit the New Borrower; and

     NOW, THEREFORE, the Borrowers and NationsBank do hereby agree as follows:

1.   Definitions.  The term  "Agreement"  as used  herein  and in the other Loan
     Documents (as defined in the Agreement) shall mean the Revolving Credit and
     Reimbursement Agreement referred to above, as heretofore and hereby amended
     and modified.  Unless the context otherwise requires, all terms used herein
     without  definition  shall have the  definition  provided  therefor  in the
     Agreement.

2.   Amendments to Agreement. Subject to the conditions hereof, the Agreement is
     hereby amended,  in addition to the amendments effected by Section 1 above,
     as follows:


                                       31

<PAGE>



     (a)  The  definition  of  "Borrowers"  in the Agreement and in each Exhibit
          thereto is hereby amended to mean, collectively, the Old Borrowers (as
          defined  above in this  Amendment)  and the New  Borrower  (as defined
          above in this Amendment).

     (b)  The  definition  of "Notes" in Section 1.01 of the Agreement is hereby
          amended  by  deleting  from such  definition  the  reference  "Exhibit
          G-1996"  and  substituting  in lieu  thereof  the  reference  "Exhibit
          G-1996A".

     (c)  Exhibit G-1996 to the Agreement is deleted in its entirety and Exhibit
          G- 1996A,  in the form attached to this  Amendment,  is substituted in
          lieu thereof.

3.   Amendment to Guaranty and  Subsidiary  Security  Agreement  and  Subsidiary
     Consents.

     (a)  The  definition of "Borrowers" as used in each Guaranty and Subsidiary
          Security  Agreement is hereby amended to mean,  collectively,  the Old
          Borrowers and the New Borrower.

     (b)  Each  Subsidiary  of CCA that is not a Borrower  that has  delivered a
          Guaranty to the Agent has joined in the  execution  of this  Amendment
          Agreement  for the purpose of (i)  agreeing to the  amendments  to the
          Agreement  and the  other  Loan  Documents  and  (ii)  confirming  its
          guarantee of payment of all the Obligations.

     (c)  The parties hereto agree that in the event any additional  Guaranty or
          Subsidiary  Security  Agreement  shall be delivered  after the date of
          this  Amendment,  the description of the Borrowers as contained in the
          forms of Guaranty and Subsidiary  Security  Agreement  attached to the
          Agreement  shall be modified to give effect to the amendment  effected
          by this Section 3.

4.   Amendments to Security Agreement and LC Account Agreement.

     (a)  Each of the  definition  of (i)  "Borrowers"  as used in the  Security
          Agreement and (ii) "Pledgors" as used in the LC Account  Agreement are
          hereby  amended to mean,  collectively,  the Old Borrowers and the New
          Borrower.

5.   New Borrower Undertakings. The New Borrower acknowledges and agrees that it
     is a party to and bound by, and shall  observe,  perform and fulfill all of
     the  obligations,   undertakings  and  liabilities  of  any  "Borrower"  or
     "Pledgor" under the Agreement, the Notes, the Security Agreement and the LC
     Account  Agreement  to the same extent as if it were an original  signatory
     thereto. Without limiting the generality of the foregoing, the New Borrower
     acknowledges  and agrees that by its execution  hereof,  it is granting and
     conveying  to the  Agent  for the  benefit  of the  Lenders a Lien upon and
     security  interest  in certain of its  property  in which it now has or may
     hereafter  acquire  an  interest,  pursuant  to  and as  more  particularly
     described in the Security Agreement.

6.   Representations and Warranties.  The Borrowers (including the New Borrower)
     hereby represents and warrants that:

     (a)  The  representations  and  warranties  made by or with respect to such
          Borrower and its Subsidiaries in Article VII of the Agreement are true
          on and as of the


                                       32

<PAGE>



         date hereof except that the financial statements referred to in Section
         7.01(f) shall be those most recently  furnished to each Lender pursuant
         to Section 8.01(a) and (b);

     (b)  There has been no  material  change  in the  condition,  financial  or
          otherwise,  of CCA and its  Subsidiaries  since  the  date of the most
          recent financial reports of CCA and its Subsidiaries  received by each
          Lender under Section 8.01 thereof,  other than changes in the ordinary
          course of business,  none of which has been a material adverse change;
          and

     (c)  The business and properties of CCA and its  Subsidiaries  are not, and
          since  the date of the most  recent  financial  report  of CCA and its
          Subsidiaries  received by each Lender under  Section 8.01 thereof have
          not been,  adversely  affected in any substantial way as the result of
          any  fire,   explosion,   earthquake,   accident,   strike,   lockout,
          combination  of workers,  flood,  embargo,  riot,  activities of armed
          forces,  war or acts of God or the public enemy,  or  cancellation  or
          loss of any major contracts.

7.   Conditions.   This  Amendment   Agreement   shall  become   effective  upon
     satisfaction of all of the following conditions:

     (i)  the Borrowers shall deliver or cause to be delivered to the Agent, the
          following:

          (a)  four  counterparts  of this Amendment  Agreement duly executed by
               the Borrowers and consented to by each of the  Subsidiaries  that
               is not a Borrower;

          (b)  a  replacement  Note in the  form  of  Exhibit  G-1996A  attached
               hereto,  duly  executed by the Borrowers and payable to the order
               of  NationsBank  in the  amount  of the  Total  Revolving  Credit
               Commitment;

          (c)  an opinion of counsel for the  Borrower and its  Subsidiaries  in
               form  and  content   acceptable  to  the  Agent;

          (d)  the stock certificates  evidencing ownership of the New Borrower,
               with duly executed stock power in blank affixed thereto; and

          (e)  such other  instruments and documents as the Agent may reasonably
               request;

     (ii) the  Agent  shall  receive  the  written  consent  to  this  Amendment
          Agreement of the Required Lenders; and

     (iii)all  instruments  and documents  incident to the  consummation  of the
          transactions  contemplated  hereby shall be  satisfactory  in form and
          substance to the Agent and its counsel;  the Agent shall have received
          copies of all additional  agreements,  instruments and documents which
          it may reasonably request in connection therewith,  including evidence
          of the  authority  of CCA and  its  Subsidiaries  to  enter  into  the
          transactions


                                       33

<PAGE>



         contemplated  by  this  Amendment  Agreement,   such  documents,   when
         appropriate,  to be certified by appropriate  corporate or governmental
         authorities;  and all proceedings of CCA and its Subsidiaries  relating
         to the matters  provided for herein shall be  satisfactory to the Agent
         and its counsel.

8.   Entire   Agreement.   This  Amendment   Agreement  sets  forth  the  entire
     understanding  and  agreement  of the  parties  hereto in  relation  to the
     subject matter hereof, and supersedes any prior negotiations and agreements
     among the parties relative to such subject matter. No promise,  conditions,
     representation or warranty,  express or implied, not herein set forth shall
     bind any party  hereto,  and no one of them has relied on any such promise,
     condition,   representation  or  warranty.   Each  of  the  parties  hereto
     acknowledges  that,  except  as  in  this  Amendment   Agreement  otherwise
     expressly stated, no representations, warranties or commitments, express or
     implied,  have been made by any other party to the other. None of the terms
     or conditions of this Amendment Agreement may be changed,  modified, waived
     or  canceled  orally or  otherwise,  except by  writing,  signed by all the
     parties   hereto,   specifying   such  change,   modification,   waiver  or
     cancellation  of  such  terms  or  conditions,  or  of  any  proceeding  or
     succeeding breach thereof.

9.   Full Force and Effect of Agreement.  Except as hereby specifically amended,
     modified or supplemented, the Agreement and all of the other Loan Documents
     are hereby  confirmed and ratified in all respects and shall remain in full
     force and effect according to their respective terms.


                                       34

<PAGE>



     IN WITNESS WHEREOF, the parties hereto have caused this Amendment Agreement
to be duly  executed by their duly  authorized  officers,  all as of the day and
year first above written.

                           BORROWERS:
                                      COMMUNITY CARE OF AMERICA, INC.
                                      ECA HOLDINGS, INC.
                                      ECA PROPERTIES, INC.
                                      COMMUNITY CARE OF NEBRASKA, INC.
                                      CCA OF MAINE, INC.
                                      W.S.T. CARE, INC.
                                      QUALITY CARE OF LYONS, INC.
                                      QUALITY CARE OF COLUMBUS, INC.
                                      CCA ACQUISITION I, INC.
                                      GLENWOOD/SCC, INC.
                                      MARIETTA/SCC, INC.
                                      DUBLIN/SCC, INC. MACON/SCC, INC.
                                      COLLEGE PARK/SCC, INC. LULING, INC.
                                      COMMUNITY CARE OF GEORGIA, INC.
WITNESS:
_______________________               By:    /s/__David H. Fater_______
                                      Name:  David H. Fater
_______________________               Title: Executive Vice President and
                                             Financial Officer of
                                             EACH OF THE NAMED CORPORATIONS
                                      GUARANTORS:
                                      COMMUNITY CARE OF AMERICA OF
                                      ALABAMA, INC.
                                      CCA OF MIDWEST, INC.
                                      By:    /s/ David H. Fater_________
                                      Name:  David H. Fater
                                      Title: Executive Vice President and
                                             Chief Financial Officer
                                      NATIONSBANK, NATIONAL ASSOCIATION
                                      (SOUTH), as Agent for the Lenders
                                      By:    /s/ Michael Sylvester
                                      Name:  Michael Sylvester
                                      Title: Officer
                                      NATIONSBANK, NATIONAL ASSOCIATION
                                      (SOUTH), as Lender
                                      By:    /s/ Michael Sylvester
                                      Name:  Michael Sylvester
                                      Title: Officer



                                       35



                 THIRD ALLONGE AND AMENDMENT TO PROMISSORY NOTE


     Reference is made to that certain Promissory Note in the original principal
amount of  $13,600,000,  dated  December  30, 1993 as modified by an Allonge and
Amendment dated as of April 1, 1995 and an Allonge and Amendment dated as of May
10,  1996  (the  "Original  Note")  , made by ECA  Holdings,  Inc.,  a  Delaware
corporation  ("Maker"),  and payable to Health and Retirement  Properties  Trust
("Lender").  This Allonge and  Amendment  (this  "Allonge")  shall be and remain
attached  to and  shall  constitute  an  integral  part of the  above  described
Original  Note from and after the date hereof (the  Original Note as modified by
this Allonge being hereinafter referred to as the "Note"). Terms capitalized but
not  otherwise   defined   herein  shall  have  the  meanings   given  to  them,
respectively, in the Original Note.

         The Original Note is hereby amended in the following particulars:

          1.   Paragraph  6 of the  Original  Note is amended in full to read as
               follows:

               6. Required  Principal  Payments.  Commencing on January 31, 1996
               and  thereafter  on the  last day of each  calendar  month to and
               including  June 30, 1996,  Maker shall make  monthly  payments of
               principal  and  interest on this Note,  each in the amount of One
               Hundred  Thirty-eight  Thousand  Two  Hundred  Forty  and  No/100
               ($138,240.00).  Commencing on July 31, 1996 and thereafter on the
               last day of each calendar  month to and including  June 30, 1998,
               Maker  shall pay accrued  and unpaid  interest  only on the Note.
               Commencing  on July 31,  1998 and  thereafter  on the last day of
               each  calendar  month until the Maturity  Date,  Maker shall make
               monthly  payments of principal and interest on this Note, each in
               the amount of $137,745.93. The balance of all amounts advanced as
               principal  hereunder  shall be due and  payable  on the  Maturity
               Date.

          2.   Paragraph 7(a) of the Original Note is amended in full to read as
               follows:

               7.  Prepayment.  (a) (i) In the event the  option to renew  those
               certain leases variously dated as of December 30, 1993,  November
               1, 1994 and April 1, 1995,  each as  amended,  between  Lender as
               landlord  and Maker,  as tenant  with  respect  to  certain  real
               property  and  improvements  located in Colorado,  Kansas,  Iowa,
               Missouri,  Nebraska and Wyoming,  for the First Extended Term (as
               such term is defined  therein) is not  exercised on the terms set
               forth in such leases,  Lender,  at its election by written notice
               to Maker  given on or prior to January 31,  2010,  shall have the
               right, in its sole discretion and for any reason or no reason, to
               require  the Maker to prepay  this Note in full on  December  31,
               2010,  together with  interest and the  Make-Whole  Premium,  and
               other charges accrued and unpaid hereunder and/or under the Deeds
               of Trust and the Security  Instruments  on such  monthly  payment
               date.

               (ii) In the  event  the  option  to renew  those  certain  leases
               variously dated as of May 10, 1996 between Lender as landlord and
               Marietta/SCC,   Inc.,  Glenwood/SCC,   Inc.,  Dublin/SCC,   Inc.,
               Macon/SCC,  Inc.  and  College  Park/SCC,  Inc.,  each a  Georgia
               corporation  (collectively,  the "SCC Subsidiaries"),  as tenants
               with respect to certain real property,  related  improvements and
               personal property located in Georgia, for the First Extended Term
               (as such term is defined  therein) is not  exercised on the terms
               set forth in such  leases,  Lender,  at its  election  by written
               notice to Maker given on or prior to January 31, 2010, shall have
               the  right,  in its  sole  discretion  and for any  reason  or no
               reason,  to  require  the  Maker to  prepay  this Note in full on
               December  31, 2010,  together  with  interest and the  Make-Whole
               Premium,  and other charges accrued and unpaid  hereunder  and/or
               under  the Deeds of Trust and the  Security  Instruments  on such
               monthly payment date.


                                       36
<PAGE>


     Except as modified  hereby,  all the terms and  conditions  of the Original
Note are hereby  ratified  and  confirmed.  This Allonge may be signed in one or
more counterparts each of which taken together shall constitute one and the same
instrument.

     NON-LIABILITY OF TRUSTEES.  THE DECLARATION OF TRUST  ESTABLISHING  LENDER,
DATED  OCTOBER 9, 1986, A COPY OF WHICH , TOGETHER WITH ALL  AMENDMENTS  THERETO
(THE  "DECLARATION"),  IS DULY  FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND
TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME "HEALTH AND RETIREMENT
PROPERTIES  TRUST" REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS
TRUSTEES,  BUT NOT  INDIVIDUALLY  OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER,
SHAREHOLDER,  EMPLOYEE  OR  AGENT  OF  LENDER  SHALL  BE  HELD  TO ANY  PERSONAL
LIABILITY,  JOINTLY  OR  SEVERALLY,  FOR ANY  OBLIGATION  OF, OR CLAIM  AGAINST,
LENDER.  ALL PERSONS  DEALING  WITH LENDER,  IN ANY WAY,  SHALL LOOK ONLY TO THE
ASSETS  OF  LENDER  FOR  THE  PAYMENT  OF  ANY  SUM OR  THE  PERFORMANCE  OF ANY
OBLIGATION.

     IN  WITNESS  WHEREOF,  and  intending  to  be  legally  bound  hereby,  the
undersigned  has caused this  Allonge to be  executed  under seal by its officer
thereunto duly authorized as of the 16th day of July, 1996.

Attest:                                     ECA HOLDINGS, INC.


By: /s/ Fredric H. Aaron                            By: /s/ Tim J. Trybus
    Name:Fredric H. Aaron                               Tim J. Trybus
    Title: Assistant to Secretary                       Vice President

ACCEPTED BY:

HEALTH AND RETIREMENT PROPERTIES TRUST

By: /s/ David J. Hegarty
    David J. Hegarty
    President




                                       37





                 THIRD ALLONGE AND AMENDMENT TO PROMISSORY NOTE


     Reference is made to that certain Promissory Note in the original principal
amount of  $6,000,000,  dated  December  30,  1993 as modified by an Allonge and
Amendment dated as of April 1, 1995 and an Allonge and Amendment dated as of May
10, 1996 (the  "Original  Note") , made by COMMUNITY  CARE OF NEBRASKA,  INC., a
Delaware corporation ("Maker"),  and payable to HEALTH AND RETIREMENT PROPERTIES
TRUST,  a Maryland real estate  investment  trust  ("Lender").  This Allonge and
Amendment (this  "Allonge") shall be and remain attached to and shall constitute
an integral  part of the above  described  Original Note from and after the date
hereof (the Original Note as modified by this Allonge being hereinafter referred
to as the "Note"). Terms capitalized but not otherwise defined herein shall have
the meanings given to them, respectively, in the Original Note.

     The Original Note is hereby amended in the following particulars:

     4.Paragraph 4 of the Original Note is amended in full to read as follows:

          4.   Required Principal  Payments.  Commencing on January 31, 1996 and
               thereafter  on  the  last  day  of  each  calendar  month  to and
               including  June 30, 1996,  Maker shall make  monthly  payments of
               principal and interest on this Note,  each in the amount of Fifty
               Thousand  Three  Hundred   Fifty-two  and  No/100   ($50,352.00).
               Commencing  on July 31,  1996 and  thereafter  on the last day of
               each calendar month to and including  June 30, 1998,  Maker shall
               pay accrued and unpaid interest only on this Note.  Commencing on
               July 31,  1998 and  thereafter  on the last day of each  calendar
               month until the Maturity Date,  Maker shall make monthly payments
               of  principal  and  interest on this Note,  each in the amount of
               $50,077.21.  The  balance of all amounts  advanced  as  principal
               hereunder shall be due and payable on the Maturity Date.

     5.Paragraph  5(a)  of the  Original  Note  is  amended  in  full to read as
     follows:

          5.   Prepayment. (a)(i) In the event the option to renew those certain
               leases variously dated as of December 30, 1993,  November 1, 1994
               and April 1, 1995,  each as amended,  between  Lender as landlord
               and ECA Holdings,  Inc., a Delaware  corporation,  as tenant with
               respect to certain  real  property  and  improvements  located in
               Colorado,  Kansas, Iowa, Missouri,  Nebraska and Wyoming, for the
               First  Extended  Term (as such term is  defined  therein)  is not
               exercised on the terms set forth in such leases,  Lender,  at its
               election by written  notice to Maker given on or prior to January
               31, 2010,  shall have the right,  in its sole  discretion and for
               any reason or no reason,  to  require  the Makers to prepay  this
               Note in full on December 31, 2010, together with interest and the
               MakeWhole Premium, and other charges accrued and unpaid hereunder
               and/or under the Deeds of Trust and the Security  Instruments  on
               such monthly payment date.

          (ii) In the event the option to renew those certain  leases  variously
               dated as of May 10,  1996,  each as  amended,  between  Lender as
               landlord and Marietta/SCC,  Inc., Glenwood/SCC, Inc., Dublin/SCC,
               Inc., Macon/SCC,  Inc. and College Park/SCC, Inc., each a Georgia
               corporation  (collectively,  the "SCC Subsidiaries"),  as tenants
               with respect to certain real property,  related  improvements and
               personal property located in Georgia, for the First Extended Term
               (as such term is defined  therein) is not  exercised on the terms
               set forth in such  leases,  Lender,  at its  election  by written
               notice to Maker given on or prior to January 31, 2010, shall have
               the  right,  in its  sole  discretion  and for any  reason  or no
               reason,  to  require  the  Maker to  prepay  this Note in full on
               December  31, 2010,  together  with  interest and the  Make-Whole
               Premium,  and other charges accrued and unpaid  hereunder  and/or
               under  the Deeds of Trust and the  Security  Instruments  on such
               monthly payment date.


                                       38

<PAGE>



     Except as modified  hereby,  all the terms and  conditions  of the Original
Note are hereby  ratified  and  confirmed.  This Allonge may be signed in one or
more counterparts each of which taken together shall constitute one and the same
instrument.

     NON-LIABILITY OF TRUSTEES.  THE DECLARATION OF TRUST  ESTABLISHING  LENDER,
DATED  OCTOBER 9, 1986, A COPY OF WHICH , TOGETHER WITH ALL  AMENDMENTS  THERETO
(THE  "DECLARATION"),  IS DULY  FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND
TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME "HEALTH AND RETIREMENT
PROPERTIES  TRUST" REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS
TRUSTEES,  BUT NOT  INDIVIDUALLY  OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER,
SHAREHOLDER,  EMPLOYEE  OR  AGENT  OF  LENDER  SHALL  BE  HELD  TO ANY  PERSONAL
LIABILITY,  JOINTLY  OR  SEVERALLY,  FOR ANY  OBLIGATION  OF, OR CLAIM  AGAINST,
LENDER.  ALL PERSONS  DEALING  WITH LENDER,  IN ANY WAY,  SHALL LOOK ONLY TO THE
ASSETS  OF  LENDER  FOR  THE  PAYMENT  OF  ANY  SUM OR  THE  PERFORMANCE  OF ANY
OBLIGATION.

     IN  WITNESS  WHEREOF,  and  intending  to  be  legally  bound  hereby,  the
undersigned  has caused this  Allonge to be  executed  under seal by its officer
thereunto duly authorized as of the 16th day of July, 1996.

Attest:                                     COMMUNITY CARE OF NEBRASKA, INC.


By: /s/ Fredric H. Aaron                            By: /s/ Tim J. Trybus
    Name:Fredric H. Aaron                               Tim J. Trybus
    Title: Assistant to Secretary                       Vice President

ACCEPTED BY:

HEALTH AND RETIREMENT PROPERTIES TRUST

By: /s/ David J. Hegarty
    David J. Hegarty
    President

                                       39




                 SECOND ALLONGE AND AMENDMENT TO PROMISSORY NOTE


     Reference is made to that certain Promissory Note in the original principal
amount  of  $2,045,000,  dated  April 1,  1995 as  modified  by an  Allonge  and
Amendment dated as of May 10, 1996 (the "Original Note"), made by COMMUNITY CARE
OF  NEBRASKA,  INC.,  a Delaware  corporation,  W.S.T.  CARE,  INC.,  a Nebraska
corporation,  QUALITY CARE OF LYONS,  INC., a Nebraska  corporation  and QUALITY
CARE OF COLUMBUS, INC., a Nebraska corporation (collectively,  the "Makers") and
payable to HEALTH AND  RETIREMENT  PROPERTIES  TRUST,  a  Maryland  real  estate
investment trust  ("Lender").  This Allonge and Amendment (this "Allonge") shall
be and remain  attached to and shall  constitute  an integral  part of the above
described  Original  Note from and after the date hereof (the  Original  Note as
modified by this Allonge  being  hereinafter  referred to as the "Note").  Terms
capitalized  but not otherwise  defined  herein shall have the meanings given to
them, respectively, in the Original Note.


     A. The Original Note is hereby  amended by amending  Paragraph 4 thereof in
     full to read as follows:

          4.   Required  Payments.  Commencing on July 1, 1998 and thereafter on
               the last day of each calendar  month until the Maturity Date, the
               Makers shall make required monthly prepayments of the outstanding
               principal,  together  with  interest,  of this  Note in an amount
               equal to an  amortized  portion of the  principal  amount  hereof
               based on a 25- year direct reduction  amortization  schedule. The
               balance of all amounts  advanced as principal  hereunder shall be
               due and payable on the Maturity Date.

     B. The Original Note is hereby  amended by amending  Paragraph 5(a) thereof
     in full to read as follows:

          5.   Prepayment. (a)(i) In the event the option to renew those certain
               leases variously dated as of December 30, 1993,  November 1, 1994
               and April 1, 1995,  each as amended,  between  Lender as landlord
               and ECA Holdings,  Inc., a Delaware  corporation,  as tenant with
               respect to certain  real  property  and  improvements  located in
               Colorado,  Kansas, Iowa, Missouri,  Nebraska and Wyoming, for the
               First  Extended  Term (as such term is  defined  therein)  is not
               exercised on the terms set forth in such leases,  Lender,  at its
               election by written notice to Makers given on or prior to January
               31, 2010,  shall have the right,  in its sole  discretion and for
               any reason or no reason,  to  require  the Makers to prepay  this
               Note in full on December 31, 2010, together with interest and the
               Make-  Whole  Premium,  and  other  charges  accrued  and  unpaid
               hereunder  and/or  under  the  Deeds  of Trust  and the  Security
               Instruments on such monthly payment date.

          (ii) In the event the option to renew those certain  leases  variously
               dated  as  of  May  10,  1996  between  Lender  as  landlord  and
               Marietta/SCC,   Inc.,  Glenwood/SCC,   Inc.,  Dublin/SCC,   Inc.,
               Macon/SCC,  Inc.  and  College  Park/SCC,  Inc.,  each a  Georgia
               corporation  (collectively,  the "SCC Subsidiaries"),  as tenants
               with respect to certain real property,  related  improvements and
               personal property located in Georgia, for the First Extended Term
               (as such term is defined  therein) is not  exercised on the terms
               set forth in such  leases,  Lender,  at its  election  by written
               notice to Makers  given on or prior to January  31,  2010,  shall
               have the right,  in its sole  discretion and for any reason or no
               reason,  to  require  the  Makers to prepay  this Note in full on
               December  31, 2010,  together  with  interest and the  Make-Whole
               Premium,  and other charges accrued and unpaid  hereunder  and/or
               under  the Deeds of Trust and the  Security  Instruments  on such
               monthly payment date.

     Except as modified  hereby,  all the terms and  conditions  of the Original
Note are hereby  ratified  and  confirmed.  This Allonge may be signed in one or
more counterparts each of which


                                       40

<PAGE>



taken together shall constitute one and the same instrument.

     NON-LIABILITY OF TRUSTEES.  THE DECLARATION OF TRUST  ESTABLISHING  LENDER,
DATED  OCTOBER 9, 1986, A COPY OF WHICH , TOGETHER WITH ALL  AMENDMENTS  THERETO
(THE  "DECLARATION"),  IS DULY  FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND
TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME "HEALTH AND RETIREMENT
PROPERTIES  TRUST" REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS
TRUSTEES,  BUT NOT  INDIVIDUALLY  OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER,
SHAREHOLDER,  EMPLOYEE  OR  AGENT  OF  LENDER  SHALL  BE  HELD  TO ANY  PERSONAL
LIABILITY,  JOINTLY  OR  SEVERALLY,  FOR ANY  OBLIGATION  OF, OR CLAIM  AGAINST,
LENDER.  ALL PERSONS  DEALING  WITH LENDER,  IN ANY WAY,  SHALL LOOK ONLY TO THE
ASSETS  OF  LENDER  FOR  THE  PAYMENT  OF  ANY  SUM OR  THE  PERFORMANCE  OF ANY
OBLIGATION.

     IN  WITNESS  WHEREOF,  and  intending  to  be  legally  bound  hereby,  the
undersigned  has caused this  Allonge to be  executed  under seal by its officer
thereunto duly authorized as of the 16th day of July, 1996.

                                            COMMUNITY CARE OF NEBRASKA, INC.,
Attest:                                       a Delaware corporation

By: /s/ Fredric H. Aaron                            By: /s/ Tim J. Trybus
    Name:Fredric H. Aaron                               Tim J. Trybus
    Title: Assistant to Secretary                       Vice President

ACCEPTED BY:

HEALTH AND RETIREMENT PROPERTIES TRUST

By: /s/ David J. Hegarty
    David J. Hegarty
    President




                                       41




                    ALLONGE AND AMENDMENT OF PROMISSORY NOTE


     Reference  is  made  to  that  certain  ECA  Holdings   Renovation  Funding
Promissory Note in the original  principal amount of $6,466,700,  dated April 1,
1995 as  modified  by an Allonge  and  Amendment  dated as of May 10,  1996 (the
"Original Note"), made by ECA HOLDINGS,  INC., a Delaware corporation ("Maker"),
and payable to HEALTH AND  RETIREMENT  PROPERTIES  TRUST, a Maryland real estate
investment trust  ("Lender").  This Allonge and Amendment (this "Allonge") shall
be and remain  attached to and shall  constitute  an integral  part of the above
described  Original  Note from and after the date hereof (the  Original  Note as
modified by this Allonge  being  hereinafter  referred to as the "Note").  Terms
capitalized  but not otherwise  defined  herein shall have the meanings given to
them, respectively, in the Original Note.

     A. The Original Note is hereby  amended by amending  Paragraph 4 thereof in
     full to read as follows:

          4.   Required  Payments.  Commencing on July 1, 1998 and thereafter on
               the last day of each calendar  month until the Maturity Date, the
               Maker shall make required monthly  prepayments of the outstanding
               principal,  together  with  interest,  of this  Note in an amount
               equal to an  amortized  portion of the  principal  amount  hereof
               based on a 25- year direct reduction  amortization  schedule. The
               balance of all amounts  advanced as principal  hereunder shall be
               due and payable on the Maturity Date.

     B. The Original Note is hereby  amended by amending  Paragraph 5(a) thereof
     in full to read as follows:

          5.   Prepayment. (a)(i) In the event the option to renew those certain
               leases variously dated as of December 30, 1993,  November 1, 1994
               and April 1, 1995,  each as amended,  between  Lender as landlord
               and Maker as tenant with  respect to certain  real  property  and
               improvements   located  in  Colorado,   Kansas,  Iowa,  Missouri,
               Nebraska and Wyoming,  for the First  Extended Term (as such term
               is defined  therein) is not  exercised  on the terms set forth in
               such leases,  Lender,  at its election by written notice to Maker
               given on or prior to January 31, 2010,  shall have the right,  in
               its sole  discretion and for any reason or no reason,  to require
               the  Maker to  prepay  this Note in full on  December  31,  2010,
               together  with  interest and the  Make-Whole  Premium,  and other
               charges  accrued and unpaid  hereunder  and/or under the Deeds of
               Trust and the Security Instruments on such monthly payment date.

          (ii) In the event the option to renew those certain  leases  variously
               dated  as  of  May  10,  1996  between  Lender  as  landlord  and
               Marietta/SCC,   Inc.,  Glenwood/SCC,   Inc.,  Dublin/SCC,   Inc.,
               Macon/SCC,  Inc.  and  College  Park/SCC,  Inc.,  each a  Georgia
               corporation  (collectively,  the "SCC Subsidiaries"),  as tenants
               with respect to certain real property,  related  improvements and
               personal property located in Georgia, for the First Extended Term
               (as such term is defined  therein) is not  exercised on the terms
               set forth in such  leases,  Lender,  at its  election  by written
               notice to Maker given on or prior to January 31, 2010, shall have
               the  right,  in its  sole  discretion  and for any  reason  or no
               reason,  to  require  the  Maker to  prepay  this Note in full on
               December  31, 2010,  together  with  interest and the  Make-Whole
               Premium,  and other charges accrued and unpaid  hereunder  and/or
               under  the Deeds of Trust and the  Security  Instruments  on such
               monthly payment date.

     Except as modified  hereby,  all the terms and  conditions  of the Original
Note are hereby  ratified  and  confirmed.  This Allonge may be signed in one or
more counterparts each of which taken together shall constitute one and the same
instrument.


                                       42

<PAGE>



     NON-LIABILITY OF TRUSTEES.  THE DECLARATION OF TRUST  ESTABLISHING  LENDER,
DATED  OCTOBER 9, 1986, A COPY OF WHICH , TOGETHER WITH ALL  AMENDMENTS  THERETO
(THE  "DECLARATION"),  IS DULY  FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND
TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME "HEALTH AND RETIREMENT
PROPERTIES  TRUST" REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS
TRUSTEES,  BUT NOT  INDIVIDUALLY  OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER,
SHAREHOLDER,  EMPLOYEE  OR  AGENT  OF  LENDER  SHALL  BE  HELD  TO ANY  PERSONAL
LIABILITY,  JOINTLY  OR  SEVERALLY,  FOR ANY  OBLIGATION  OF, OR CLAIM  AGAINST,
LENDER.  ALL PERSONS  DEALING  WITH LENDER,  IN ANY WAY,  SHALL LOOK ONLY TO THE
ASSETS  OF  LENDER  FOR  THE  PAYMENT  OF  ANY  SUM OR  THE  PERFORMANCE  OF ANY
OBLIGATION.

     IN  WITNESS  WHEREOF,  and  intending  to  be  legally  bound  hereby,  the
undersigned  has caused this  Allonge to be  executed  under seal by its officer
thereunto duly authorized as of the 16th of July, 1996.


                                            ECA HOLDINGS, INC., a Delaware
Attest:                                     corporation


By: /s/ Fredric H. Aaron                            By: /s/ Tim J. Trybus
    Name:Fredric H. Aaron                               Tim J. Trybus
    Title: Assistant to Secretary                       Vice President

ACCEPTED BY:

HEALTH AND RETIREMENT PROPERTIES TRUST

By: /s/ David J. Hegarty
    David J. Hegarty
    President



                                       43




                 SECOND ALLONGE AND AMENDMENT TO PROMISSORY NOTE


     Reference is made to that certain CCN Group Renovation  Funding  Promissory
Note in the  original  principal  amount of  $2,833,300  dated  April 1, 1995 as
modified by an Allonge  and  Amendment  dated as of May 10, 1996 (the  "Original
Note"),  made by  COMMUNITY  CARE OF  NEBRASKA,  INC.,  a Delaware  corporation,
QUALITY  CARE OF LYONS,  INC.,  a Nebraska  corporation,  W.S.T.  CARE,  INC., a
Nebraska  corporation,  QUALITY CARE OF COLUMBUS,  INC., a Nebraska corporation,
(collectively,   the  "Co-  Makers"),  and  payable  to  HEALTH  AND  RETIREMENT
PROPERTIES  TRUST,  a Maryland real estate  investment  trust  ("Lender").  This
Allonge and Amendment (this "Allonge") shall be and remain attached to and shall
constitute an integral part of the above described  Original Note from and after
the date hereof (the Original Note as modified by this Allonge being hereinafter
referred to as the "Note").  Terms  capitalized but not otherwise defined herein
shall have the meanings given to them, respectively, in the Original Note.

     A. The Original Note is hereby  amended by amending  Paragraph 4 thereof in
     full to read as follows:

          4.   Required  Payments.  Commencing on July 1, 1998 and thereafter on
               the last day of each calendar  month until the Maturity Date, the
               Co-Makers  shall  make  required   monthly   prepayments  of  the
               outstanding principal, together with interest, of this Note in an
               amount  equal to an  amortized  portion of the  principal  amount
               hereof based on a 25-year direct reduction amortization schedule.
               The balance of all amounts advanced as principal  hereunder shall
               be due and payable on the Maturity Date.

     B. The Original Note is hereby  amended by amending  Paragraph 5(a) thereof
     in full to read as follows:

          5.Prepayment.  (a)(i) In the event the option to renew  those  certain
               leases variously dated as of December 30, 1993,  November 1, 1994
               and April 1, 1995,  each as amended,  between  Lender as landlord
               and ECA Holdings,  Inc., a Delaware  corporation,  as tenant with
               respect to certain  real  property  and  improvements  located in
               Colorado,  Kansas, Iowa, Missouri,  Nebraska and Wyoming, for the
               First  Extended  Term (as such term is  defined  therein)  is not
               exercised on the terms set forth in such leases,  Lender,  at its
               election by written notice to the Co-Makers  given on or prior to
               January 31, 2010,  shall have the right,  in its sole  discretion
               and for any  reason or no reason,  to  require  the Co- Makers to
               prepay  this Note in full on December  31,  2010,  together  with
               interest and the Make-Whole  Premium,  and other charges  accrued
               and  unpaid  hereunder  and/or  under  the Deeds of Trust and the
               Security Instruments on such monthly payment date.

          (ii) In the event the option to renew those certain  leases  variously
               dated  as  of  May  10,  1996  between  Lender  as  landlord  and
               Marietta/SCC,   Inc.,  Glenwood/SCC,   Inc.,  Dublin/SCC,   Inc.,
               Macon/SCC,  Inc.  and  College  Park/SCC,  Inc.,  each a  Georgia
               corporation  (collectively,  the "SCC Subsidiaries"),  as tenants
               with respect to certain real property,  related  improvements and
               personal property located in Georgia, for the First Extended Term
               (as such term is defined  therein) is not  exercised on the terms
               set forth in such  leases,  Lender,  at its  election  by written
               notice to the  Co-Makers  given on or prior to January 31,  2010,
               shall have the right,  in its sole  discretion and for any reason
               or no reason,  to require  the Co- Makers to prepay  this Note in
               full  on  December  31,  2010,  together  with  interest  and the
               Make-Whole   Premium,   and  other  charges  accrued  and  unpaid
               hereunder


                                       44

<PAGE>



               and/or under the Deeds of Trust and the Security  Instruments  on
               such monthly payment date.

     Except as modified  hereby,  all the terms and  conditions  of the Original
Note are hereby  ratified  and  confirmed.  This Allonge may be signed in one or
more counterparts each of which taken together shall constitute one and the same
instrument.

     NON-LIABILITY OF TRUSTEES.  THE DECLARATION OF TRUST  ESTABLISHING  LENDER,
DATED  OCTOBER 9, 1986, A COPY OF WHICH,  TOGETHER WITH ALL  AMENDMENTS  THERETO
(THE  "DECLARATION"),  IS DULY  FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND
TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME "HEALTH AND RETIREMENT
PROPERTIES  TRUST" REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS
TRUSTEES,  BUT NOT  INDIVIDUALLY  OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER,
SHAREHOLDER,  EMPLOYEE  OR  AGENT  OF  LENDER  SHALL  BE  HELD  TO ANY  PERSONAL
LIABILITY,  JOINTLY  OR  SEVERALLY,  FOR ANY  OBLIGATION  OF, OR CLAIM  AGAINST,
LENDER.  ALL PERSONS  DEALING  WITH LENDER,  IN ANY WAY,  SHALL LOOK ONLY TO THE
ASSETS  OF  LENDER  FOR  THE  PAYMENT  OF  ANY  SUM OR  THE  PERFORMANCE  OF ANY
OBLIGATION.

     IN  WITNESS  WHEREOF,  and  intending  to  be  legally  bound  hereby,  the
undersigned  has caused this  Allonge to be  executed  under seal by its officer
thereunto duly authorized as of the 16th day of July, 1996.



                                            COMMUNITY CARE OF NEBRASKA, INC.,
Attest:                                     a Delaware corporation

By: /s/ Fredric H. Aaron                By: /s/ Tim J. Trybus
    Name:Fredric H. Aaron                   Tim J. Trybus
    Title: Assistant to Secretary           Vice President

ACCEPTED BY:
HEALTH AND RETIREMENT PROPERTIES TRUST

By: /s/ David J. Hegarty
    David J. Hegarty
    President



                                       45





                                 August 30, 1996




Community Care of America, Inc.
3050 N. Horseshoe Drive, #260
Naples, FL 33942

         Attn.:
         Mr. David Fater

         Chief Financial Officer

Gentlemen:

     During  the  past  few days we have  had  discussions  concerning  plans of
Community Care of America,  Inc. and its subsidiaries  (collectively,  "CCA") to
acquire  certain  hospitals,  to raise  debt or  equity  capital  to fund  those
acquisitions,  and to repay  certain  indebtedness  due  Health  and  Retirement
Properties  Trust ("HRP") and others.  Because of the timing of the  acquisition
expenditures  and the fund raising  activities,  CCA has requested that HRP make
modifications in the existing loan and lease  requirements  between CCA and HRP.
After  considering  these requests and, at your request,  conferring  with CCA's
investment bankers, HRP is willing to make certain modifications to the existing
loan and lease requirements, as follows:

1.   Compliance with the CCA working capital covenant contained in the lease and
     loan documentation will be waived to November 29, 1996.

2.   Payments of interest, principal, rent and charges due from CCA to HRP under
     the loan and lease  documentation  on or about  September  1 and October 1,
     1996 may be deferred to November  29,  1996.  Interest  shall accrue on the
     amount  of all such  deferred  payments  from the date  they are  currently
     contractually  due through the date of their payment at the overdue rate of
     18% per annum.  All such deferred  payments  together with interest thereon
     will be due and payable on the earlier of i) November 29, 1996,  or ii) the
     date CCA completes any debt or equity issuance.

3.   Among  the  obligations  currently  due from CCA to HRP is a  certain  loan
     evidenced  by a note dated as of March 29, 1996 in the  original  principal
     amount  of $10  million.  The  documentation  of this loan  permits  HRP to
     require  prepayments,  together  with a  prepayment  premium,  on or  after
     January 1, 1997, from the prepayment  premium, on or after January 1, 1997,
     from the  proceeds  received  by CCA from  certain  sales of equity or debt
     securities. The terms of this loan are hereby modified as follows:




                                       46

<PAGE>



Community Care of America, Inc.
August 30, 1996
Page 2


     (i)This loan, together with the prepayment  premium,  shall be prepaid from
     the  first  proceeds  of any  equity or debt (or any  combination  thereof)
     issued by CCA after the date hereof.

     (ii)The  prepayment premium is hereby fixed as the greater of i) the amount
     due as of the date of prepayment as calculated under the current  contract;
     or ii) $2,600,000.

4.   All loan and lease  documentation  between CCA and HRP shall remain in full
     force and effect, as specifically  modified hereby, and are hereby ratified
     and  confirmed.  The  modifications  set forth  herein do not  constitute a
     waiver or modification of any term,  condition or covenant of such loan and
     lease documentation other than as expressly set forth herein, and shall not
     prejudice  any  rights  which  HRP may now or  hereafter  have  under or in
     connection with such loan or lease documentation.

5.   CCA acknowledges  that immediately  prior to its acceptance of this letter,
     it is obligated to pay all indebtedness  and obligations  arising under its
     loan and lease documentation with HRP, and that it has no right of set-off,
     counterclaim or defense with respect  thereto.  In  consideration  of HRP's
     agreements  contained herein, CCA does hereby release and forever discharge
     HRP and its affiliates,  officers, directors, agents, attorneys, employees,
     successors  and  assigns,  of and from all  manner  of  actions,  causes of
     action,  suits,  judgments,  claims and  demands  whatsoever,  in law or in
     equity,  which have arisen from the  beginning of time up and including the
     date  hereof,   whether  arising  in  connection   with  the   transactions
     contemplated hereby or by the loan or lease documentation, or otherwise.

6.   THE DECLARATION OF TRUST ESTABLISHING HRP, DATED OCTOBER 9, 1986, A COPY OF
     WHICH,  TOGETHER WITH ALL AMENDMENTS THERETO (THE  "DECLARATION"),  IS DULY
     FILED WITH THE  DEPARTMENT  OF  ASSESSMENTS  AND  TAXATION  OF THE STATE OF
     MARYLAND,  PROVIDES THAT THE NAME "HEALTH AND RETIREMENT  PROPERTIES TRUST"
     REFERS TO THE TRUSTEES UNDER THE DECLARATION  COLLECTIVELY AS TRUSTEES, BUT
     NOT INDIVIDUALLY OR PERSONALLY,  AND THAT NO TRUSTEE,  OFFICER SHAREHOLDER,
     EMPLOYEE OR AGENT OF HRP SHALL BE HELD TO ANY PERSONAL  LIABILITY,  JOINTLY
     OR SEVERALLY,  FOR ANY OBLIGATION  OF, OR CLAIM  AGAINST,  HRP. ALL PERSONS
     DEALING  WITH HRP IN ANY WAY SHALL  LOOK ONLY TO THE  ASSETS OF HRP FOR THE
     PAYMENT OF ANY SUM OR THE PERFORMANCE OF ANY OBLIGATION.





                                       47

<PAGE>



Community Care of America, Inc.
August 30, 1996
Page 3


     The modifications set forth herein shall be effective upon their acceptance
by CCA on or before 5:00 p.m.,  E.D.T.  on Tuesday,  September 3, 1996. If these
modifications  are  acceptable to CCA please sign and return a copy hereof to be
undersigned  via  FAX on  September  3 with  original  via  FEDEX  for  delivery
thereafter.





                                                         Very truly yours,

                                                         /s/ Barry M. Portnoy

                                                         Barry M. Portnoy

                                                         Managing Trustee

ACCEPTED
COMMUNITY CARE OF AMERICA, INC.

By__/s/ Gary Singleton
Gary Singleton
Chief Executive Officer

By__/s/ David H. Fater
David H. Fater
Chief Financial Officer

ECA HOLDINGS, INC.
ECA PROPERTIES, INC.
CCA ACQUISITION I, INC.
MARIETTA/SCC, INC.
GLENWOOD/SCC, INC.
DUBLIN/SCC, INC.
MACON/SCC, INC.
COLLEGE PARK/SCC, INC.
COMMUNITY CARE OF NEBRASKA, INC.
W.S.T. CARE, INC.
QUALITY CARE OF LYONS, INC.
QUALITY CARE OF COLUMBUS, INC.

By:____/s/ David H. Fater
Name:David H. Fater
Title:CFO

By signing above the foregoing  officers  certify that this action has been duly
authorized.



                                       48



                              SETTLEMENT AGREEMENT


     THIS  SETTLEMENT  AGREEMENT  made and  entered  into as of the _27th day of
October,  1996 by and among DAVID L. FRIEDMAN of Boulder,  Colorado,  MICHAEL C.
TYLER,  of Camden,  Maine,  MICHAEL B.  PRIOR,  of  Portland,  Maine,  DANIEL J.
MAGUIRE,  of Harpswell,  Maine (referred to collectively as the  "Individuals");
BIRCH  GROVE  MANAGEMENT  COMPANY,  INC.,  a  Maine  corporation,   CEDAR  RIDGE
MANAGEMENT,  INC.,  a  Maine  corporation,   CEDAR  RIDGE  NURSING  CARE  CENTER
ASSOCIATES, a Maine limited partnership,  HARBOR HILL LIMITED LIABILITY COMPANY,
a Maine limited liability company, HOMEWOOD LIMITED PARTNERSHIP, a Maine limited
partnership,  NURSING  ADMINISTRATORS,  INC.,  a Maine  corporation,  OAK  GROVE
MANAGEMENT COMPANY,  INC., a Maine corporation,  PINE POINT NURSING CARE CENTER,
INC., a Maine  corporation,  RIVERRIDGE  MANAGEMENT,  INC., a Maine corporation,
RIVER RIDGE ASSOCIATES,  a Maine general  partnership,  SANDY RIVER DEVELOPMENT,
INC., a Maine corporation,  SANDY RIVER GROUP, a Maine corporation,  SPRINGBROOK
ASSOCIATES, a Maine general partnership,  SPRINGBROOK MANAGEMENT,  INC., a Maine
corporation,  SRG/HOMEWOOD,  INC., a Maine  corporation,  SRG/WINDWARD  GARDENS,
INC.,  a Maine  corporation,  THE  WILLOWS  MANAGEMENT  COMPANY,  INC.,  a Maine
corporation,  WILSON  STREAM  MANAGEMENT,  INC., a Maine  corporation,  WINDWARD
GARDENS LIMITED PARTNERSHIP, a Maine limited partnership,  WOODFORD PARK NURSING
CARE CENTER,  INC., a Maine  corporation  (collectively  the "SRG Entities") and
SANDY RIVER HEALTH SYSTEM LLC, a Maine limited liability  company,  as agent for
the SRG  Entities  ("SRHS"),  and  COMMUNITY  CARE OF AMERICA,  INC., a Delaware
corporation with its principal place of business in Naples,  Florida ("CCA") and
CCA OF MAINE, INC., a Delaware  corporation with its principal place of business
in Naples,  Florida ("CCA Maine") and CCA acting on behalf of MEDICAL  SUPPLY OF
AMERICA and REHAB AMBASSADORS, such entities being affiliates of CCA

                              W I T N E S S E T H :

     WHEREAS, Leon Bresloff,  Mary Bayer, Richard Boisvert,  Christine Boisvert,
David  Sylvester,  Sara  Sylvester,  Eleanor  Goldberg and D. Wayne Silby,  High
Valley  Group,  Inc.  and Elder  Solutions,  Inc.  (collectively  the  "Minority
Holders") and the Individuals  entered into a certain  Purchase Option Agreement
with CCA and CCA Maine dated June 23, 1995 (the "Option Agreement"); and

     WHEREAS, CCA Maine entered into ten Management  Agreements,  all dated June
23, 1995,  with certain of the  Individuals and of the SRG Entities with respect
to Woodford Park Nursing Care Center, Pine Point Nursing Care Center,  Marshwood
Nursing Care Center,  RiverRidge,  Springbrook Nursing Care Center,  Sandy River
Nursing Care Center, Cedar Ridge Nursing Care Center,  Sedgewood Commons, Harbor
Hill and  Windward  Gardens,  all  nursing  homes  owned by  certain  of the SRG
Entities,  as well as a letter of intent  dated  August 14, 1995 with respect to
The Willows,  Oak Grove and Birch Grove  (collectively the  "Facilities")  (such
Management  Agreements are referred to  collectively  herein as the  "Management
Agreements"); and

     WHEREAS,  CCA Maine sent the SRG Entities a written notice on July 14, 1996
stating its intention to terminate the Management Agreements; and

     WHEREAS,  CCA and/or CCA Maine have entered into a number of other  written
agreements  with  certain  of  the  Individuals,  Minority  Holders  and/or  SRG
Entities,  more  particularly  described on Exhibit A attached hereto and made a
part hereof (collectively the "Miscellaneous Agreements"); and

     WHEREAS,  certain of the SRG Entities  commenced  suit,  for injunctive and
other relief, in


                                       49

<PAGE>



Superior  Court,  Androscoggin  County,  in a  civil  action  captioned  Nursing
Administrators,  Inc. v.  Community  Care of America,  Inc., et al.,  Docket No.
CV-96-____ (the "Lawsuit"); and

     WHEREAS,  the parties to this Agreement have determined that it is in their
mutual best interests to terminate the Management Agreements,  modify the Option
Agreement and terminate or continue certain of the Miscellaneous  Agreements and
to enter into a comprehensive  financial settlement of their mutual obligations,
all on the terms and conditions set forth in this Agreement; and

     WHEREAS, as part of the consideration for this settlement, SRHS is assuming
the obligation to settle any claims owed by CCA to the SRG Entities;

     NOW THEREFORE,  for valuable consideration,  the receipt and sufficiency of
which are hereby acknowledged, the parties agree as follows:

     Termination of Management  Agreements.  Subject to the terms and conditions
of this  Agreement,  the  Management  Agreements  and the letter of intent dated
August 14,  1995 with  respect to Birch  Grove,  Oak Grove and The  Willows  are
hereby  terminated  effective the date of this Agreement.  At the closing of the
settlement  described  in this  Agreement,  CCA Maine  shall  assign to SRHS all
accrued, unpaid management fees under the Management Agreements by assignment in
form and substance similar to that attached hereto as Exhibit B.

     Limited Continuation of Option Agreement.  The time during which the option
granted by the Option  Agreement may be  exercised,  as provided in Section 3 of
the  Option  Agreement,  is hereby  made to expire at the close of  business  on
January  2, 1997.  In the event CCA Maine  exercises  the option  granted in the
Option  Agreement  pursuant  to the terms of the Option  Agreement  on or before
January 2, 1997, and  notwithstanding  anything to the contrary contained in the
Option  Agreement,  CCA of Maine (a) shall pay as an  additional  non-refundable
deposit  $480,000  as a  condition  of, and at the time of,  such  exercise,  in
immediately available funds paid by wire transfer to SRHS as agent and (b) shall
have a period of 30 days after exercise,  subject to the next sentence, in which
to  close on its  purchase  of the  Facilities.  In no event  shall  the  Option
Agreement  extend  beyond 5:00 PM February 3, 1997,  even if the option has been
exercised.  The Option Agreement shall be deemed modified by this Section and by
other provisions of this Agreement specifically amending,  changing or modifying
the Option Agreement. The Option Agreement shall be construed together with this
Agreement,  and to the extent there are any  inconsistencies  between the Option
Agreement and this Agreement, this Agreement shall be controlling.

     Miscellaneous Agreements. Exhibit A attached hereto identifies those of the
Miscellaneous Agreements which shall survive and those which shall be terminated
effective as of the date of this Agreement. As to those Miscellaneous Agreements
listed on Exhibit A that are to terminate  effective the date of this Agreement,
neither party shall have further liability to the other. CCA and CCA Maine agree
that they shall  continue to perform their  respective  obligations  under those
Miscellaneous  Agreements  that shall  survive  the  closing  of the  settlement
described in this  Agreement.  SRHS shall be responsible  for and shall have the
benefit of all cost  reports  and  exceptions  to the Routine  Cost  Limitations
("RCLs").  CCA  Maine  shall  send all work  relating  to 1995  Medicare  RCLs ,
including all work papers,  diskettes and other materials to SRHS and SRHS shall
complete the 1995 Medicare RCLs. In addition,  any other agreements  between CCA
and/or  CCA Maine and Leon  Bresloff  and Mary  Bayer are not  affected  by this
Agreement.

     Offset of Claims. In consideration of CCA and CCA Maine waiving,  canceling
and  forgiving  all amounts due  (including  any  interest  accrued  thereon) by
certain of the SRG Entities with respect to the Facilities and more particularly
described on Exhibit C attached hereto and made a part hereof  (collectively the
"Working Capital Lines"),  the SRG Entities and the Individuals,  for themselves
and their successors and assigns, hereby forever waive and relinquish


                                       50

<PAGE>



all claims against CCA and CCA Maine asserted in the Lawsuit,  but not including
those  obligations  of CCA and  CCA  Maine  undertaken,  continued  or  modified
pursuant  to this  Agreement.  In  consideration  of the  foregoing  waiver  and
relinquishment  by certain of the SRG Entities of all claims against CCA and CCA
Maine asserted in the Lawsuit,  but not including  those  obligations of CCA and
CCA Maine undertaken,  continued or modified pursuant to this Agreement, CCA and
CCA Maine,  for  themselves and their  successors and assigns,  do hereby waive,
cancel and forgive all amounts due under the Working  Capital  Lines  (including
any interest accrued  thereon).  Upon executing this Settlement  Agreement,  CCA
Maine hereby  authorizes and directs its attorney John P. Doyle,  Jr. to execute
and to deliver to those SRG  Entities  that are  liable on the  Working  Capital
Lines  discharges  and  UCC-3   terminations  of  all  mortgages  and  financing
statements  securing the Working Capital Lines.  CCA and CCA Maine shall deliver
the original Working Capital Line promissory notes to SRHS as agent marked "paid
in full." CCA and CCA Maine shall  provide  such  evidence  as the SRG  Entities
shall request  showing that  NationsBank of Florida,  N.A., has consented to the
cancellation  of the Working  Capital Lines and the return of the collateral for
the same.

     Modification   of  Stock  Options  and  Put  Option  with  Respect  to  the
Individuals and Minority Holders.


     (a)  With  respect  to the  rights  granted  by CCA  and CCA  Maine  to the
          Individuals  to  acquire  shares  of common  stock of CCA (the  "Stock
          Options") in and  pursuant to those  certain  Stock Option  Agreements
          between  each  of  the  Individuals  and  CCA  dated  July  11,  1995,
          (collectively the "Stock Option Agreements"),  and notwithstanding any
          provisions in the Stock Option Agreements to the contrary dealing with
          the vesting of the Stock Options,  CCA and CCA Maine agree that all of
          the shares of the common  stock of CCA  subject to the Stock  Options,
          for a total of twenty thousand (20,000) shares,  are as of the date of
          this Agreement fully vested with respect to the Stock Options, and, as
          to such twenty thousand  (20,000)  shares,  the Stock Options shall be
          nonforfeitable  and  immediately   exercisable,   and,  upon  exercise
          thereof, all stock so acquired shall be freely tradeable.


     (b)  With respect to the rights  granted by CCA and CCA Maine under Section
          9(j) of the Option  Agreement  to require the purchase of common stock
          of CCA previously  issued to each of the  Individuals and the Minority
          Holders in  connection  with the payment of the deposit  under Section
          8(a) of the Option Agreement (the "Put Option") covering the shares of
          CCA  common  stock  held by the  Individuals,  such Put  Option  shall
          continue in full force and effect,  as modified by this  Section,  and
          CCA hereby  agrees that it is liable  with  respect to the Put Option.
          Without  regard to any  limitations as to percentages of such stock to
          be put or as to dates for such puts, all shares of stock under the Put
          Option are hereby  exercised and CCA  acknowledges  and agrees to such
          exercise.  The Individuals agree they shall not demand payment for the
          stock hereby put to CCA until the earlier to occur of (i) February 28,
          1997 or (ii) the sale of all or substantially all of the assets of CCA
          or the sale of a  majority  of the issued  and  outstanding  shares of
          stock  of CCA to a third  party,  or the  merger  of CCA  with or into
          another  entity,  or any similar type of  transaction  (each,  a "Sale
          Transaction").  If the sale of CCA is structured as a  stock-for-stock
          transaction,  the  Individuals  and Minority  Holders  hereby agree to
          accept, in lieu of cash, shares of stock in the acquiring entity in an
          amount that results in the Individuals and Minority Holders  receiving
          stock in the acquiring entity of a market value on the date of closing
          equal to the value of the  shares in CCA held by the  Individuals  and
          Minority Holders at the price under the Put Option,  and provided that
          the stock of the  acquiring  entity  is fully  registered  and  freely
          tradeable upon issuance to the Individuals and Minority Holders.

     Continuation  and Extension of Put Rights with Respect to Maine Head Trauma
Center.  The put  options  granted  to the  Individuals  in the  Stock  Purchase
Agreement (the "MHTC Agreement") among CCA, CCA Maine, Maine Head Trauma Center,
Inc. and the Individuals


                                       51

<PAGE>



and others dated as of November 1, 1995 (the "MHTC Put Options")  shall continue
in full force and effect,  and the dates contained in Section 2.1(j) of the MHTC
Agreement  governing  the  period  during  which  the  MHTC Put  Options  may be
exercised  are hereby  changed as follows:  The shares  subject to the First Put
Period (as defined in the MHTC  Agreement) and the Second Put Period (as defined
in the MHTC  Agreement) are hereby  exercised and shall be paid at the same time
as those  Put  Option  rights  set  forth in  Section  5(b)  above  and the MHTC
Agreement shall be deemed to be amended accordingly.  The Put Option price shall
be as provided in the MHTC Agreement.

     Appointment of Agent with Respect to Put Option.  The holders of the rights
described in Sections 5 and 6 above hereby irrevocably  appoint James N. Broder,
Esquire,  Curtis Thaxter Stevens Broder & Micoleau,  One Canal Plaza,  Portland,
Maine 04412 as agent to hold the shares of stock to be tendered under Sections 5
and 6 and to deliver  the  certificates  evidencing  said  shares upon tender of
payment as required  hereunder.  In the event CCA fails to make payment of or to
otherwise  perform under this  Agreement,  CCA agrees that such holders shall be
entitled  to  recover  from CCA their  reasonable  legal  fees and  expenses  in
addition  to any other  damages  incurred by reason of CCA's said  failure.  CCA
waives any  conflict of interest  arising  from Mr.  Broder's  serving as escrow
agent under this Section and releases Mr. Broder from all  liability  except for
that arising from his intentional tortious acts.

     Additional   Consideration  for  Settlement.   The  consideration  for  the
Settlement  described  herein shall be the mutual offset  described in Section 4
above.  In  addition,  CCA and CCA Maine agree  jointly and  severally to pay to
SRHS,  as agent for the SRG Entities  and the  Individuals,  including,  without
limitation,   David  L.  Friedman,  without  offset  or  deduction,  $50,000  in
immediately available funds, as follows: $25,000 on or before November 15, 1996,
and  $25,000  on the  earlier to occur of (i)  February  28,  1997,  or (ii) the
closing of a Sale  Transaction,  in payment of legal fees and  expenses  paid or
accrued by the SRG Entities and the  Individuals,  including  David L. Friedman,
between September 15, 1996 and the closing of this Agreement.


     Rehab Ambassadors.  CCA represents and warrants to the SRG Entities and the
Individuals  that One Hundred Twenty Thousand Dollars  ($120,000.00)  previously
paid to CCA in July or August  1996 was  applied on that date to the  account of
Rehab  Ambassadors,  an affiliate of CCA. Provided the $120,000 payment was made
to Rehab Ambassadors, the SRG Entities agree that they shall continue to use the
services of Rehab Ambassadors, except that the SRG Entities shall have the right
to  terminate  Rehab  Ambassadors  severally  on  thirty  (30) days  notice.  In
addition,  Rehab  Ambassadors  will be treated the same as other trade payables,
i.e.,  shall be paid no sooner or later than any other  accounts  payable of the
SRG Entities.  The amounts owing to Rehab  Ambassadors as of August 31, 1996 are
as  shown  on  Exhibit  D  hereto  and are  hereby  confirmed  by CCA and  Rehab
Ambassadors.

     Office  Lease.  SRHS shall enter into a Sublease with CCA Maine in form and
substance similar to that attached hereto as Exhibit E. The rent payable by SRHS
shall be the rent  payable by CCA Maine to Dead River  Properties,  the Landlord
under the Lease.  The Sublease shall be for an initial term expiring on February
14, 1997 with the right to extend for  additional  six month terms.  CCA and CCA
Maine acknowledge that all furniture,  fixtures, machinery and equipment located
on the  premises  described  in the  Sublease  belong  to SRHS.  Any  additions,
accessions,   modifications  or  substitutions  to  such  equipment  are  hereby
transferred, sold and conveyed to SRHS.

     Continuation  of Workers  Compensation  Program.  The SRG Entities agree to
continue utilizing the workers  compensation  program currently covering the SRG
Entities' employees until the end of the current policy term, which is March 31,
1997.



                                       52

<PAGE>



     No  Amounts  Owed to  Medical  Supply.  CCA and CCA Maine  acknowledge  and
confirm that none of the SRG Entities and none of the Individuals  owes any sums
whatsoever to Medical Supply of America, an affiliate of CCA.

     Representations  and  Warranties  of CCA and CCA  Maine.  CCA and CCA Maine
jointly and  severally  warrant and  represent  to the  Individuals  and the SRG
Entities as follows:

     a.   Each of CCA and CCA Maine is a  validly  created  corporation  in good
          standing  under the laws of Delaware  and has been  authorized  by all
          necessary  corporate  action to execute and deliver this Agreement and
          to complete the transactions  described  herein.  Certified  corporate
          resolutions  to that effect will be delivered to SRHS within 5 days of
          execution of this Agreement.

     b.   Neither  CCA nor CCA Maine is  required  to obtain the  consent of any
          party in order  to  enter  into  this  Agreement  and to  perform  its
          respective obligations hereunder.

     c.   Except for the Lawsuit,  there is no litigation pending or threatened,
          nor any proceeding  before any other court or tribunal  either pending
          or  threatened  against  CCA or CCA Maine  that  would have a material
          adverse  effect  upon  the  performance  by CCA or CCA  Maine of their
          respective obligations under this Agreement.

     d.   Except for an assignment in favor of NationsBank of Florida, N.A., CCA
          Maine is the holder of the promissory notes, security agreements,  and
          all other documents and instruments evidencing or securing the Working
          Capital  Lines,  has not assigned or transferred  the Working  Capital
          Lines,  and has the  right  to  discharge  and  terminate  the same as
          required by the terms of this  Agreement.  NationsBank of Florida N.A.
          has consented to the terms of this Settlement Agreement.

     Representations  and  Warranties  by the SRG  Entities.  The  SRG  Entities
jointly and severally warrant to CCA and CCA Maine as follows:

     a.   Each of the SRG  Entities is a validly  created  corporation,  general
          partnership,  limited partnership or limited liability company, as the
          case may be,  in good  standing  under  the laws of Maine and has been
          authorized  by all necessary  corporate  action to execute and deliver
          this Agreement and to complete the transactions described herein.

     b.   None of the SRG  Entities  is  required  to obtain the  consent of any
          party in order  to  enter  into  this  Agreement  and to  perform  its
          respective obligations hereunder.

     c.   Except for the Lawsuit,  there is no litigation pending or threatened,
          nor any proceeding  before any other court or tribunal  either pending
          or  threatened  against  any of the SRG  Entities  that  would  have a
          material  adverse  affect upon the  performance by the SRG Entities of
          their respective obligations under this Agreement.

     Indemnification  by CCA and CCA of  Maine.  CCA and CCA  Maine,  and  their
respective  successors  and assigns,  shall jointly and severally  indemnify and
defend the SRG  Entities,  the  Individuals,  and their  respective  successors,
assigns,  heirs  and  personal  representatives  from  and  against  any and all
liability,  costs, damages, and claims arising from or in any way related to (i)
all claims,  demands and liabilities by or in favor of Rehab Ambassadors arising
from or in any way  related to the  $120,000  payment  referred  to in Section 9
above,  including  whether or not such  payment  was in fact  received  by Rehab
Ambassadors, (ii) all claims, demands and liabilities (including fines) that may
be imposed upon or asserted  against the SRG  Entities by reason of  operational
matters within the Facilities  arising from actions or omissions of CCA Maine or
any affiliates  between August 15, 1995 and August 14, 1996 and (iii) any breach
of the  representations  and warranties set forth in Section 13 above.  Upon the
happening of any event  covered by this  indemnity,  CCA and CCA Maine shall pay
the amount of such loss upon


                                       53

<PAGE>



demand.  This indemnity shall also cover all costs associated with collection or
enforcement  of this  indemnity,  including  reasonable  attorneys'  fees.  This
indemnity  shall continue in full force and effect for a period of six (6) years
from the closing of this settlement.

     Indemnification  by SRG  Entities.  The SRG Entities  and their  respective
successors  and assigns,  shall jointly and severally  indemnify and defend CCA,
CCA Maine, and their respective successors and assigns, from and against any and
all liability,  costs, damages, and claims arising from or in any way related to
(i) any breach of the  representations  and  warranties  set forth in Section 14
above,  and (ii) any claims by the Minority  Holders arising from the settlement
described in this  Agreement,  except with respect to continuing  obligations of
CCA or CCA Maine to certain of the Minority  Holders as described in Sections 3,
5 and 6 above.  This  indemnity  shall  also  cover  all costs  associated  with
collection or enforcement of this  indemnity,  including  reasonable  attorneys'
fees. This indemnity shall continue in full force and effect for a period of six
(6) years from the closing of this settlement.

     Closing.  The closing of the settlement  described in this Agreement  shall
take place on October 27, 1996. At the closing:

     a.   CCA shall  execute and deliver  original  termination  statements  and
          mortgage  discharges  releasing  all of the  mortgages  and all of the
          UCC-1 financing statements covering the Facilities, in form for proper
          recording and filing at the appropriate public office.

     b.   CCA Maine shall  execute and deliver the  Assignment  with  respect to
          unpaid  management  fees,  the  form of which is  attached  hereto  as
          Exhibit B.

     c.   CCA Maine and SRHS shall  execute the  Sublease,  the form of which is
          attached hereto as Exhibit E.

     d.   The parties shall execute such other and further documents as shall be
          necessary to complete the settlement described in this Agreement.

     Release by CCA and CCA of Maine.  CCA and CCA of Maine,  for themselves and
their  respective  successors and assigns,  hereby  remise,  release and forever
discharge  and, by these  presents,  do, for themselves and for their agents and
representatives,  hereby remise, release and forever discharge the SRG Entities,
the  Individuals  and the Facilities  and their  respective  heirs,  successors,
agents, attorneys,  personal representatives and assigns of and from all claims,
debts, demands, actions, causes of action, covenants, contracts,  controversies,
agreements, promises, doings, omissions, variances, damages, executions, claims,
rights, liabilities,  suits, dues, sums and sums of money, accounts, reckonings,
presentments,  liens and any other claim of whatsoever  kind or nature,  whether
known or  unknown,  of every  name and  nature,  either  at law or in  equity or
otherwise,  which CCA and CCA Maine,  or either of them,  ever had,  now have or
which may result in the future from the  existing or past state of things,  from
the  beginning  of time to the date of  closing  specified  in Section 17 above,
arising from, or in any way relating to, the Management  Agreements,  the Option
Agreement (except as provided below), and those Miscellaneous  Agreements listed
on  Exhibit  A  attached  hereto  that are  being  terminated  pursuant  to this
Agreement,  as well as the Lawsuit. This release shall not cover or apply to any
obligations  of the  SRG  Entities  or the  Individuals  under  this  Agreement,
including, without limitation, the indemnities set forth in Section 16 above, or
under the Option  Agreement as it has been  modified by this  Agreement,  all of
which obligations shall continue in full force and effect.

     Release by the  Individuals  and the SRG Entities.  The Individuals and the
SRG Entities, for themselves and their respective heirs, successors and assigns,
hereby remise,  release and forever  discharge and, by these  presents,  do, for
themselves and for their agents and representatives,  hereby remise, release and
forever  discharge CCA and CCA Maine and their respective  successors,  assigns,
agents and attorneys of and from all claims, debts, demands, actions, causes


                                       54

<PAGE>



of action, covenants, contracts,  controversies,  agreements,  promises, doings,
omissions,  variances, damages, executions, claims, rights, liabilities,  suits,
dues, sums and sums of money, accounts, reckonings,  presentments, liens and any
other claim of whatsoever  kind or nature,  whether  known or unknown,  of every
name and nature, either at law or in equity or otherwise,  which the Individuals
and the SRG Entities,  or any of them, ever had, now have or which may result in
the future from the existing or past state of things, from the beginning of time
to the date of closing  specified in Section 17 above,  arising  from, or in any
way relating to, the  Management  Agreements,  the Option  Agreement  (except as
provided below), and those Miscellaneous Agreements listed on Exhibit A attached
hereto  that are being  terminated  pursuant to this  Agreement,  as well as the
Lawsuit.  This release shall not cover or apply to (i) any obligations of CCA or
CCA Maine under this Agreement,  including,  without limitation, the indemnities
set forth in  Section  15 above and under the  Option  Agreement,  Stock  Option
Agreement and MHTC Agreement, as they have been modified by this Agreement,  all
of which  obligations  shall  continue in full force and effect,  or to (ii) any
liability of CCA or CCA Maine arising from  operation of the  Facilities,  other
than the third party reimbursement or other financial obligations that have been
addressed by this Agreement.  The parties' intent is that this release shall not
cover  obligations  owed by CCA and CCA Maine as  Manager to  patients  and with
respect to day-to-day operations of the Facilities.

     Further  Assurances.  The parties to this  Agreement  agree that they shall
perform all such further  acts and execute all such further  documents as may be
necessary  or required in order to complete the  transactions  described in this
Agreement.

     Miscellaneous. Time is of the essence. This Agreement sets forth the entire
Agreement of the parties and supersedes all prior agreements and understandings,
whether  oral or written.  No  modification  or waiver of any  provision of this
Agreement shall be effective unless the same shall be in writing and executed by
all parties hereto. All notices,  demands,  and other  communications under this
Agreement shall be in writing and shall be deemed to have been duly given to the
recipient if mailed by certified  mail,  postage-prepaid,  or if by sent by hand
delivery or by reputable overnight delivery service, address to the recipient at
the following addresses:

If to CCA and CCA Maine:
      3050 North Horseshoe Drive
      Suite 260
      Naples, Florida  33942
with a copy to:
      Michael Blass, Esquire
      Blass & Driggs
      461 Fifth Avenue, 19th Floor
      New York, New York 10017

If to any of the SRG Entities or Individuals:
      c/o Sandy River Development
      183 Middle Street
      P.O. Box 110
      Portland, Maine  04112

with a copy to:
      James N. Broder, Esquire
      Curtis Thaxter Stevens Broder & Micoleau LLC
      One Canal Plaza--P.O. Box 7320
      Portland, Maine 04112

Any party may change addresses by providing written notice of such change to the
other parties hereto. All  representations and warranties made by the parties in
this Agreement shall survive


                                       55

<PAGE>



the delivery of this  Agreement  shall  continue in full force and effect.  This
Agreement  shall be binding  upon and shall inure the benefit of the parties and
their respective successors,  assigns, heirs and personal representatives.  This
Agreement may be executed in any number of counterparts,  each of which shall be
deemed an original,  but all of which together shall constitute one and the same
instrument.  The  representations,   warranties  and  indemnities  contained  in
Sections 13, 14, 15 and 16 of this  Agreement  shall  survive the closing of the
settlement described herein. This Agreement shall be construed under the laws of
the State of Maine.  Section headings used in this Agreement are for convenience
only and shall not affect the construction of this Agreement.

     IN WITNESS  WHEREOF,  the parties have caused this Agreement to be executed
as of the day and year first written above.

WITNESS:


                                          COMMUNITY CARE OF AMERICA, INC.
_________________________________         By:/s/Michael Blass
                                          Name: Michael Blass
                                          Title:Director

                                          CCA OF MAINE, INC.
_________________________________         By:/s/Michael Blass
                                          Name: Michael Blass
                                          Title:Director

                                          MEDICAL SUPPLY OF AMERICA
                                          BY: COMMUNITY CARE OF AMERICA, INC.,
                                          By its duly authorized agent
_________________________________         By:/s/Michael Blas
                                          Name: Michael Blass
                                          Title:Director

                                          REHAB AMBASSADORS
                                          BY: COMMUNITY CARE OFAMERICA, INC.,
                                          its duly authorized agent
_________________________________         By:/s/Michael Blass
                                          Name: Michael Blass
                                          Title:Director

                                          CEDAR RIDGE MANAGEMENT, INC.
________________________________          By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          BIRCH GROVE MANAGEMENT COMPANY, INC.

_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          CEDAR RIDGE NURSING CARE
                                          CENTER ASSOCIATES
                                          BY: SANDY RIVER GROUP, its
                                          General Partner
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President


                                       56

<PAGE>



                                          HARBOR HILL LIMITED LIABILITY COMPANY
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          HOMEWOOD LIMITED PARTNERSHIP
                                          BY:SEDGEWOOD LIMITED LIABILITY
                                          COMPANY, its General Partner
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          NURSING ADMINISTRATORS, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          OAK GROVE MANAGEMENT COMPANY, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          PINE POINT NURSING CARE CENTER,INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          RIVER RIDGE MANAGEMENT, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          RIVER RIDGE ASSOCIATES
                                          BY:SANDY RIVER GROUP, its
                                          General Partner
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SANDY RIVER DEVELOPMENT, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SANDY RIVER GROUP
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SPRINGBROOK ASSOCIATES
                                          BY:SANDY RIVER GROUP, its
                                          General Partner
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SPRINGBROOK MANAGEMENT, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SRG/HOMEWOOD, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President


                                       57

<PAGE>



                                          SRG/WINDWARD GARDENS, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          THE WILLOWS MANAGEMENT COMPANY, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          WILSON STREAM MANAGEMENT, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          WINDWARD GARDENS LIMITED
                                          PARTNERSHIP
                                          BY:WINDWARD GARDENS LIMITED
                                          LIABILITY COMPANY, its General Partner
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          WOODFORD PARK NURSING CARE
                                          CENTER, INC.
_________________________________         By:_/s/David L. Friedman
                                          David L. Friedman, its President

                                          SANDY RIVER HEALTH SYSTEM LLC
_________________________________         By:/s/David L. Friedman
                                          David L. Friedman, its President

_________________________________         /s/David L. Friedman
                                          David L. Friedman

________________________________          /s/ Michael C. Tyler
                                          Michael C. Tyler

________________________________          /s/ Michael B. Prior
                                          Michael B. Prior

_______________________________           /s/ Daniel J. Maguire
                                          Daniel J. Maguire





                                       58

<PAGE>




                                 LIMITED JOINDER

The undersigned, being all of the Minority Holders identified above, hereby join
in this  Settlement  Agreement for the purpose of agreeing to the  provisions of
Sections 5(b), 6 and 7 above, as applicable.

WITNESS:
________________________________          /s/ Leon Bresloff
                                          Leon Bresloff

_________________________________         /s/ Mary Bayer
                                          Mary Bayer

________________________________          /s/ D. Wayne Silby
                                          D. Wayne Silby

________________________________          /s/ Richard Boisvert
                                          Richard Boisvert

________________________________          /s/ Christine Boisvert
                                          Christine Boisvert

_________________________________         /s/ Eleanor Goldberg
                                          Eleanor Goldberg

_________________________________         /s/ David Sylvester
                                          David Sylvester

_________________________________         /s/ Sarah Sylvester
                                          Sarah Sylvester

                                          HIGH VALLEY GROUP, INC.
_________________________________         By:______________________________

                                          ELDER SOLUTIONS, INC.
_________________________________         By:______________________________

_________________________________         /s/ Anne Hess
                                          Anne Hess

_________________________________         /s/ Terri-Lee Brown
                                          Terri-Lee Brown

_________________________________         /s/ Judith Smith
                                          Judith Smith

_________________________________         /s/ Robert Gass
                                          Robert Gass

_________________________________         /s/ Marc Sarkady
                                          Marc Sarkady

_________________________________         /s/ Peter Troast
                                          Peter Troast


                                       59

<PAGE>



                     SETTLEMENT AGREEMENT--LIST OF EXHIBITS


Exhibit A:        Miscellaneous Agreements.
Exhibit B:        Form of Assignment of unpaid management fees.
Exhibit C:        List of Working Capital Lines.
Exhibit D:        Rehab Ambassadors Payables.
Exhibit E:        Form of Sublease.








                                       60

<PAGE>



                                    EXHIBIT A

                            MISCELLANEOUS AGREEMENTS


MISCELLANEOUS AGREEMENTS BEING TERMINATED:


     1.   Side letter to David L. Friedman from CCA and CCA Maine dated June 23,
          1995 re depreciation recapture.

     2.   Side letter  between  Harbor Hill  Limited  Liability  Company and CCA
          dated June 23, 1995, as amended, re Harbor Hill start-up.

     3.   Side letter  between CCA and David L. Friedman  dated June 23, 1995 re
          automobile leases.

     4.   Consulting  Agreement  dated July 10, 1995 between CCA and Sandy River
          Development, Inc.

     5.   Services  Agreement  dated June 23,  1995  between CCA Maine and Sandy
          River Development, Inc.

     6.   Development  Agreement  term sheet dated June 30, 1995 between CCA and
          Sandy River Development, Inc.

     7.   Replacement  Promissory  Note  in the  original  principal  amount  of
          $21,846.61 dated July 12, 1991 made by River ridge Management, Inc. in
          favor of Amethyst E.G.  Mountfort  Revocable Trust and endorsed to CCA
          Maine.

     8.   Replacement  Promissory  Note  in the  original  principal  amount  of
          $21,704.31 dated August 6, 1991 made by River ridge  Management,  Inc.
          in favor of Amethyst E.G.  Mountfort  Revocable  Trust and endorsed to
          CCA Maine.

     9.   Replacement  Promissory  Note  in the  original  principal  amount  of
          $14,470.20 dated August 2, 1991 made by River ridge  Management,  Inc.
          in favor of Christine Boisvert and endorsed to CCA Maine.

     10.  Replacement  Promissory  Note  in the  original  principal  amount  of
          $14,564.40 dated July 15, 1991 made by River ridge Management, Inc. in
          favor of Christine Boisvert and endorsed to CCA Maine.

     11.  Replacement Promissory Note in the original principal amount of $8,000
          dated August 4, 1992 made by River ridge Management,  Inc. in favor of
          Christine Boisvert and endorsed to CCA Maine.

     12.  Replacement  Promissory  Note  in the  original  principal  amount  of
          $12,000 dated August 7, 1992 made by River ridge  Management,  Inc. in
          favor of David L. Friedman and endorsed to CCA Maine.

     13.  Side letter to David Fater from David  Friedman  dated August 10, 1995
          re Owner Entities' working capital loans.

     14.  Non-Competition  Agreements  of various  dates  between  CCA Maine and
          Richard  Boisvert  and  Christine  Boisvert,  Sara  Sylvester,   David
          Sylvester, Eleanor Goldberg, David


                                       61

<PAGE>



Friedman,   Michael  Tyler,  Michael  Prior,  Daniel  Maguire  and  Sandy  River
Development, Inc.


MISCELLANEOUS AGREEMENTS CONTINUING IN FULL FORCE AND EFFECT:


     1.   The MHTC  Agreement  and all  documents  and  instruments  executed in
          connection therewith, as modified by this Agreement.

     2.   The Stock Options, as modified by this Agreement.





                                       62

<PAGE>



                                    EXHIBIT B

                                   ASSIGNMENT


     KNOW ALL PERSONS BY THESE  PRESENTS,  that CCA OF MAINE,  INC.,  a Delaware
corporation with a place of business in Naples,  Florida (the  "Assignor"),  for
valuable  consideration,   the  receipt  and  sufficiency  of  which  is  hereby
acknowledged, hereby grants, transfers, assigns, sets over and delivers to SANDY
RIVER  HEALTH  SYSTEM LLC, a Maine  limited  liability  company  with a place of
business in Portland,  Maine (the  "Assignee"),  all accrued,  unpaid management
fees due to assignor under those certain  Management  Agreements  dated June 23,
1995 with Assignor as manager with respect to Woodford Park Nursing Care Center,
Pine Point  Nursing Care  Center,  Marshwood  Nursing  Care Center,  RiverRidge,
Springbrook  Nursing Care Center,  Sandy River Nursing Care Center,  Cedar Ridge
Nursing Care Center, Sedgewood Commons, Harbor Hill and Windward Gardens.

     This Assignment is the assignment  referred to in Section 1 of that certain
Settlement Agreement by and among Assignor, Assignee and others. This Assignment
is  subject  to  and  shall  be  construed  consistently  with  such  Settlement
Agreement.

     IN WITNESS  WHEREOF,  CCA of Maine,  Inc. has caused this  Assignment to be
executed by _____________________________,  its ________________, thereunto duly
authorized, this _27____ day of October, 1996.

WITNESS:                                             CCA OF MAINE, INC.
________________________________                     By:/s/ Michael Blass
                                                     Its:Director
                                                     Print Name: Michael Blass






                                       63

<PAGE>



                                    EXHIBIT C

                          LIST OF WORKING CAPITAL LINES



                                                        OUTSTANDING LINE AMOUNT
         NAME OF FACILITY             FACE AMOUNT OF     AS OF August 14, 1996
         ----------------             --------------     ---------------------



Windward Gardens Limited Partnership      $145,000                  $
Revolver
Windward Gardens Term Note                $200,000                  $
Homewood Limited Partnership Revolver     $450,000                  $
Nursing Administrators, Inc. Revolver     $325,000                  $
Springbrook Management Revolver           $350,000                  $      *
RiverRidge Management Revolver            $570,000                  $      *
Cedar Ridge Management Revolver           $225,000                  $      *
Pine Point Nursing Care Center, Inc.      $150,000                  $
Revolver
Wilson Stream Management Revolver         $200,000                  $
Woodford Park Nursing Care Center, Inc.   $300,000                  $
Revolver


* Includes  principal  amount of SRG land loans with respect to land adjacent to
these Facilities.

To be agreed upon




                                       64

<PAGE>



                                    EXHIBIT D

                                     SUMMARY

                             ACCOUNTS PAYABLE DUE TO
                                REHAB AMBASSADORS
                              AS OF AUGUST 31, 1996


Sandy River Nursing Care Center                                        $

Marshwood Nursing Care Center                                          $

Springbrook Nursing Care Center                                        $

Pine Point Nursing Care Center                                         $

Woodford Park Nursing Care Center                                      $

                                     TOTAL:                            $

To be agreed upon.





                                       65

<PAGE>



                                    EXHIBIT E
                                    SUBLEASE

     SUBLEASE  made this  __27____ day of October,  1996,  by and between CCA OF
MAINE, INC., a Delaware corporation with a place of business in Portland,  Maine
("Landlord")  and SANDY  RIVER  HEALTH  SYSTEM  LLC, a Maine  limited  liability
company with a place of business in Portland, Maine ("Tenant")

                              W I T N E S S E T H:

     WHEREAS,  Landlord is tenant  under that certain  Lease dated  November 14,
1995 (the  "Prime  Lease")  with Dead River  Company,  acting by and through its
division, Dead River Properties, as Landlord (the "Prime Landlord") with respect
to approximately  3,838 square feet of office space in Prime Landlord's building
known as  Atlantic  Place and located at Darling  Avenue and Foden  Road,  South
Portland, Maine; and

     WHEREAS,  Landlord  wishes to sublease  such space to Tenant upon the terms
and conditions contained in this Sublease and in the Prime Lease;

     NOW, THEREFORE, for valuable consideration,  the receipt and sufficiency of
which are hereby acknowledged, the parties agree as follows:

     1.   Premises Subleased.Landlord  subleases to Tenant, and Tenant subleases
          from  Landlord,  the entire space leased to Landlord by Prime Landlord
          under the terms of the Prime  Lease,  with all  rights in common  with
          others in common areas in Prime Landlord's building  (collectively the
          "Premises").

     2.   Term;  Right  to  Renew.  The term of this  Sublease  shall be for six
          months beginning on the date of this Lease and ending on February ___,
          1997.  Provided  Tenant is not in default under this Sublease,  Tenant
          may renew this  Sublease  for  successive  terms,  each of six months'
          duration,  upon the terms and conditions  contained  herein,  provided
          Tenant gives written notice to Landlord of Tenant's  election to renew
          at least sixty (60) days before the end of the then-current term.

     3.   Rent.  Tenant  covenants and agrees to pay rent during the term in the
          amount  of   ___(same  as  prime   lease)___________________   Dollars
          ($__________)  per month,  payable in advance on the first day of each
          month during the term. Rent for partial months shall be prorated.

     4.   Utilities. Tenant shall pay all charges for gas, electricity,  lights,
          heat, water, sewer and telephone or other communication  service used,
          rendered or supplied to the Premises.

     5.   Use of Premises.  Tenant shall use the Premises  only for the purposes
          allowed in Section 4.1 of the Prime Lease.

     6.   Maintenance and Repair.  Tenant  acknowledges that the Premises are in
          reasonable condition as of the date of this Sublease.  Tenant shall at
          all times  maintain  the Premises in the same order and repair as they
          are in at the  commencement  of the term,  reasonable use and wear and
          damage  by fire or  other  casualty  only  excepted;  shall  keep  all
          fixtures and equipment in the Premises,  including without  limitation
          all  heating,   plumbing,   electrical  and  mechanical  fixtures  and
          equipment in the same  operating  condition as they are in on the date
          of this  Sublease,  reasonable  use and  wear  and  damage  by fire or
          casualty only excepted. At the end of the term, Tenant shall surrender
          the Premises to Landlord in the same  condition as they were in on the
          date of this  Sublease,  reasonable use and wear and damage by fire or
          other  casualty only  excepted.  Tenant shall make no  alterations  or
          modifications to the Premises without the Landlord's  written consent,
          which consent shall not be unreasonably withheld.


                                       66

<PAGE>



     7.   Insurance.  Tenant  shall  maintain  a  policy  of  general  liability
          insurance  insuring  Landlord  and  Tenant,  said  policy to be in the
          amounts required of the tenant under the Prime Lease. The policy shall
          name Landlord as an additional insured.

     8.   Indemnification.  Except  for claims  arising  before the date of this
          Lease,  and except  for claims  arising at any time due in whole or in
          part to Landlord's  negligence or wilful acts,  Tenant shall indemnify
          and hold  Landlord  harmless  from and  against any and all claims for
          injury to persons or damage to  property  in or about the  Premises or
          arising  in any way from the use or  condition  of the  Premises,  and
          against any costs or damages which Landlord may incur by reason of the
          assertion of any such claims.

     9.   Assignment  and  Subletting.  Tenant shall not assign this Sublease or
          sublet the  Premises or any part  thereof  without  the prior  written
          consent of Landlord, which consent shall not be unreasonably withheld.
          Landlord  represents and warrants to Tenant that Landlord has received
          all  approvals  from Prime  Landlord  that are  necessary in order for
          Landlord to enter into this Sublease.

     10.  Damage or  Destruction  by Fire,  Eminent  Domain or Casualty.  In the
          event that the Premises or any part thereof  shall be taken by eminent
          domain or shall be so  damaged  or  destroyed  by fire or  unavoidable
          casualty,  that the Premises are thereby rendered  untenantable,  then
          either  Landlord or Tenant may  terminate  this  Sublease upon written
          notice to the other and the rent shall be  prorated  as of the date of
          such termination.

     11.  Tenant's Property.  All property of every kind of Tenant's or Tenant's
          employees or invitees which may be on the Premises  during the term or
          any occupancy by Tenant thereof,  shall be at the sole risk and hazard
          of Tenant.

     12.  Default.  If Tenant  shall  default in the  performance  of any of its
          obligations  hereunder,  and such default is not cured within  fifteen
          (15) days of the date of a written notice from Landlord if the default
          is a  failure  to pay  rent,  or  thirty  (30) days from the date of a
          written notice from Landlord in the case of other defaults,  including
          any default  under the Prime  Lease,  or if Tenant  shall file or have
          filed against it a petition in bankruptcy or if an assignment shall be
          made by Tenant for the benefit of creditors, then in any of such cases
          Landlord may lawfully, immediately and at any time thereafter, without
          further notice or demand, and without prejudice to any other remedies,
          terminate this Sublease by written  notice  addressed to Tenant at the
          Premises, and upon such mailing this Sublease shall terminate.

     13.  Successors  and  Assigns;   Incorporation  of  the  Prime  Lease.  The
          provisions  of this  Sublease  shall be binding  upon and inure to the
          benefit of the  respective  successors  and  assigns of  Landlord  and
          Tenant. The Prime Lease is incorporated herein by reference and a copy
          of the Prime Lease is attached hereto as Exhibit A. Tenant shall abide
          by all terms and conditions of the Prime Lease.

     14.  Settlement  Agreement.  This  Sublease is the Sublease  referred to in
          Section 10 of that certain  Settlement  Agreement  dated as of October
          ___,  1996 by and among  Landlord,  Tenant  and  others,  and shall be
          subject to and construed consistently with, such Settlement Agreement.




                                       67

<PAGE>


     IN WITNESS  WHEREOF,  Landlord and Tenant have executed this Sublease as of
the date first above written.

WITNESS:                                      CCA OF MAINE, INC., Landlord
_________________________________             By:/s/ Michael Blass
                                              Its:Director

                                              SANDY RIVER HEALTH SYSTEM
                                              LLC, Tenant
________________________________              By:______________________________
                                              Its Member



                                       68


<TABLE> <S> <C>

<ARTICLE>                     5

<LEGEND>
THIS SCHEDULE  CONTAINS SUMMARY  FINANCIAL  INFORMATION  EXTRACTED FROM THE FORM
10-Q FOR THE NINE MONTH PERIOD ENDED SEPTEMBER 30, 1996, AND IS QUALIFIED IN ITS
ENTIRETY BY REFERENCE TO SUCH FINANCIAL STATEMENTS.
</LEGEND>
<CIK>                                0000945772
<NAME>          Community Care of America, Inc.
<MULTIPLIER>                                  1
<CURRENCY>                         U.S. Dollars
       
<S>                                <C>
<PERIOD-TYPE>                             9-MOS
<FISCAL-YEAR-END>                   DEC-31-1996
<PERIOD-START>                      JAN-01-1996
<PERIOD-END>                        SEP-30-1996
<EXCHANGE-RATE>                               1
<CASH>                                1,545,000
<SECURITIES>                                  0
<RECEIVABLES>                        20,241,000
<ALLOWANCES>                          3,248,000
<INVENTORY>                           1,795,000
<CURRENT-ASSETS>                     24,455,000
<PP&E>                               69,927,000
<DEPRECIATION>                        4,908,000
<TOTAL-ASSETS>                      116,621,000
<CURRENT-LIABILITIES>                40,285,000
<BONDS>                                       0
                         0
                                   0
<COMMON>                                 18,000
<OTHER-SE>                           28,085,000
<TOTAL-LIABILITY-AND-EQUITY>        116,621,000
<SALES>                                       0
<TOTAL-REVENUES>                     95,726,000
<CGS>                                         0
<TOTAL-COSTS>                       109,035,000
<OTHER-EXPENSES>                              0
<LOSS-PROVISION>                              0
<INTEREST-EXPENSE>                    3,280,000
<INCOME-PRETAX>                     (13,309,000)
<INCOME-TAX>                         (5,059,000)
<INCOME-CONTINUING>                  (8,250,000)
<DISCONTINUED>                                0
<EXTRAORDINARY>                               0
<CHANGES>                                     0
<NET-INCOME>                         (8,250,000)
<EPS-PRIMARY>                             (1.13)
<EPS-DILUTED>                              0.00


        



</TABLE>


© 2022 IncJournal is not affiliated with or endorsed by the U.S. Securities and Exchange Commission