COMMUNITY CARE OF AMERICA INC
8-K, 1997-01-13
SKILLED NURSING CARE FACILITIES
Previous: AIG ALL AGES FUNDS INC, 497J, 1997-01-13
Next: NATIONAL MUNICIPAL TRUST SERIES 180/NY/, 485BPOS, 1997-01-13








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



                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549

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

                                    FORM 8-K

                                 CURRENT REPORT
                     Pursuant to Section 13 or 15 (d) of the
                         Securities Exchange Act of 1934


       Date of Report (Date of earliest event reported): December 23, 1996

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


       Delaware                     0-26502                     52-1823411
     State or other               (Commission                 (IRS Employer
     jurisdiction of              file number)             Identification No.)
     incorporation)


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


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


                                 Not Applicable
          (Former name or former address, if changed since last report)





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






                                     Page 1

<PAGE>



Item 5.     Other Events


On December 27, 1996 the Company  obtained a $15,000,000  secured line of credit
with Daiwa  Securities of America,  Inc. to replace the existing secured line of
credit with NationsBank.  The $15,000,000  secured line of credit is for a three
year term and is secured through the assignment of certain  Company  receivables
to the lender.

The Company engaged Integrated Health Services,  Inc. ("IHS") under a management
agreement to assist in the  provision  of certain  financial,  accounting,  MIS,
reimbursement  and  ancillary  services for a term of five years  commencing  on
January 1, 1997.  The Company  believes  that this will  provide  access to more
sophisticated  and  responsive  systems at a lower cost  enabling the Company to
reduce its  overhead.  Additionally,  the Company  entered  into a  subordinated
revolving  credit agreement with IHS Financial  Holdings,  Inc., a subsidiary of
IHS,  pursuant to which,  as of January 13,  1997,  the Company may borrow up to
$5,000,000 for additional working capital. The Company issued to IHS warrants to
purchase an aggregate of 9.9% of its outstanding common stock in connection with
the $5 million  credit line.  The exercise price of half the warrants will be at
current  fair market value and will expire in two years.  The exercise  price of
the rest of the  warrants  will be at double the current  fair market  value and
will expire in five  years.  The current  fair market  value will be  determined
based upon the average of the high and low trading price of the Company's common
stock  for the  next  two  full  trading  days.  The  Company  has  granted  IHS
registration rights relating to the warrants. Two of the Company's directors are
also directors of IHS and one is IHS's  Chairman,  chief  executive  officer and
largest stockholder.

The Company  expects a loss in its fourth  quarter,  as a result of  write-offs,
non-recurring  charges,  and  adjustments,  which the  Company  estimates  could
aggregate  between  $8 and $14  million,  before  giving  effect to  income  tax
benefits.  The Company is  evaluating  the  potential  write off of the deferred
offering  costs related to its stock  offering  which was not completed in 1996,
alternative courses of action with respect to the previously  announced Memorial
transaction  which  could  result  in a  write-off,  as well as non-  recurring
charges and adjustments. Finalization of these matters is pending a review with
the Audit  Committee of the Board of  Directors  and the  Company's  independent
auditors.

The Board of Directors  has  appointed a search  committee to seek two qualified
replacements to fill the vacancies  created by the December 1996 resignations of
Rohit Desai and Damon Ball, both of Desai Capital  Management,  Inc., neither of
whom resigned due to any  expressed  disagreement  with the Company  relating to
operations, policies or practices.





                                     Page 2

<PAGE>



Item 7.  Financial Statements, Pro Forma Financial Information and Exhibits

   (a)   Financial Statements of business acquired:   Not applicable.

   (b)   Pro Forma financial information:   Not applicable.

   (c)   Exhibits:

     Regulation S-K
     Exhibit Number      Description
     --------------      -----------

          4.1       Healthcare  Receivables  Purchase And Transfer Agreement
                    dated  December  23, 1996 among  Community  Care of America,
                    Inc. and Each Of The  Providers  Named In The  Agreement and
                    CCA Funding, LLC.

          4.2       Loan And Security  Agreement dated December 23, 1996 between
                    CCA Funding, LLC and Daiwa Healthco-2, LLC.

          4.3       Assignment  Of  Healthcare   Receivables  Purchase  And
                    Transfer Agreement As Collateral Security.

          4.4       Amended and Restated  Revolving Credit Agreement dated as
                    of December 27, 1996 between Community Care of America, Inc.
                    and Integrated Health Services, Inc.

          4.5       Subordinated  Note  dated  December  27,  1996  between
                    Community  Care  of  America,  Inc.  and  Integrated  Health
                    Services, Inc. in the principal sum of $5,000,000.

          4.6       Warrant  Acquisition  Agreement  dated as of January 13,
                    1997 between Community Care of America,  Inc. and Integrated
                    Health Services,  Inc., including Form of Series A Warrants,
                    Form of Series B Warrant and Registration Rights Agreement.

          99.0      Management  Agreement  dated as of December 27, 1996 between
                    Community  Care  of  America,  Inc.  and  Integrated  Health
                    Services, Inc.







                                     Page 3

<PAGE>



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


                                    SIGNATURE

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.



Date:    January 13, 1997                   By:   /s/ David H. Fater
                                                  David H. Fater
                                                  Executive Vice President and
                                                  Chief Financial Officer

























                                     Page 4








                             HEALTHCARE RECEIVABLES
                              PURCHASE AND TRANSFER
                                    AGREEMENT

                          Dated as of December 23, 1996


                                      Among


                         COMMUNITY CARE OF AMERICA, INC.
                               as Primary Servicer

                                       and

                       EACH OF THE PROVIDERS NAMED HEREIN
                                  as Providers

                                       and


                                CCA FUNDING LLC,
                                  as Purchaser


          ALL THE RIGHT,  TITLE AND  INTEREST  OF THE  PURCHASER  IN AND TO, ALL
          BENEFITS OF THE PURCHASER UNDER AND ALL MONIES DUE OR TO BECOME DUE TO
          THE PURCHASER  UNDER OR IN CONNECTION  WITH,  THIS AGREEMENT HAVE BEEN
          ASSIGNED TO DAIWA  HEALTHCO-2 LLC, AS COLLATERAL  SECURITY FOR ANY AND
          ALL THE  OBLIGATIONS OF THE PURCHASER  PURSUANT TO A LOAN AND SECURITY
          AGREEMENT  DATED AS OF DECEMBER  23, 1996  BETWEEN THE  PURCHASER  AND
          DAIWA HEALTHCO-2 LLC


<PAGE>




<TABLE>
<C>                                                                                                            <S>

                                TABLE OF CONTENTS


                                                                                                               Page

ARTICLE I

         COMMITMENTS; AMOUNTS AND TERMS
         OF THE PURCHASES AND CONTRIBUTIONS

         SECTION 1.01.  Sale, Contribution and Purchase of Receivables............................................1
         SECTION 1.02.  Receivable Information and Transferred Batch Determination................................1
         SECTION 1.03.  The Transfers.............................................................................2
         SECTION 1.04.  Collection and Payment Procedures.........................................................2
         SECTION 1.05.  Allocation of Servicer Responsibilities...................................................2

ARTICLE II

         GENERAL PAYMENT MECHANICS;
         GOVERNMENTAL ENTITIES PAYMENT MECHANICS;
         EOB'S; MISDIRECTED PAYMENTS

         SECTION 2.01.  General Payment Mechanics.................................................................4
         SECTION 2.02.  Governmental Entities Payment Mechanics...................................................4
         SECTION 2.03.  Misdirected Payments; EOB's...............................................................5
         SECTION 2.04.  Unidentified Payments; Purchaser's Right of Presumption...................................5
         SECTION 2.05.  No Rights of Withdrawal...................................................................5

ARTICLE III

         REPRESENTATIONS AND WARRANTIES; COVENANTS;
         EVENTS OF TERMINATION

         SECTION 3.01.  Representations and Warranties; Covenants.................................................6
         SECTION 3.02.  Group-Wide Events of Termination; Events of Termination...................................6

ARTICLE IV

         INDEMNIFICATION;
         GRANT OF SECURITY INTEREST

         SECTION 4.01.  Indemnification and Set-Off Rights for Denied Receivables.................................7
         SECTION 4.02.  Indemnities by the Providers..............................................................7
         SECTION 4.03.  Right of Set-Off..........................................................................9
         SECTION 4.04.  Grant of Security Interest................................................................9


                                        i
<PAGE>



                                                                                                               Page


ARTICLE V

         MISCELLANEOUS

         SECTION 5.01.  Amendments, etc...........................................................................9
         SECTION 5.02.  Notices, etc.............................................................................10
         SECTION 5.03.  Assignability............................................................................10
         SECTION 5.04.  Further Assurances.......................................................................10
         SECTION 5.05.  Costs, Expenses and Termination Fee......................................................10
         SECTION 5.06.  Confidentiality..........................................................................11
         SECTION 5.07.  Term and Termination.....................................................................12
         SECTION 5.08.  Sale Treatment...........................................................................12
         SECTION 5.09.  Grant of Security Interest...............................................................12
         SECTION 5.10.  No Liability of the Purchaser............................................................13
         SECTION 5.11.  Attorney-in-Fact.........................................................................13
         SECTION 5.12.  Entire Agreement; Severability...........................................................13
         SECTION 5.13.  GOVERNING LAW............................................................................13
         SECTION 5.14.  WAIVER OF JURY TRIAL, JURISDICTION AND VENUE.............................................13
         SECTION 5.15.  Execution in Counterparts................................................................14
         SECTION 5.16.  No Proceedings...........................................................................14
         SECTION 5.17.  Joint and Several Liability; Providers...................................................14
         SECTION 5.18.  Survival of Termination..................................................................14
         SECTION 5.19.  Addition, Removal and Suspension of Providers............................................14


                                       ii

<PAGE>



EXHIBITS

Exhibit IDefinitions
Exhibit II                Conditions of Purchases
Exhibit III               Representations and Warranties
Exhibit IV                Covenants
Exhibit V                 Events of Termination
Exhibit VI                Receivable Information
Exhibit VII-A             Form of Notice to Governmental Entities
Exhibit VII-B             Form of Notice to Insurers
Exhibit VIII              Primary Servicer Responsibilities
Exhibit IX                Servicer Termination Events
Exhibit X                 Interface Between Providers and Master Servicer
Exhibit XI-A              Form of Opinion of Providers' Counsel
                          with Respect to the Patient Consent Form
Exhibit XI-B              Form of Opinion of Providers' Counsel
                          with Respect to Certain Corporate Matters
Exhibit XII               Form of Depositary Agreement

SCHEDULES

Schedule I                Addresses for Notices
Schedule II               Credit and Collection Policy
Schedule III              License Revocations
Schedule IV               Lockbox Information
Schedule V                List of the Providers


                                      iii

</TABLE>


             Healthcare Receivables Purchase and transfer Agreement

                          Dated as of December __, 1996

     COMMUNITY CARE OF AMERICA,  INC., a Delaware corporation (together with its
corporate successors and assigns,  the "Primary Servicer"),  each of the parties
named on  Schedule V hereto and as such  Schedule V may be amended  from time to
time  pursuant to Section 5.19 herein (each a "Provider"  and  collectively  the
"Providers"),  and  CCA  FUNDING  LLC,  a  Delaware  limited  liability  company
(together with its successors and assigns, the "Purchaser"), agree as follows:

     PRELIMINARY  STATEMENTS.  Certain  terms  that  are  capitalized  and  used
throughout this Agreement are defined in Exhibit I to this Agreement. References
herein and in the Exhibits and Schedules hereto to the "Agreement" refer to this
Agreement, as amended,  restated,  modified or supplemented from time to time in
accordance with its terms (the "Agreement").

     Each Provider wishes to sell or contribute to the Purchaser on a continuing
basis all of its healthcare  receivables.  The Purchaser is prepared to purchase
or to accept the  contribution of such  healthcare  receivables on the terms and
subject to the  conditions set forth herein.  Accordingly,  the parties agree as
follows:


                                    ARTICLE I

                         COMMITMENTS; AMOUNTS AND TERMS
                       OF THE PURCHASES AND CONTRIBUTIONS

     SECTION  1.01.  Sale,  Contribution  and Purchase of  Receivables.  On each
Transfer  Date  until  the  Facility  Termination  Date  and  on the  terms  and
conditions  set forth herein,  each Provider  agrees to sell,  without  recourse
except to the extent expressly  provided herein, or contribute to the Purchaser,
and the Purchaser agrees to purchase or accept such contribution of, all of such
Provider's Accounts.

     SECTION 1.02. Receivable Information and Transferred Batch Determination.

     (a) On each Batching Day after the Initial Transfer Date, the Servicer,  on
behalf of the Providers,  shall provide the Master Servicer by Transmission  the
information  listed on Exhibit VI hereto (as such Exhibit may be modified by the
Purchaser from time to time, the "Receivable  Information")  with respect to new
Accounts that it has determined  constitute Eligible  Receivables (the "Proposed
Eligible  Receivables")  and with respect to new Accounts that it has determined
do  not  constitute  Eligible  Receivables.   Each  Transmission  of  Receivable
Information  shall  constitute  an offer by each  Provider to sell,  or, at such
Provider's option,  contribute,  the Proposed Eligible  Receivables set forth in
the Transmission.

     (b) All Proposed Eligible Receivables for which Receivable  Information has
been  received by the Master  Servicer  between the prior  Batching Time and the
current Batching Time


                                        1

<PAGE>




shall be reviewed by the Daiwa Group.  On or prior to each  Transfer  Date,  the
Purchaser or the Program Manager shall prepare a list of those Proposed Eligible
Receivables  that the Purchaser will purchase on the Transfer Date (a "Purchased
Batch", and together with the remaining Proposed Eligible  Receivables that will
not  be  purchased  and  instead  will  be  contributed  to the  Purchaser,  the
"Transferred  Batch"),  together with an explanation stating that the identified
Proposed  Eligible  Receivables  not  included  in the  Purchased  Batch are not
Eligible Receivables and the basis thereof.

     SECTION  1.03.  The  Transfers.  (a) On  each  Transfer  Date,  subject  to
satisfaction  of the applicable  conditions set forth in Exhibit II hereto,  the
Purchaser shall pay to the Providers in same day funds, at the Primary  Servicer
Account, an amount equal to the Purchase Price of the Purchased Batch.

     (b) Effective on each Transfer Date, in consideration of the Purchase Price
and  other  good  and  valuable  consideration,   each  Provider  hereby  sells,
contributes and assigns to the Purchaser and the Purchaser  hereby purchases and
accepts,  as absolute owner, the Transferred Batch purchased and/or  contributed
on such Transfer Date.

     SECTION 1.04. Collection and Payment Procedures.

     (a) Collections on the Transferred  Batch.  The Purchaser shall be entitled
with respect to each  Transferred  Batch, (i) to receive all Collections on such
Transferred  Batch,  and (ii) to have and to exercise  any and all rights (x) to
collect,  record,  track and take all actions to obtain Collections with respect
to each Batch Receivable  payable by Persons other than  Governmental  Entities,
and (y) to the  extent  permitted  by law and in a  manner  consistent  with all
applicable laws and regulations,  to collect, record, track and take all actions
to  obtain  Collections  with  respect  to  each  Batch  Receivable  payable  by
Governmental Entities.

     (b) Collections Not Part of Transferred Batch. On each Settlement Date, and
provided that the  Providers  shall have (i) paid all amounts then due and owing
to  the  Purchaser  under  this  Agreement,   and  (ii)   successfully  sent  by
Transmission to the Master Servicer all information required with respect to the
Batch Receivables for the immediately preceding Settlement Period, the Purchaser
shall pay or turn over, as the case may be, to the Primary  Servicer any and all
cash  collections or other cash or non-cash  proceeds  received by the Purchaser
during the immediately preceding Settlement Period with respect to Accounts that
are not part of any Transferred Batch.

     (c) Distributions on each Settlement Date. On each Settlement Date and with
respect to each Transferred Batch, Total Collections shall be distributed to the
Purchaser.

     SECTION  1.05.  Allocation  of Servicer  Responsibilities.  (a) Tracking of
purchases,  Collections and other  transactions  pertaining to each  Transferred
Batch shall be administered  by the Master Servicer in a manner  consistent with
the terms of this Agreement. The responsibilities of the Providers to the Master
Servicer have been set forth in Exhibit X attached  hereto.  The Providers shall
cooperate  fully with the Master  Servicer in  establishing  and maintaining the
Transmission of the Receivable Information,  including,  without limitation, the
matters described in Exhibit X, and


                                        2
<PAGE>




shall provide promptly to the Master Servicer such other  information  necessary
or desirable for the  administration  of Collections on the Batch Receivables as
may be requested from time to time.

     (b) The  Purchaser  hereby  appoints  each  Provider  as its  agent for the
administration  and servicing  obligations set forth in Exhibit VIII hereto with
respect  to the  Accounts  sold or  transferred  by each  such  Provider  to the
Purchaser hereunder (the "Primary Servicer Responsibilities"), and each Provider
hereby  accepts  such  appointment  and agrees to perform the  Primary  Servicer
Responsibilities.  Each of the Providers  hereby  contracts its Primary Servicer
Responsibilities  to the Primary  Servicer and appoints the Primary  Servicer to
act  as  Servicer  hereunder,  provided,  however,  that  such  contracting  and
appointment   shall  not   relieve  any   Provider   from  any  of  its  duties,
responsibilities,  liabilities and obligations  resulting or arising  hereunder.
The Primary  Servicer hereby accepts such  appointment as Servicer and agrees to
perform the Primary Servicer  Responsibilities on behalf of the Providers.  Each
of the Providers,  the Servicer and the Purchaser  hereby  acknowledge  that the
Servicer's  appointment  is subject to and limited by DH-2's  appointment of the
Purchaser as its agent for performance of the Primary Servicer  Responsibilities
under the Loan  Agreement and DH-2's rights  thereunder to replace the Purchaser
(which  replacement may be effectuated  through the  outplacement to a qualified
and  experienced  third-party  of all back  office  duties,  including  billing,
collection  and  processing  responsibilities,  and  access  to  all  personnel,
hardware and software  utilized in connection with such  responsibilities).  The
Purchaser may, at any time  following the  occurrence of a Servicer  Termination
Event (and shall,  without  requirement of notice to any party,  upon a Servicer
Termination  Event resulting from the events  described in clauses (g) or (j) of
Exhibit V hereto)  appoint  another  Person to succeed the Servicer as its agent
for performance of the Primary Servicer  Responsibilities (which appointment may
be  effectuated   through  the  outplacement  to  a  qualified  and  experienced
third-party  of all  back  office  duties,  including  billing,  collection  and
processing responsibilities,  and access to all personnel, hardware and software
utilized in connection  with such  responsibilities).  The Purchaser may, at any
time  following the occurrence of one or more Servicer  Termination  Events (and
may,  without  requirement  of notice to any  party,  upon one or more  Servicer
Termination  Events resulting from the events described in clauses (g) or (j) of
Exhibit V hereto)  affecting the Providers  that have sold or contributed to the
Purchaser more than 25% of the Batch  Receivables  (whether or not purchased) in
the prior ninety days (or the number of days from the date of this  Agreement to
such date,  if less than  ninety  days) (in each case,  a  "Group-Wide  Servicer
Termination  Event"),  designate  the  Master  Servicer  or any other  Person to
succeed  the  Servicer  as its agent for  performance  of the  Primary  Servicer
Responsibilities.

     (c)  As  compensation   for  the   performance  of  the  Primary   Servicer
Responsibilities,  the Primary Servicer (or the successor  Servicer who performs
such Primary Servicer Responsibilities) shall be entitled to a Primary Servicing
Fee with respect to each Purchased Batch;  provided,  that the Primary Servicing
Fee shall be payable solely, to the extent received,  from a similar fee payable
by DH-2 to the Purchaser,  and, to the extent not received,  the Servicer hereby
waives its right to receive it.



                                  3

<PAGE>




                                   ARTICLE II

                           GENERAL PAYMENT MECHANICS;
                    GOVERNMENTAL ENTITIES PAYMENT MECHANICS;
                           EOB'S; MISDIRECTED PAYMENTS

     SECTION 2.01.  General  Payment  Mechanics.  (a) On or prior to the Initial
Transfer Date each of the Primary Servicer,  the Providers,  the Purchaser,  and
DH-2 shall have entered into the Depositary  Agreement and shall have caused the
Lockbox Bank to establish the Purchaser Lockbox,  the Purchaser Lockbox Account,
the Provider Ancillary Lockbox, and the Provider Ancillary Lockbox Account.

     (b) Each Provider shall prepare,  execute and deliver to each Insurer, with
copies to the Purchaser,  on or prior to the Initial  Transfer Date, a Notice to
Insurers addressed to each Insurer who is proposed to be a payor of Receivables,
which Notice to Insurers  shall  provide that,  effective  the Initial  Transfer
Date, all checks and EOB's from Insurers on account of Receivables shall be sent
to the Purchaser  Lockbox and all wire transfers on account of Receivables shall
be wired directly into the Purchaser Lockbox Account.

     (c) Each  Provider  covenants  and agrees  that,  on and after the  Initial
Transfer  Date,  all  invoices  (and,  if  provided  by  such  Provider,  return
envelopes)  shall, (i) if to be sent to Insurers,  set forth only the address of
the  Purchaser  Lockbox  as a return  address  for  payment of  Receivables  and
delivery of EOB's,  and only the Purchaser  Lockbox Account with respect to wire
transfers for payment of Receivables,  and (ii) if to be sent to private payors,
set forth only the address of the Provider Ancillary Lockbox as a return address
for payment of such  Receivables  and  delivery of EOB's,  and only the Provider
Ancillary  Lockbox  Account with respect to wire  transfers  for payment of such
Receivables.  Each Provider hereby further  covenants and agrees to instruct and
notify each of the members of its  accounting and  collections  staff to provide
identical  information in  communications  with Persons other than  Governmental
Entities with respect to Collections, wire transfers and EOB's.

     SECTION 2.02.  Governmental Entities Payment Mechanics.  (a) On or prior to
the Initial  Transfer Date,  each of the Primary  Servicer,  the Providers,  the
Purchaser,  and DH-2 shall have entered into the Depositary  Agreement,  and the
Providers  shall  have  caused  the  Lockbox  Bank  to  establish  the  Provider
Government Lockbox and the Provider  Government  Lockbox Account.  Each Provider
shall  prepare,  execute and deliver to the Purchaser on or prior to the Initial
Transfer Date,  Notices to Governmental  Entities addressed to each Governmental
Entity or its fiscal  intermediary who is proposed to be a payor of Receivables,
which Notices to  Governmental  Entities shall provide that all checks and EOB's
from  Governmental  Entities  on  account  of  Receivables  shall be sent to the
Provider  Government  Lockbox and all wire  transfers on account of  Receivables
shall be wired directly into the Provider Government Lockbox Account.

     (b) Each  Provider  covenants  and agrees  that,  on and after the  Initial
Transfer  Date,  all  invoices  to be sent to  Governmental  Entities  (and,  if
provided by such Provider, return envelopes)


                                        4

<PAGE>




shall set forth only the address of the Provider  Government Lockbox as a return
address for payment of Receivables and delivery of EOB's,  and only the Provider
Government  Lockbox  Account  with  respect  to wire  transfers  for  payment of
Receivables.  Each Provider further  covenants and agrees to instruct and notify
each of the members of its accounting and collections staff to provide identical
information  in  communications  with  Governmental  Entities  with  respect  to
Collections, wire transfers and EOB's.

     SECTION 2.03. Misdirected Payments; EOB's. (a) In the event that a Provider
receives an EOB or a Misdirected  Payment in the form of a check,  such Provider
shall immediately send such Misdirected Payment by overnight delivery service to
the  appropriate  Purchaser  Lockbox or  Provider  Lockbox,  as the case may be,
together  with the EOB and the envelope in which such payment was  received.  In
the event a Provider receives a Misdirected  Payment in the form of cash or wire
transfer,  such  Provider  shall  immediately  wire  transfer the amount of such
Misdirected Payment directly into the Purchaser Lockbox Account. All Misdirected
Payments and EOB's shall be sent promptly upon receipt thereof,  and in no event
later  than the close of  business,  on the  first  Business  Day after  receipt
thereof.

     (b) If a  Misdirected  Payment  in the form of a check is  received  by the
Purchaser more than six days after the postmark date on the envelope enclosing a
check from the Obligor (or, if no such envelope is sent to the Purchaser Lockbox
Account by a  Provider,  more than six days after the date of such check or wire
transfer with respect  thereto),  then the Providers  shall pay interest on such
Misdirected  Payment  to the  Purchaser  from such sixth  subsequent  day to and
including the date such check is received in the Purchaser Lockbox Account, at a
rate  equal to the LIBO  Rate then in effect  under the Loan  Agreement  (or the
maximum rate legally permitted if less than such rate).

     (c) Each Provider  hereby agrees and consents to the Purchaser  taking such
actions as are  reasonably  necessary  to ensure that future  payments  from the
Obligor of a Misdirected  Payment  shall be made in  accordance  with the Notice
previously  delivered to such Obligor,  including,  without  limitation,  to the
maximum extent  permitted by law, (i) any member of the Daiwa Group executing on
a Provider's  behalf and  delivering to such Obligor a new Notice,  and (ii) any
member of the Daiwa Group  contacting  such  Obligor by telephone to confirm the
instructions  previously  set  forth in the  Notice  to such  Obligor.  Upon the
Purchaser's  request,  a Provider shall  promptly (and in any event,  within two
Business Days from such request) take such similar  actions as the Purchaser may
request.

     SECTION 2.04. Unidentified Payments; Purchaser's Right of Presumption. Each
of the Providers and the Purchaser  agrees and consents that the Daiwa Group may
apply any  payment it  receives  from an Obligor  or any other  payor  against a
Purchased  Batch if the  Daiwa  Group is  unable  in good  faith  (after  making
reasonable  attempts to contact the  applicable  Provider) to determine from the
information in the EOB whether such payment relates to a Purchased Batch.

     SECTION  2.05.  No  Rights of  Withdrawal.  None of the  Providers  nor the
Purchaser  shall have any rights of  direction  or  withdrawal  with  respect to
amounts held in the Purchaser Lockbox Account.


                                        5

<PAGE>






                                   ARTICLE III

                   REPRESENTATIONS AND WARRANTIES; COVENANTS;
                              EVENTS OF TERMINATION

     SECTION 3.01.  Representations  and  Warranties;  Covenants.  Each Provider
makes, on the Initial  Transfer Date and on each  subsequent  Transfer Date, the
representations  and  warranties  on and as of such dates,  and hereby agrees to
perform  and  observe  the  covenants,   set  forth  in  Exhibits  III  and  IV,
respectively, hereto.

     SECTION 3.02. Group-Wide Events of Termination;  Events of Termination. (a)
If any  Group-Wide  Event of  Termination  shall  occur and be  continuing,  the
Purchaser  may,  by  notice  to the  Primary  Servicer  on behalf of each of the
Providers  (which  notice shall be deemed to have been given to each  Provider),
take  either  or  both  of the  following  actions:  (x)  declare  the  Facility
Termination  Date to have occurred  (except with respect to the Group-Wide Event
of  Termination  in  clause  (g) of  Exhibit  V,  in  which  case  the  Facility
Termination  Date shall be deemed to have  occurred  automatically  and  without
notice),   and  (y)  without  limiting  any  rights  hereunder,   terminate  the
appointment  of the  Servicer  to  perform  any or all of the  Primary  Servicer
Responsibilities  and  replace  the  Servicer in the manner set forth in Section
1.05(b). Upon any such declaration or designation,  the Purchaser shall have, in
addition to the rights and remedies which it may have under this Agreement,  all
other rights and remedies  provided  after default under the UCC and under other
applicable law, which rights and remedies shall be cumulative.

     (b) If an Event of Termination shall occur and be continuing, the Purchaser
may terminate the  appointment of the Primary  Servicer to perform any or all of
the  Primary  Servicer  Responsibilities  in the  manner  set  forth in  Section
1.05(b),  and, with respect to an individual Provider that does not constitute a
Group-Wide  Event of Termination,  the Purchaser,  in its sole  discretion,  may
require the immediate removal of such Provider from the program and, on or prior
to the effective date of such removal,  (x) all Receivables  contributed by such
Provider to the  Purchaser  shall be  re-purchased  by such  Provider as if such
Receivables were Denied Receivables and payment in full shall have been received
by the  Purchaser,  or (y) all rights and  obligations in respect of Receivables
contributed  by such Provider to the Purchaser  shall be  transferred to another
Provider.  Such  Provider  shall  also  withdraw  as a member of the  Purchaser;
provided,  however,  that such  Provider's  capital  account  as a member of the
Purchaser  shall not be paid out until the date of termination of this Agreement
as set forth in Section 5.07 herein.



                                        6

<PAGE>




                                   ARTICLE IV

                                INDEMNIFICATION;
                           GRANT OF SECURITY INTEREST

     SECTION 4.01.  Indemnification  and Set-Off Rights for Denied  Receivables.
(a) If a breach of any of the  representations  or warranties  contained  herein
relating to a Purchased  Receivable  shall be  discovered  at any time (each,  a
"Denied  Receivable"),  the  Provider  that  sold  or  contributed  such  Denied
Receivable shall, on the next Settlement Date, repurchase such Denied Receivable
from the Purchaser at the Repurchase Price.

     (b) For ease of administration,  the Purchaser shall be entitled to presume
that the failure of any Purchased  Receivable (or portion thereof) to be paid in
full on or after the 180th day  following  the Last  Service Date thereof is the
result of a breach of a representation or warranty contained herein with respect
to such Purchased  Receivable,  unless the Purchaser shall have actual knowledge
to the contrary (such as, by way of example,  actual  knowledge of the financial
inability of an Obligor to pay its obligations represented by a Receivable).  In
the event the Purchaser  receives the  Repurchase  Price for any such  Purchased
Receivable  and it is thereafter  determined  that the failure of such Purchased
Receivable  to be paid in full was not the result of a breach of  representation
or warranty  contained  herein,  the parties  hereto  shall make an  appropriate
adjustment  by  increasing  the  Purchase  Price  of any  Purchased  Batch to be
purchased on or after such date.

     (c) Upon receipt by (or on behalf of) the Purchaser of the Repurchase Price
with respect to any Denied  Receivable,  the  Purchaser  shall be deemed to have
reassigned and resold to the applicable  Provider such Denied Receivable without
any representation,  warranty or recourse whatsoever, and thereafter neither the
Purchaser nor any member of the Daiwa Group shall have any further  servicing or
other obligation to such Provider with respect to such Denied Receivable.

     (d) From time to time at the request of a  Provider,  the  Purchaser  shall
deliver  to such  Provider  (at such  Provider's  sole  cost and  expense)  such
documents, assignments, releases and instruments of termination as such Provider
may reasonably request to evidence the reconveyance by the Purchaser of a Denied
Receivable pursuant to the terms of Section 4.01(c).

     SECTION 4.02.  Indemnities  by the  Providers.  Without  limiting any other
rights that the Purchaser,  the Program  Manager,  the Master Servicer or any of
their respective Affiliates (together with their respective officers, directors,
shareholders  and lenders,  each, an "Indemnified  Party") may have hereunder or
under  applicable  law,  each Provider  hereby  agrees  jointly and severally to
indemnify each Indemnified Party from and against any and all claims, losses and
liabilities (including, without limitation,  reasonable attorneys' fees) (all of
the foregoing being collectively  referred to as "Indemnified  Amounts") arising
out of or resulting from any of the following:


                                        7

<PAGE>




     (a) the sale of any  Receivable  which  purports  to be part of a Purchased
Batch  but  which is not,  at the  date of such  sale,  the  type of  Receivable
described in subsection (j) of Exhibit III to this Agreement;

     (b) any  representation or warranty made or deemed made by any Provider (or
any of its officers) under or in connection with this Agreement and not relating
to a  Purchased  Receivable  which  shall have been  incorrect  in any  material
respect when made;

     (c) the failure by any Provider or any Batch  Receivable to comply with any
applicable law, rule or regulation with respect to any Batch Receivable;

     (d) the failure to vest in the Purchaser a perfected  ownership interest in
each Receivable  included in a Transferred  Batch and the Collections in respect
thereof, free and clear of any Liens;

     (e) any dispute,  claim,  set-off or defense to the payment, in whole or in
part, of any Receivable (including,  without limitation, a defense based on such
Receivable not being a legal,  valid and binding  obligation) or any other claim
resulting  from the services or  merchandise  related to such  Receivable or the
furnishing  or failure to furnish such  services or  merchandise  or relating to
collection  activities  with  respect  to such  Receivable  (if such  collection
activities  were  performed by any Provider or any of its  Affiliates  acting as
Servicer), provided, however, this clause (e) shall not be deemed to include any
dispute,  claim, set-off or defense to the payment of any Receivable (i) arising
out of the financial inability of an Obligor to pay its obligations  represented
by such Receivable including,  without limitation, a discharge in bankruptcy, or
(ii) arising after the sale of such  Receivable  to the Purchaser  hereunder and
arising solely as a result of actions taken by any member of the Daiwa Group;

     (f) a failure of any Provider,  including,  without limitation, the Primary
Servicer's  actions on behalf of the  Providers  under  Section  1.05(b) of this
Agreement  with  respect to Primary  Servicer  Responsibilities,  to perform its
duties or obligations in accordance with the provisions hereof or to perform its
duties or obligations hereunder; or

     (g) the  commingling  by any Provider of Collections at any time with other
funds of such  Provider,  provided,  however,  that in all events there shall be
excluded from the foregoing  indemnification  any claims,  losses or liabilities
resulting  solely  from  the  gross  negligence  or  willful  misconduct  of  an
Indemnified Person or which constitutes recourse for an uncollectible  Purchased
Receivable.

     Such Indemnified Person shall notify the Primary Servicer, on behalf of the
Providers,  of such  claim,  provided  that the  failure to so notify  shall not
affect or invalidate the indemnity granted pursuant to this Section 4.02.


                                        8

<PAGE>




     SECTION 4.03. Right of Set-Off. Unless a Provider notifies the Purchaser in
writing that it desires to pay on the date when due the  Repurchase  Price under
Section 4.01 or any  Indemnified  Amounts  under  Section 4.02 and such Provider
makes such payment to the Purchaser in immediately available funds on such date,
each such  Provider  hereby  irrevocably  instructs the Purchaser to set-off the
full amount of the Repurchase Price or the Indemnified  Amounts, as the case may
be,  against the  Purchase  Price of any  Purchased  Batch to be purchased on or
after  such  date.  No  further  notification,  act or  consent  of  any  nature
whatsoever  is required  prior to the right of the  Purchaser  to exercise  such
right of set-off,  provided,  however,  the  Purchaser  or a member of the Daiwa
Group  shall  notify the  Primary  Servicer  on behalf of such  Provider  that a
set-off pursuant to this Section 4.03 occurred, the amount of such set-off and a
description of the Denied Receivable or Indemnified Amounts, as the case may be.
The Purchaser shall exercise its right to set-off  hereunder to the extent funds
are available prior to making a demand for indemnification under Section 4.02

     SECTION 4.04. Grant of Security  Interest.  (a) As collateral  security for
each  Provider's  existing  and  future (i)  obligations  to  repurchase  Denied
Receivables under Section 4.01 hereof, (ii)  indemnification  obligations to the
Purchaser  under  Section 4.02 hereof,  and (iii)  obligations  to pay costs and
expenses under Section 5.05 hereof, each Provider hereby grants to the Purchaser
a first priority lien on and security  interest in and right of set-off against,
all of the Accounts owned or held by the Providers.

     (b) Each Provider agrees to execute, and hereby authorizes the Purchaser to
file, one or more financing statements or continuation  statements or amendments
thereto or assignments  thereof in respect of the lien created  pursuant to this
Section  4.04  which  may at any time be  required  or,  in the  opinion  of the
Purchaser,  be  desirable,  and to do so without the  signature of such Provider
where permitted by law.

                                    ARTICLE V

                                  MISCELLANEOUS

     SECTION 5.01. Amendments,  etc. (a) No amendment or waiver of any provision
of this Agreement or consent to any departure  therefrom by a party hereto shall
be effective  unless in writing signed by the Primary  Servicer,  the Providers,
the  Purchaser,  and  DH-2 as  assignee  of all of the  Purchaser's  rights  and
remedies  hereunder,  and  then  such  amendment,  waiver  or  consent  shall be
effective only in the specific  instance and for the specific  purpose for which
given.  No failure  on the part of the  Purchaser,  the  Primary  Servicer  or a
Provider to exercise,  and no delay in  exercising,  any right  hereunder  shall
operate as a waiver  thereof;  nor shall any single or partial  exercise  of any
right hereunder  preclude any other or further  exercise thereof or the exercise
of any other right.

     (b) The parties hereto agree to make any change,  modification or amendment
to this  Agreement as may be requested by Duff & Phelps Credit Rating Co. or any
other rating agency

                                        9

<PAGE>




     then rating the  healthcare  finance  program of DH-2,  so long as any such
change,  modification  or amendment  does not  materially  adversely  affect the
parties hereto.

     SECTION 5.02. Notices, etc. All notices and other communications  hereunder
shall,  unless  otherwise  stated  herein,  be in  writing  (which  may  include
facsimile  communication)  and shall be faxed or  delivered,  (i) to each  party
hereto, at its address set forth under its name on the signature pages hereto or
at such other address as shall be  designated by such party in a written  notice
to the other parties hereto (each Provider hereby  acknowledges  and agrees that
notices to or for the  benefit of a Provider  may be  delivered  to the  Primary
Servicer  and such  delivery  to the  Primary  Servicer  shall be  deemed  to be
received by each such Provider),  and (ii) to the Program Manager and the Master
Servicer at the addresses set forth on Schedule I attached  hereto.  Notices and
communications  by facsimile shall be effective when sent (and shall be followed
by hard copy sent by regular mail), and notices and communications sent by other
means shall be effective when received.

     SECTION 5.03. Assignability.  (a) This Agreement shall inure to the benefit
of and be  binding  upon the  parties  hereto  and  their  respective  permitted
successors and assigns.

     (b) Subject to Section  5.03(b) of the Loan  Agreement,  this Agreement and
the Purchaser's  rights and obligations  herein (including  without  limitation,
ownership of the Purchased  Receivables in each Purchased  Batch,  the Purchaser
Lockbox and  Purchaser  Lockbox  Account and rights in relation to the  Provider
Lockboxes  and  the  Provider  Lockbox  Accounts)  shall  be  assignable  by the
Purchaser and its successors and assigns. Each Provider hereby acknowledges that
the Purchaser is granting to DH-2, which is further  granting to its lenders,  a
security interest in this Agreement and all of the Purchaser's rights, title and
interests hereunder (including,  without limitation,  the Purchased Receivables,
each  Provider's  obligations  hereunder,  the  Purchaser  Lockbox and Purchaser
Lockbox  Account,  and rights in  relation  to the  Provider  Lockboxes  and the
Provider Lockbox Accounts).

     (c) No  Provider  may  assign its rights or  obligations  hereunder  or any
interest herein without the prior written consent of the Purchaser and DH-2.

     SECTION 5.04.  Further  Assurances.  The Providers shall, at their cost and
expense,  upon the request of the Purchaser,  duly execute and deliver, or cause
to be duly executed and delivered, to the Purchaser such further instruments and
do and cause to be done such  further  acts as may be necessary or proper in the
reasonable opinion of the Purchaser to carry out more effectively the provisions
and purposes of this Agreement.

     SECTION  5.05.  Costs,  Expenses  and  Termination  Fee. In addition to the
rights of indemnification granted under Section 4.02 hereof, the Providers agree
to pay on demand  all  reasonable  costs and  expenses  in  connection  with the
preparation,   execution  and  delivery  of  this   Agreement  and  any  waiver,
modification, supplement or amendment hereto, including, without limitation, the
reasonable fees and out-of-pocket  expenses of counsel for the Purchaser and the
members  of the  Daiwa  Group,  and all costs and  expenses,  if any  (including
reasonable counsel fees

                                       10

<PAGE>




and  expenses),  of the  Purchaser,  its Affiliates and the members of the Daiwa
Group in  connection  with the  enforcement  of this  Agreement.  The  Providers
further agree to pay on the Initial Transfer Date (and with respect to costs and
expenses  incurred  following the Initial  Transfer  Date,  within seven days of
demand therefor) (a) all reasonable costs and expenses incurred by the Purchaser
or its agent in connection  with  periodic  audits of the  Receivables,  (b) all
reasonable  costs and  expenses  incurred by the Master  Servicer or the Program
Manager to accommodate any  significant  coding or data system changes made by a
Provider that would affect the transmission or  interpretation  of data received
through the interface, and (c) all reasonable costs and expenses incurred by the
Purchaser  for  additional  time  (calculated  at a rate of $100 per  hour)  and
material expenses of the Master Servicer resulting from a lack of cooperation or
responsiveness  of any Provider or the Primary Servicer to agreed-upon  protocol
and  schedules  with the Master  Servicer;  provided,  that such Provider or the
Primary  Servicer  has been  informed  of the  alleged  lack of  cooperation  or
responsiveness and has been provided an opportunity to correct such problems.

     In the event that any Facility  Termination  Date is declared (or is deemed
to have  occurred)  pursuant to Section 3.02 of this  Agreement,  the  Providers
shall pay to the Purchaser an early  termination fee in an amount equal to 1.25%
of the Revolving  Commitment (as defined in the Loan  Agreement)  then in effect
pursuant to the Loan Agreement.

     SECTION 5.06. Confidentiality.  (a) Each Provider, the Primary Servicer and
the Purchaser hereby acknowledge that this Agreement, the Loan Agreement and the
documents  delivered  hereunder,  thereunder or in connection  with,  including,
without limitation,  any information  relating to any member of the Daiwa Group,
contains confidential and proprietary information.  Unless otherwise required by
applicable  law, each of the Providers,  the Primary  Servicer and the Purchaser
hereby agrees to maintain the  confidentiality of this Agreement (and all drafts
and  other  documents  delivered  in  connection  therewith  including,  without
limitation,  any information relating to any member of the Daiwa Group delivered
hereunder or under the Loan Agreement) in communications  with third parties and
otherwise and to take all reasonable  action to prevent the  unauthorized use or
disclosure  of  and  to  protect  the   confidentiality   of  such  confidential
information;  provided,  that, such confidential information may be disclosed to
(i) the Providers' and Purchaser's legal counsel and auditors,  (ii) the Program
Manager,  DH-2, the Primary Servicer,  each member of the Daiwa Group, investors
in and creditors of DH-2, appropriate rating agencies with respect to DH- 2, and
each of their respective legal counsel and auditors,  (iii) any Person,  if such
information  otherwise  becomes  available to such Person or publicly  available
through  no  fault  of any  party  governed  by  this  Section  5.06,  (iv)  any
Governmental  Entity  requesting such  information,  and (v) to any other Person
with the written  consent of the  applicable  party,  which consent shall not be
unreasonably  withheld,  and  provided  further  that the  Providers  shall  not
disclose such  confidential  information to any financial adviser not a party to
this Agreement except with the consent of the Program  Manager.  Notwithstanding
the foregoing,  it is understood that the Primary  Servicer is a publicly traded
company and, as such, may be required to disclose this transaction and the terms
thereof  by a filing  with the  Securities  and  Exchange  Commission  or by the
issuance of a press release.


                                       11

<PAGE>




     (b)  Each  of  the  Providers,  the  Primary  Servicer  and  the  Purchaser
understands and agrees that the other or the Daiwa Group may suffer  irreparable
harm if the  obligations  under this Section 5.06 are breached and that monetary
damages shall be  inadequate  to  compensate  the injured party for such breach.
Accordingly,  each of the  Providers,  the Primary  Servicer  and the  Purchaser
agrees that, in the event of their  respective  breach of Section  5.06(a),  the
injured  party,  in addition  and not in  limitation  of its rights and remedies
under law,  shall be  entitled  to a temporary  restraining  order,  preliminary
injunction and permanent injunction to prevent or restrain any such breach.

     (c) All parties hereto agree to comply with all applicable state or federal
statutes or regulations relating to patient medical record confidentiality.

     SECTION 5.07. Term and  Termination.  This Agreement shall continue in full
force and effect from the date hereof until the Final  Payment  Date;  provided,
however, that while the occurrence of the Final Payment Date shall terminate any
security interest of the Purchaser hereunder,  it shall not relieve or discharge
any of the Providers,  the Primary Servicer or the Purchaser of their respective
duties,  obligations  or covenants  hereunder  with  respect to any  Transferred
Batches transferred prior to the Final Payment Date and not repurchased pursuant
to Section 4.01, and all the terms,  provisions and conditions of this Agreement
shall  remain  in effect  for such  purpose  until  such  obligations  have been
satisfied and performed in full.  The Purchaser  shall deliver all  assignments,
certificates,  releases,  notices and other documents at the Providers' expense,
as the Providers may reasonably request to effect such termination.

     SECTION  5.08.  Sale  Treatment.  The  Providers  and  the  Purchaser  have
structured the transactions  contemplated by this Agreement with respect to each
Purchased Batch as a sale and intend that such  transactions  constitute a sale,
and each of the Providers and the Purchaser agree to treat each such transaction
as a sale for all purposes,  including,  without limitation, in their respective
books,  records,  computer  files,  tax  returns  (federal,  state  and  local),
regulatory  and  governmental  filings  (and  shall  reflect  such sale in their
respective  financial  statements).   Each  Provider  will  advise  all  persons
inquiring  about  the  ownership  of  the  Batch   Receivables  that  all  Batch
Receivables  have been sold or contributed to the Purchaser.  The Providers will
pay all taxes (excluding  income or franchise  taxes),  if any,  relating to the
transactions contemplated under this Agreement,  including,  without limitation,
the sale, transfer and contribution of each Transferred Batch to the Purchaser.

     SECTION 5.09. Grant of Security  Interest.  In the event that,  contrary to
the  mutual  intent  of the  Providers  and the  Purchaser,  any  purchase  of a
Purchased Batch is not  characterized as a sale, each Provider shall,  effective
as of the date hereof,  be deemed to have granted (and each Provider hereby does
grant) to the Purchaser a first priority security interest in and to any and all
Batch  Receivables  and the  proceeds  thereof  to secure the  repayment  of all
amounts paid to the Providers hereunder with accrued interest thereon,  and this
Agreement shall be deemed to be a security agreement. With respect to such grant
of a security  interest,  the Purchaser may at its option  exercise from time to
time any and all rights and remedies available to it under the UCC or otherwise.
Each  Provider  agrees that five days shall be  reasonable  prior  notice to the
applicable Provider or to the Primary Servicer on behalf of such Provider of the
date of any public or  private  sale or other  disposition  of all or any of the
Batch Receivables.

                                       12

<PAGE>




     SECTION 5.10. No Liability of the Purchaser. Neither this Agreement nor any
document  executed in connection  herewith shall constitute an assumption by the
Purchaser of any obligation to an Obligor or a patient of any Provider.

     SECTION 5.11. Attorney-in-Fact. Each Provider hereby
irrevocably  designates and appoints the Purchaser,  the Primary  Servicer,  the
Master Servicer and each Person in the Daiwa Group,  to the extent  permitted by
applicable  law and  regulation,  as such  Provider's  attorneys-in-fact,  which
irrevocable  power of attorney is coupled  with an interest,  with  authority to
endorse or sign such Provider's  name to financing  statements and checks (other
than payments from  Governmental  Entities),  and,  during the continuance of an
Event of  Termination,  to (i) endorse or sign such Provider's name to financing
statements, remittances, invoices, assignments, checks (other than payments from
Governmental  Entities),  drafts or other instruments or documents in respect of
the Batch  Receivables,  (ii)  notify  Insurers  to make  payments  on the Batch
Receivables  directly to the Purchaser,  and (iii) bring suit in such Provider's
name and settle or  compromise  such Batch  Receivables  as the  Purchaser,  the
Primary Servicer,  the Master Servicer or each Person in the Daiwa Group may, in
its discretion, deem appropriate.

     SECTION 5.12. Entire Agreement;  Severability.  (a) This Agreement embodies
the entire  agreement and  understanding  of the parties  concerning the subject
matter contained herein. This Agreement  supersedes any and all prior agreements
and understandings between the parties, whether written or oral.

     (b) If any  provision  of this  Agreement  shall  be  declared  invalid  or
unenforceable,  the parties  hereto agree that the remaining  provisions of this
Agreement shall continue in full force and effect.

     SECTION  5.13.  GOVERNING  LAW.  THIS  AGREEMENT  SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE  WITH, THE LAW OF THE STATE OF NEW YORK (WITHOUT  GIVING
EFFECT TO THE CONFLICT OF LAWS PRINCIPLES THEREOF).

     SECTION 5.14.  WAIVER OF JURY TRIAL,  JURISDICTION  AND VENUE.  THE PARTIES
HERETO HEREBY WAIVE ALL RIGHTS TO A TRIAL BY JURY IN THE EVENT OF ANY LITIGATION
WITH RESPECT TO ANY MATTER  RELATED TO THIS  AGREEMENT,  AND HEREBY  IRREVOCABLY
CONSENT TO THE  JURISDICTION OF THE STATE AND FEDERAL COURTS LOCATED IN NEW YORK
COUNTY,  NEW YORK CITY,  NEW YORK IN  CONNECTION  WITH ANY ACTION OR  PROCEEDING
ARISING  OUT OF OR  RELATING  TO THIS  AGREEMENT.  IN ANY SUCH  LITIGATION,  THE
PARTIES HERETO WAIVE PERSONAL SERVICE OF ANY SUMMONS, COMPLAINT OR OTHER PROCESS
AND AGREES THAT  SERVICE  THEREOF MAY BE MADE BY CERTIFIED  OR  REGISTERED  MAIL
DIRECTED TO EACH PROVIDER AT ITS ADDRESS SET FORTH ON THE SIGNATURE PAGE HEREOF.
THE PARTIES  HERETO SHALL APPEAR IN ANSWER TO SUCH  SUMMONS,  COMPLAINT OR OTHER
PROCESS WITHIN THE TIME PRESCRIBED BY

                                       13

<PAGE>




LAW,  FAILING WHICH THE PARTIES  FAILING TO SO APPEAR SHALL BE DEEMED IN DEFAULT
AND JUDGMENT MAY BE ENTERED BY THE PARTY PROSECUTING THE CLAIM FOR THE AMOUNT OF
THE CLAIM AND OTHER RELIEF REQUESTED THEREIN.

     SECTION 5.15. Execution in Counterparts.  This Agreement may be executed in
counterparts,  each of which when so executed  shall be deemed to be an original
and all of  which  when  taken  together  shall  constitute  one  and  the  same
agreement.

     SECTION 5.16. No Proceedings.  Each of the Providers  hereby agrees that it
will not  institute  against the  Purchaser or DH-2 any  proceeding  of the type
referred  to in  paragraph  (g) of Exhibit V so long as any senior  indebtedness
issued by the  Purchaser  or DH-2 shall be  outstanding  or there shall not have
elapsed  one year  plus one day  since  the  last day on which  any such  senior
indebtedness shall have been outstanding.

     SECTION 5.17. Joint and Several Liability;  Providers. Each Provider agrees
that each  reference to "the  Providers"  in this  Agreement  shall be deemed to
refer to each such Provider  jointly and  severally.  Each Provider (i) shall be
jointly and severally  liable for the  obligations,  duties and covenants  under
this Agreement and the acts and omissions of each other such Provider including,
without  limitation,  under  Article IV hereof,  and (ii) jointly and  severally
makes each  representation  and warranty under this Agreement;  provided however
that the breach of an obligation, duty, covenant,  representation or warranty by
one  Provider  shall not result in an Event of  Termination  with respect to any
other Provider unless such breach constitutes a Group-Wide Event of Termination.

     SECTION 5.18.  Survival of  Termination.  The provisions of Article IV (and
the  representations  and warranties  with respect  thereto) (other than Section
4.04) and Sections  5.05,  5.06 and 5.16 shall survive any  termination  of this
Agreement.

     SECTION 5.19. Addition, Removal and Suspension of Providers. (a) Subject to
the conditions set forth below, upon 30-days' prior written request from time to
time of the Primary Servicer, the Purchaser hereby agrees to the adding of other
Persons  designated by the Primary  Servicer as additional  Providers  hereunder
(each such event, an "Addition");  provided,  that, in the reasonable commercial
judgment of the Purchaser and its designees and assignees):

     (i) no  Group-Wide  Event  of  Termination  is  existing  and the  proposed
Addition  shall not cause,  or not reasonably be expected to cause, a Group-Wide
Event of Termination;

     (ii) as of the effective date of such Addition,  such applicable conditions
precedent set forth in Exhibit II hereto shall have been  fulfilled with respect
to such Person;

                                       14

<PAGE>




     (iii)  as  of  the  effective  date  of  such  Addition,   each  applicable
representation  and  warranty  set forth in Exhibit III hereto shall be true and
correct in all material respects with respect to such Person;

     (iv) if such  Person  is not an  Affiliate  of the  Primary  Servicer,  the
Purchaser  shall have  determined  that such  Person will be able to perform the
Primary Servicer Responsibilities, or have waived such requirement in writing;

     (v) the  Purchaser  shall  have  received  a  certificate  from the  Master
Servicer  stating  that  all  computer  linkups  and  interfaces   necessary  or
desirable,  in the sole  discretion of the Master  Servicer,  to effectuate  the
transactions and information  transfers under this Agreement with respect to the
Addition are fully  operational to the  satisfaction  of the Master Servicer and
the Master  Servicer  shall have received an interface  fee for each  additional
computer interface;

     (vi) such Person shall execute such  agreements,  instruments and documents
as the Purchaser may reasonably request,  in form and substance  satisfactory to
the Purchaser to effectuate the Addition,  including  without  limitation (x) an
amendment to this Agreement  whereby such Person agrees to be bound by the terms
of this Agreement,  and (y) financing  statements covering Receivables that such
Person may contribute to the Purchaser;

     (vii) the  Purchaser  and its assigns  shall have been  provided  with such
information  (whether  financial or otherwise)  and time necessary and desirable
(in  the  sole  discretion  of the  Purchaser  and  its  assigns)  to  make  the
assessments under clauses (i), (ii) and (iii); and

     (viii) such Person shall become a member of the Purchaser.

     (b) Subject to the conditions set forth below,  upon 30-days' prior written
request from time to time of the Primary  Servicer,  the Purchaser hereby agrees
to the removal of any Provider  designated by the Primary  Servicer from time to
time  (each  such  event,  a  "Removal");  provided,  that,  in  the  reasonable
commercial judgment of the Purchaser (and DH-2 as its assignee):

     (i) no Group-Wide Event of Termination is existing and the proposed Removal
shall not cause,  or not reasonably be expected to cause, a Group-Wide  Event of
Termination;

     (ii) on or prior to the effective date of such Removal (x) all  Receivables
contributed  by such  Provider to the  Purchaser  shall be  repurchased  by such
Provider  as if such  Receivables  were Denied  Receivables  and payment in full
shall have been received by the Purchaser,  or (y) all rights and obligations in
respect of Receivables  contributed  by such Provider to the Purchaser  shall be
transferred to another Provider;

                                       15

<PAGE>




     (iii) after giving effect to such Removal,  the aggregate  minimum Tangible
Net  Worth  of the  remaining  Providers  hereunder  shall  (x)  equal  at least
$5,000,000, and (y) not have decreased as a result of the Removal (combined with
all other Removals) by greater than 10%;

     (iv) such Person shall execute such  agreements,  instruments and documents
as the Purchaser may reasonably request,  in form and substance  satisfactory to
the  Purchaser  to  effectuate  the Removal,  including  without  limitation  an
amendment to this Agreement effectuating such Removal;

     (v) the Purchaser  and DH-2, as its assignee,  have been provided with such
information  (whether  financial or otherwise)  and time necessary and desirable
(in the sole  discretion of the Purchaser and DH-2, as its assignee) to make the
assessments under clauses (i), (ii), (iii) and (iv) above; and

     (vi) such Person  shall  withdraw as a member of the  Purchaser;  provided,
however, that such Provider's capital account as a member of the Purchaser shall
not be paid out until the date of  termination of this Agreement as set forth in
Section 5.07 herein.

     (c)  The  Purchaser  hereby  agrees  to  the  suspension  of  any  Provider
designated  by the  Primary  Servicer  from  time to  time  (each  such  event a
"Suspension");  provided,  that in the  reasonable  commercial  judgment  of the
Purchaser  (and DH-2 as its  assignee),  no Group-Wide  Event of  Termination is
existing and the  proposed  Suspension  shall not cause,  or not  reasonably  be
expected to cause,  a  Group-Wide  Event of  Termination.  For the period of the
Suspension, such suspended Provider shall be deemed not to be a Provider for the
purpose hereof or for the purposes of the Loan Agreement.  Such Suspension shall
cure any breach of a covenant,  representation  or  warranty  by such  suspended
Provider,  provided,  that such cure shall not be deemed,  in and of itself,  to
cure a Group-Wide  Event of Termination and not reasonably be expected to cure a
Group-Wide Event of Termination.


                     [REMAINDER OF PAGE INTENTIONALLY BLANK]

                                       16

<PAGE>





     IN WITNESS  WHEREOF,  the parties have caused this Agreement to be executed
by their respective  officers  thereunto duly  authorized,  as of the date first
above written.


  PRIMARY SERVICER:          COMMUNITY CARE OF AMERICA, INC.

                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408


         PROVIDERS:          ECA HOLDINGS, INC.


                             By:
                             Name:
                             Title:
                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto

                             COMMUNITY CARE OF NEBRASKA, INC.


                             By:
                             Name:
                             Title:


                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                                       17

<PAGE>




                             COMMUNITY CARE OF GEORGIA, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             COMMUNITY CARE OF AMERICA OF ALABAMA, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             CCA OF MIDWEST, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                                       18

<PAGE>




                             ECA PROPERTIES, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto

                             LULING/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             DUBLIN/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto



                                       19

<PAGE>




                             MARIETTA/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             MACON/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             COLLEGE PARK/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                                       20

<PAGE>




                             GLENWOOD/SCC, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             QUALITY CARE OF COLUMBUS, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto


                             QUALITY CARE OF LYONS, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                             Trade names: See Schedule V attached hereto



                                       21

<PAGE>




                             W.S.T. CARE, INC.


                             By:
                             Name:
                             Title:

                             Address:    3050 North Horseshoe Drive, Suite 260
                                         Naples, Florida 34104
                                         Facsimile Number: (941) 435-0408

                            Trade names: See Schedule V attached hereto


PURCHASER:                  CCA FUNDING LLC


                            By:
                            Name:
                            Title: Manager

                            Address:    3050 North Horseshoe Drive, Suite 260
                                        Naples, Florida 34104
                                        Facsimile Number: (941) 435-0408

                                       22

<PAGE>




                                    EXHIBIT I

                                   DEFINITIONS

     As used in the  Agreement  (including  its  Exhibits  and  Schedules),  the
following  terms shall have the following  meanings (such meanings to be equally
applicable to both the singular and plural forms of the terms defined):

     "Accounts"  means  all  accounts   (including,   without  limitation,   all
Receivables), general intangibles and other obligations for the payment of money
arising out of a Provider's  sale of merchandise or rendition of services in the
ordinary  course  of  business,  whether  now  existing  or  hereafter  arising,
including all rights to  reimbursement  under any  agreements  with and payments
from Obligors, patients, residents and other Persons, and all proceeds of any of
the foregoing.

     "Affiliate"  means,  as to any Person,  any other Person that,  directly or
indirectly,  is in control of, is controlled by or is under common  control with
such Person or is a director or officer of such Person. For the purposes of this
definition, "control", when used with respect to any specified Person, means the
power to  direct  the  management  and  policies  of such  Person,  directly  or
indirectly,  whether through the ownership of voting securities,  by contract or
otherwise.

     "Agreement" has the meaning set forth in the preliminary statements hereto.

     "Batch  Receivable"  means a Receivable  that is included in a  Transferred
Batch, but excludes a Denied  Receivable for which the Repurchase Price has been
received by the Purchaser.

     "Batching  Day"  means each  Monday of each  week,  or if such day is not a
Business Day, the next preceding Business Day.

     "Batching Time" means 11:00 a.m. New York City time, on each Batching Day.

     "Business  Day" means any day on which banks are not authorized or required
to close in New York City or Naples, Florida.

     "Capital Lease" means, as applied to any Person,  any lease of any Property
(whether real,  personal or mixed) by that Person as lessee,  the obligations of
which are required,  in accordance  with GAAP, to be  capitalized on the balance
sheet of that Person.

     "CHAMPUS"  means the Civilian  Health and Medical  Program of the Uniformed
Service, a program of medical benefits covering former and active members of the
uniformed services and certain of their dependents, financed and administered by
the  United  States  Departments  of  Defense,  Health  and Human  Services  and
Transportation  and  established  pursuant to 10 USC ss.ss.  1071-1106,  and all
regulations  promulgated thereunder including without limitation (a) all federal
statutes (whether set forth in 10 USC ss.ss.  1071-1106 or elsewhere)  affecting
CHAMPUS; and (b) all rules,  regulations (including 32 CFR 199), manuals, orders
and administrative, reimbursement and

                                       I-1

<PAGE>




other guidelines of all Governmental Authorities (including, without limitation,
the  Department of Health and Human  Services,  the  Department of Defense,  the
Department  of  Transportation,  the  Assistant  Secretary  of  Defense  (Health
Affairs),  and the Office of CHAMPUS,  or any Person or entity succeeding to the
functions of any of the foregoing) promulgated pursuant to or in connection with
any of the  foregoing  (whether  or not having the force of law) in each case as
may be amended, supplemented or otherwise modified from time to time.

     "Collections"  means,  with respect to any Batch  Receivable or Transferred
Batch,  all cash  collections,  wire transfers,  electronic  funds transfers and
other cash proceeds of such Batch  Receivable or Transferred  Batch, as the case
may  be,  deposited  in  the  Purchaser  Lockbox  Account,  including,   without
limitation, all cash proceeds of any related security with respect to such Batch
Receivable.

     "Credit  and  Collection   Policy"  means  those  receivables   credit  and
collection  policies and practices of the Providers in effect on the date of the
Agreement  and  described in Schedule II hereto,  as modified  from time to time
with the consent of the Purchaser.

     "Daiwa Group" means (i) DH-2, the Program  Manager and the Master  Servicer
and (ii) DH-2's agents and delegates  identified from time to time to effectuate
this Agreement.

     "Debt" means as to any Person (without duplication): (i) all obligations of
such party for borrowed  money,  (ii) all obligations of such party evidenced by
bonds, notes, debentures, or other similar instruments, (iii) all obligations of
such party to pay the  deferred  purchase  price of property of services  (other
than trade payables in the ordinary course of business), (iv) all Capital Leases
of such party, (v) all Debt of others directly or indirectly  Guaranteed  (which
term shall not include  endorsements in the ordinary course of business) by such
party, (vi) all obligations secured by a Lien existing on property owned by such
party,  whether or not the obligations secured thereby have been assumed by such
party or are non-recourse to the credit of such party (but only to the extent of
the value of such  property),  and (vii) all  reimbursement  obligations of such
party  (whether  contingent  or  otherwise)  in  respect  of  letters of credit,
bankers' acceptance and similar instruments.

     "Defaulted Receivable" means a Batch Receivable (i) as to which the Obligor
thereof or any other Person obligated  thereon has taken any action, or suffered
any event to occur,  of the type described in paragraph (g) of Exhibit V or (ii)
which,  consistent with the Credit and Collection  Policy,  would be written off
the appropriate Provider's books as uncollectible.

     "Delinquency  Ratio" means,  as of the last  Business Day of each month,  a
percentage equal to:

                                    DR / OPP

                  where:

                                       I-2

<PAGE>




                  DR=      The Expected Net Value of all  Purchased  Receivables
                           which became Delinquent  Receivables in the four week
                           period immediately prior to the date of calculation.

                  OPP=     The average Outstanding Purchase Price (calculated as
                           the arithmetic  average of all daily balances) of all
                           Purchased   Receivables   in  the  four  week  period
                           immediately prior to the date of calculation.

     "Delinquent Receivable" means a Batch Receivable (a) that has not been paid
in full on or following  the 180th day  following the Last Service Date thereof,
or (b) that is a Denied Receivable.

     "Denied Receivable" has the meaning set forth in Section 4.01 hereto.

     "Depositary  Agreement" means that certain  Depositary  Account  Agreement,
dated the date hereof, among each of the Providers, the Purchaser,  DH-2 and the
Lockbox Bank, in substantially  the form attached hereto as Exhibit XII, as such
agreement  may be  amended,  modified  or  supplemented  from  time  to  time in
accordance with its terms.

     "DH-2" means Daiwa Healthco-2 LLC, a Delaware limited liability company.

     "Eligibility  Criteria" has the meaning  specified in the Loan Agreement as
such Eligibility Criteria may be modified from time to time by DH-2 upon written
notice to the Provider.

     "Eligible Receivables" has the meaning specified in the Loan Agreement.

     "Employee  Benefit Plan" means any employee benefit plan within the meaning
of ss. 3(3) of ERISA maintained by any Provider or any ERISA Affiliate,  or with
respect to which any of them have any liability.

     "EOB" means the  explanation of benefit from an Obligor that identifies the
services rendered on account of the Batch Receivable specified therein.

     "ERISA"  means the Employee  Retirement  Income  Security  Act of 1974,  as
amended.

     "ERISA  Affiliate"  means any entity which is under common control with any
Provider  within the  meaning of ERISA or which is treated as a single  employer
with any Provider under the Internal Revenue Code of 1986, as amended.

     "Event of  Termination"  means any of the  events  specified  in  Exhibit V
hereto.

     "Expected Net Value" means, with respect to any Batch Receivable, the gross
unpaid amount of such  Receivable on the Transfer Date  therefor,  times the Net
Value Factor.


                                       I-3

<PAGE>




     "Facility  Termination  Date" means the earlier of (a) 36 months  after the
Initial  Transfer Date (subject to an automatic  extension of such date to equal
the "Facility Termination Date" under the Loan Agreement) and (b) the occurrence
of a  Group-Wide  Event of  Termination  and the delivery of notice with respect
thereto,  if required  pursuant  to Section  3.02  hereof,  unless such event is
waived by the Purchaser in writing.

     "Final  Payment  Date"  means  the  first  Settlement  Date  following  the
Settlement  Period in which final collection has been received for all Purchased
Receivables  or such  Purchased  Receivables  have become Denied  Receivables or
Defaulted Receivables.

     "GAAP" means generally accepted accounting  principles in the United States
of  America,  applied on a  consistent  basis,  as set forth in  Opinions of the
Accounting  Principles  Board of the  American  Institute  of  Certified  Public
Accountants  and/or in statements of the Financial  Accounting  Standards  Board
and/or the rules and  regulations  of the  Securities  and  Exchange  Commission
and/or their respective successors and which are applicable in the circumstances
as of the date in question.

     "Governmental  Entity" means the United States of America,  any state,  any
political subdivision of a state and any agency or instrumentality of the United
States of America or any state or political  subdivision  thereof and any entity
exercising  executive,  legislative,   judicial,  regulatory  or  administrative
functions of or pertaining to government.  Payments from  Governmental  Entities
shall be deemed to include  payments  governed under the Social Security Act (42
U.S.C.  1395,  et  seq.),  including  payments  under  Medicare,  Medicaid,  and
CHAMPUS/Champva, and payments administered or regulated by HCFA.

     "Group-Wide Event of Termination" has the meaning set forth in Exhibit V.

     "Group-Wide Providers" has the meaning set forth in Exhibit V.

     "Group-Wide  Servicer  Termination  Event"  has the  meaning  set  forth in
Section 1.05(b).

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


                                       I-4

<PAGE>




     "HCFA" means the Health Care Financing  Administration of the United States
Department of Health and Human Services.

     "Indemnified Amounts" has the meaning set forth in Section 4.02 hereto.

     "Indemnified Party" has the meaning set forth in Section 4.02 hereto.

     "Initial  Transfer  Date"  means  the  date  of  the  initial  purchase  of
Receivables hereunder.

     "Insurer"  means any Person which in the ordinary course of its business or
activities  agrees  to  pay  for  healthcare  goods  and  services  received  by
individuals,  including  commercial  insurance  companies,  nonprofit  insurance
companies (such as Blue Cross, Blue Shield entities),  employers or unions which
self-insure  for  employee  or member  health  insurance,  prepaid  health  care
organizations,   preferred   provider   organizations  and  health   maintenance
organizations.  "Insurer" includes insurance companies issuing health,  personal
injury,  workers'  compensation or other types of insurance but does not include
any individual guarantors.

     "Last Service  Date" means,  with respect to any  Receivable,  the date set
forth on the  related  invoice or  statement  as the most  recent  date on which
services or merchandise were provided by the applicable  Provider to the related
patient.

     "LIBO Rate" has the meaning specified in the Loan Agreement.

     "Lien"  means any lien,  mortgage,  security  interest,  tax lien,  pledge,
hypothecation, assignment, preference, priority, other charge or encumbrance, or
any other type of preferential  arrangement of any kind or nature  whatsoever by
or with any Person (including, without limitation, any conditional sale or title
retention  agreement),  whether  arising  by  contract,  operation  of  law,  or
otherwise.

     "Loan Agreement" means the Loan and Security Agreement dated as of the date
hereof  between the Purchaser as borrower and DH-2 as Lender,  as such agreement
may be modified,  supplemented  or amended from time to time in accordance  with
its terms.

     "Lockbox   Bank"  means  KeyBank  as  lockbox  bank  under  the  Depositary
Agreement.

                 "Loss-to-Liquidation  Ratio" means, as of the last Business Day
of each month, a percentage equal to:

                                                     DR /C

                  where:


                                       I-5

<PAGE>




                  DR=      The Expected Net Value of all  Purchased  Receivables
                           which became  Defaulted  Receivables in the four week
                           period immediately prior to the date of calculation.

                  C=       Collections in the four week period immediately prior
                           to the date of calculation.

     "Master  Servicer"  means RJE Data  Processing,  Inc., and any other Person
then identified by the Program Manager to the Providers, or the Primary Servicer
on behalf of the  Providers,  as being  authorized  to  administer  and  service
Receivables.

     "Material Adverse Effect" means any event, condition, change or effect that
(a) has a materially adverse effect on the business, Properties, capitalization,
liabilities,  operations, prospects or financial condition of (i) the Group-Wide
Providers,  (ii) the Primary  Servicer  on a  consolidated  basis,  or (iii) the
Purchaser,  (b)  materially  impairs the ability of the  Primary  Servicer,  the
Group- Wide  Providers or the  Purchaser to perform its  obligations  under this
Agreement,  (c)  materially  impairs  the  validity  or  enforceability  of,  or
materially  impairs the rights,  remedies or benefits available to the Purchaser
under this Agreement, or (d) changes, or could reasonably be expected to change,
the  characterization  and  treatment  of the sales of  Receivables  under  this
Agreement as something other than a true sale.

     "Misdirected  Payment"  means any form of  payment  in  respect  of a Batch
Receivable made in a manner other than to the Purchaser  Lockbox,  the Purchaser
Lockbox Account, the Provider Lockboxes or the Provider Lockbox Accounts.

     "Multiemployer  Plan"  means a plan,  within the  meaning  of ss.  3(37) of
ERISA,  as to which any  Provider  or any  ERISA  Affiliate  contributed  or was
required to contribute within the preceding five (5) years.

     "Net  Value  Factor"  means,  initially,   0.85,  and  thereafter  (i)  the
historical  actual  final  collections  received on the  Provider's  Receivables
within 180 days of the Last  Service Date of such  Receivables,  divided by (ii)
the gross value of such Receivables.

     "New  Patient  Consent  Form" has the  meaning  set forth in clause  (i) of
Exhibit II hereto.

     "Notice" means a Notice to Governmental  Entities or Notice to Insurers, as
applicable.

     "Notice to  Governmental  Entities"  means a notice  letter on a Provider's
corporate letterhead in substantially the form attached hereto as Exhibit VII-A.

     "Notice  to  Insurers"  means a notice  letter  on a  Provider's  corporate
letterhead in substantially the form attached hereto as Exhibit VII-B.

                                                       I-6

<PAGE>




     "Obligor" means the Insurer or Governmental  Entity, as applicable,  who is
responsible for the payment of all or any portion of a Receivable.

     "PBGC"  means  the  Pension  Benefit  Guaranty  Corporation  or any  entity
succeeding to all or any of its functions under ERISA.

     "Person" means an individual, partnership, corporation
(including  a  business  trust),  joint  stock  company,  trust,  unincorporated
association,  joint  venture or other  entity,  or a government or any political
subdivision or agency thereof.

     "Primary  Servicer"  means  Community  Care of  America,  Inc.,  a Delaware
corporation.

     "Primary  Servicer  Account"  means account  #2090001393229  of the Primary
Servicer on behalf of the Providers at First Union National Bank of Florida, ABA
#063 0000 21,  125 North  Airport  Road,  Naples,  FL 34104,  or such other bank
account  designated by the Primary  Servicer by written notice to the Providers,
the Master Servicer, the Purchaser and the Program Manager from time to time, as
the account for receipt of proceeds on behalf of the Providers.

     "Primary  Servicer  Responsibilities"  has the meaning set forth in Section
1.05(b) hereto.

     "Primary  Servicing  Fee" means,  with respect to any Purchased  Batch,  an
amount equal to $8 multiplied  by the number of  Receivables  in such  Purchased
Batch.

     "Program  Manager"  means (i) Daiwa  Securities  America  Inc., or (ii) any
other Person then identified by DH-2 to the Primary Servicer as being authorized
to  provide  administrative  services  with  respect  to the  Purchaser  and the
Purchaser's purchase, funding and collection of healthcare receivables.

     "Property" means property of all kinds, real,  personal or mixed,  tangible
or intangible  (including,  without  limitation,  all rights relating  thereto),
whether owned or acquired on or after the date of this Agreement.

     "Proposed  Eligible  Receivables" has the meaning set forth in Section 1.02
hereto.

     "Provider"  or  "Providers"  has the meaning  set forth in the  preliminary
statements hereto.

     "Provider  Ancillary  Lockbox"  means the  lockbox set forth on Schedule IV
hereto to  receive  checks  and EOB's with  respect  to  Receivables  payable by
private payors.

     "Provider  Ancillary  Lockbox  Account"  means  the  account  set  forth on
Schedule IV hereto in the name of the Providers and associated with the Provider
Ancillary Lockbox established

                                       I-7

<PAGE>




and controlled by the Providers to deposit  Collections,  including  Collections
received in the  Provider  Ancillary  Lockbox and  Collections  received by wire
transfer, all as more fully set forth in the Depositary Agreement.

     "Provider  Government  Lockbox"  means the lockbox set forth on Schedule IV
hereto to  receive  checks  and EOB's with  respect  to  Receivables  payable by
Governmental Entities.

     "Provider  Government  Lockbox  Account"  means  the  account  set forth on
Schedule IV hereto in the name of the Providers and associated with the Provider
Government  Lockbox  established  and  controlled  by the  Providers  to deposit
Collections,  including  Collections received in the Provider Government Lockbox
and Collections  received by wire transfer directly from Governmental  Entities,
all as more fully set forth in the Depositary Agreement.

     "Provider  Lockboxes" means,  collectively,  the Provider Ancillary Lockbox
and the Provider  Government Lockbox,  or, as the context requires,  either such
lockbox.

     "Provider  Lockbox  Account" means,  collectively,  the Provider  Ancillary
Lockbox Account and the Provider Government Lockbox Account,  or, as the context
requires, either such lockbox account.

     "Purchase  Price"  means,  with respect to  Receivables  in each  Purchased
Batch, (i) the aggregate Expected Net Value of the Receivables, minus (ii) 5%.

     "Purchased Batch" has the meaning set forth in Section 1.02(b) hereto.

     "Purchased  Receivable"  means a Receivable  that has been purchased by the
Purchaser.

     "Purchaser" has the meaning set forth in the preliminary statements hereto.

     "Purchaser  Lockbox"  means the  lockbox set forth on Schedule IV hereto to
receive checks and EOB's with respect to Receivables payable by Insurers.

     "Purchaser Lockbox Account" means the lockbox account set forth on Schedule
IV hereto associated with the Purchaser Lockbox  established by the Purchaser to
deposit Collections, including Collections received in the Purchaser Lockbox and
Collections received by wire transfer directly from Insurers,  all as more fully
set forth in the Depositary Agreement.

     "Receivable Information" has the meaning set forth in Section 1.02 hereto.

     "Receivables"  means all third-party  reimbursable  portions or third-party
directly payable portions of healthcare accounts receivable, owing to a Provider
(or in the  case of  Unbilled  Receivables,  to be  owing),  arising  out of the
rendition  of  medical,  surgical,  diagnostic  or  other  professional  medical
services or nursing home services or the sale of medical products by a Provider,


                                       I-8

<PAGE>




including all rights to  reimbursement  under any  agreements  with and payments
from  Obligors,  together  with,  to the maximum  extent  permitted  by law, all
accounts  and  general  intangibles  related  thereto,  all  rights,   remedies,
guaranties, security interests and Liens in respect of the foregoing, all books,
records  and other  Property  evidencing  or  related to the  foregoing  and all
proceeds of any of the foregoing,

     "Repurchase  Price" means an amount equal to (x) the Purchase Price of such
Denied Receivable, minus (y) any cash received from the Obligor in the Purchaser
Lockbox  Account  with respect to such Denied  Receivable,  plus (z) interest on
such  amount  calculated  at the  interest  rate then in  effect  under the Loan
Agreement (or the maximum rate legally  permitted if less than such rate) on the
average  outstanding  difference  between clauses (x) and (y) from and including
the Business Day following  the Transfer  Date of such Denied  Receivable to the
date the Repurchase Price is received by the Purchaser.

     "Servicer" means the Primary Servicer,  if it is then authorized to perform
the Primary Servicer Responsibilities pursuant to Section 1.05(b), or the Master
Servicer,  or any other Person then authorized  hereunder to perform the Primary
Servicer Responsibilities.

     "Servicer  Termination  Event" means any of the events specified in Exhibit
IX hereto.

     "Settlement  Date"  means  Tuesday  of each  week;  or if such day is not a
Business Day, the next succeeding  Business Day;  provided,  that, if, following
the occurrence of an Event of  Termination,  the Purchaser shall have selected a
period shorter than one week as the Settlement Period, the Settlement Date shall
mean the 5th Business Day following the end of each such Settlement Period.

     "Settlement  Period" means the period  beginning on Friday of each week and
ending on the Friday of the following week;  provided,  that notwithstanding the
foregoing,  the first  Settlement  Period shall be the period from and including
the Initial Transfer Date through December 20, 1996; and provided, further, that
following the occurrence of an Event of Termination, the Purchaser may from time
to time, by notice to the Provider,  select a shorter  period as the  Settlement
Period.

     "Subsidiary" means, with respect to any Provider, any corporation or entity
of  which  at  least a  majority  of the  outstanding  shares  of stock or other
ownership interests having by the terms thereof ordinary voting power to elect a
majority of the board of directors (or Persons  performing similar functions) of
such  corporation or entity  (irrespective of whether or not at the time, in the
case of a corporation,  stock of any other class or classes of such  corporation
shall  have or  might  have  voting  power by  reason  of the  happening  of any
contingency)  is at the time directly or indirectly  owned or controlled by such
Provider.

     "Tangible Net Worth" means, with respect to any Person at any time, the sum
of (i) such Person's capital stock,  capital in excess of par or stated value of
shares of its capital stock,

                                       I-9

<PAGE>




retained  earnings  and any  other  account  which,  in  accordance  with  GAAP,
constitutes stockholders' equity, less (ii) treasury stock, minus (iii) the book
value of all assets  classified as  intangible  under GAAP,  including,  without
limitation,  goodwill,  deferred taxes,  deferred  financing costs,  trademarks,
trade names, patents, copyrights and licenses.

     "Total  Collections"  means, as to each  Transferred  Batch, the sum of all
Collections,  Repurchase Prices and Indemnified  Amounts, but only to the extent
that such Indemnified  Amounts are received in lieu of Collections,  distributed
to and received by the Purchaser with respect thereto.

     "Transfer Date" means Tuesday of each week after the Initial Transfer Date,
or if such day is not a Business Day, the next succeeding  Business Day provided
that there shall not be more than one  Transfer  Date in any single  week,  and,
provided further that, each Transfer Date shall occur  simultaneously  with each
Funding Date as defined in the Loan Agreement.

     "Transferred Batch" has the meaning set forth in Section 1.02 hereto.

     "Transmission"  means, upon establishment of computer interface between the
Provider  and  the  Master  Servicer  in  accordance  with  the   specifications
established by the Master Servicer,  the transmission of Receivable  Information
through  computer  interface to the Master Servicer in a manner  satisfactory to
the Master Servicer.

     "UCC" means the Uniform  Commercial  Code as in effect from time to time in
the specified jurisdiction.

     "Unbilled Receivable" means a Receivable in respect of which the goods have
been shipped, or the services rendered,  to the relevant patient,  and rights to
payment  therefor  have  accrued,  but the invoice has not been  rendered to the
applicable Obligor.

     Other Terms. All accounting terms not specifically  defined herein shall be
construed in accordance with GAAP. All terms used in Article 9 of the UCC in the
State of New York,  and not  specifically  defined  herein,  are used  herein as
defined in such Article 9.

                                      I-10

<PAGE>




                                   EXHIBIT II

                             CONDITIONS OF PURCHASES

     1.  Conditions  Precedent  on Initial  Transfer  Date.  The  purchase  of a
Purchased  Batch under the Agreement on the Initial  Transfer Date is subject to
the conditions precedent that the Purchaser shall have received on or before the
Initial  Transfer Date the following,  each (unless  otherwise  indicated) dated
such date, in form and substance satisfactory to the Purchaser:

     (a) For each Provider and the Primary Servicer, a certificate issued by the
Secretary  of State of the state of such  entity's  (i)  organization  as to the
legal  existence  and good standing of such entity and (ii) locale of operation,
if different from its state of  organization,  as to the foreign  qualification,
authorization  and good  standing  of such  entity in such  locale (all of which
certificates  shall be dated not more than 20 days prior to the Initial Transfer
Date) or an opinion of counsel for such entity to such effect.

     (b) For each  Provider and the Primary  Servicer,  certified  copies of the
charter and by-laws of such entity, certified copies of resolutions of the Board
of Directors of such entity  approving the  Agreement,  certified  copies of all
documents  filed to register  any assumed  names of such entity,  and  certified
copies  of  all  documents  evidencing  other  necessary  corporate  action  and
governmental approvals, if any, with respect to the Agreement.

     (c) For each  Provider  and the  Primary  Servicer,  a  certificate  of the
Secretary or Assistant  Secretary of such entity  certifying  the names and true
signatures  of the  incumbent  officers  of such entity  authorized  to sign the
Agreement and the other documents to be delivered by it hereunder.

     (d) (i) Certified  copies of the balance sheets of the Primary Servicer and
its  Subsidiaries  as at December 31, 1995, and for the prior 3 fiscal years and
the  related  statements  of income and  expense  and  retained  earnings of the
Primary Servicer and its Subsidiaries for the fiscal year then ended,  certified
in a manner  acceptable  to the  Purchaser  by  independent  public  accountants
acceptable to the Purchaser  and  demonstrating  that there has been no Material
Adverse Effect and (ii) unaudited balance sheets of the Primary Servicer and its
Subsidiaries  for the fiscal  quarter  ended  September 30, 1996 and the related
statements of income and expense and retained  earnings of the Primary  Servicer
and its Subsidiaries for such fiscal quarter then ended.

     (e)  Acknowledgment  or time  stamped  receipt  copies of proper  financing
statements  (showing  each Provider as  debtor/seller,  the Purchaser as secured
party/purchaser and DH-2 as assignee,  and stating that the financing statements
are being filed  because UCC Section 9-102 does not  distinguish  between a sale
and a secured  loan for filing  purposes)  duly  filed on or before the  Initial
Transfer  Date under the UCC of all  jurisdictions  that the  Purchaser may deem
necessary or desirable in order to perfect the ownership interests  contemplated
by the Agreement.


                                      II-1

<PAGE>




     (f)  Acknowledgment  or time  stamped  receipt  copies of proper  financing
statements  (showing  each Provider as debtor and the Purchaser as secured party
and DH-2 as  assignee  with  respect  to the grant by the  Providers  of a first
priority  security  interest to the  Purchaser in the  Providers'  Accounts,  as
contemplated  by  Section  4.04 of the  Agreement)  duly  filed on or before the
Initial Transfer Date under the UCC of all jurisdictions  that the Purchaser may
deem necessary or desirable in order to perfect such security interest.

     (g)  Completed  requests  for  information,  dated on or before the Initial
Transfer  Date,  listing  all  effective  financing   statements  filed  in  the
jurisdictions  referred  to in  subsections  (e) and (f)  above  that  name each
Provider  as debtor,  together  with copies of such other  financing  statements
(none of which shall cover any Receivables).

     (h) Releases of, and acknowledgment copies of proper termination statements
(Form  UCC-3),  if any,  necessary  to  evidence  the  release  of all  security
interests,  ownership and other rights of any Person  previously  granted by any
Provider in its Accounts.

     (i)  Favorable  opinions of such local  counsels  for the  Providers as the
Daiwa Group requests, substantially in the form attached hereto as Exhibit XI-A,
and including a new form of patient  consent form to be used by the Providers in
such locales (the "New Patient Consent Forms"),  and as to such other matters as
the Daiwa Group requests.

     (j) A favorable opinion of Blass & Driggs, counsel for the Primary Servicer
and the Providers, substantially in the form attached hereto as Exhibit XI-B.

     (k) Payment of $150,000  which sum is equal to the  advisory fee payable by
the Purchaser to Daiwa Securities America Inc.

     (l) Payment of all reasonable attorneys' fees and disbursements incurred by
the Purchaser and the Daiwa Group.

     (m)  A  duly  executed   Depositary   Agreement,   together  with  evidence
satisfactory  to  the  Purchaser  that  the  Purchaser  Lockbox,   the  Provider
Lockboxes,  the Purchaser Lockbox Account and the Provider Lockbox Accounts have
been established.

     (n) Copies of all Notices required pursuant to Article II of the Agreement,
together with evidence satisfactory to the Purchaser that such Notices have been
or will be delivered to the addressees thereof.

     (o) A copy of each new form of  invoice  from  each  Provider  showing  the
proper Provider Lockbox or Purchaser Lockbox as the remittance address.

     (p) A copy of all of the  Providers'  existing  forms of  patient  consents
which were signed by each patient for which the currently  existing  Receivables
were created, as well as a copy of each New Patient Consent Form to be signed by
each patient for which a Receivable will be

                                      II-2

<PAGE>




created on or after the Initial Funding Date, which consents  authorize  certain
demographic and medical information with respect to such patient to be disclosed
by each Provider to its  servicing  agents and by such  servicing  agents to any
third party obligors thereon,  certified by an officer of each Provider,  or the
Primary Servicer on behalf of the Providers,  as being true,  complete,  correct
and the only consent forms presently in effect.

     2. Conditions Precedent on All Transfer Dates. Each purchase of a Purchased
Batch on a Transfer Date (including the Initial  Transfer Date) shall be subject
to the further  conditions  precedent that the Provider and the Purchaser  shall
have agreed upon the terms of such purchase and also that:

     (a) Each  Provider  shall have  delivered  to the  Purchaser  or the Master
Servicer,  as the case may be, on or prior to such  Transfer  Date,  in form and
substance satisfactory to the Purchaser:

     (i) completed Receivable Information with respect to each Proposed Eligible
Receivable (such Receivable Information having been delivered on or prior to the
most recent  Batching Time  preceding  such Transfer  Date),  together with such
additional  information  as may  reasonably be requested by the Purchaser or the
Master Servicer; and

     (ii) to the  extent  not  previously  provided,  executed  Notices  to each
Obligor  responsible  for the  payment  of any of the  Batch  Receivables  to be
purchased on such Transfer Date,  directing such Obligors to make payment to the
address  and  account  designated  in the  Notices,  as set forth in  Article II
hereof,  together with  evidence  that such Notices have been  delivered to such
Obligors.

     (b) On each such Transfer Date the following  statements shall be true (and
acceptance of the proceeds of such purchase by the Primary Servicer on behalf of
the  Providers  shall be deemed a  representation  and warranty by each Provider
that such statements are then true):

     (i) the representations and warranties contained in Exhibit III are correct
on and as of the date of such  purchase  as  though  made on and as of such date
except to the extent made with respect to an earlier date, and

     (ii) no event has  occurred  and is  continuing,  or would result from such
purchase,  that  constitutes  a Group-Wide  Event of  Termination  or that would
constitute a Group-Wide Event of Termination but for the requirement that notice
be given or time elapse or both.

     (c) The Purchaser  shall have received  such other  approvals,  opinions or
documents as it may reasonably request.

                                      II-3

<PAGE>




                                   EXHIBIT III

                         REPRESENTATIONS AND WARRANTIES

     Each of the Providers and the Primary  Servicer  represents and warrants as
follows:

     (a) It is a corporation  duly  incorporated,  validly  existing and in good
standing  under  the laws of the  state  of its  incorporation  as set  forth on
Schedule  V  hereto,  and is  duly  qualified  to do  business,  and is in  good
standing,  in every jurisdiction where the nature of its business requires it to
be so qualified.

     (b) The execution,  delivery and performance by it of the Agreement and the
other  documents to be delivered by it thereunder,  (i) are within its corporate
powers, (ii) have been duly authorized by all necessary corporate action,  (iii)
do not  contravene  (1) its charter or by-laws,  (2) any law, rule or regulation
applicable to it, (3) any contractual  restriction binding on or affecting it or
its Property,  or (4) any order,  writ,  judgment,  award,  injunction or decree
binding on or affecting it or its Property, and (iv) do not result in or require
the  creation of any Lien upon or with respect to any of its  Properties,  other
than the interest created by the Agreement. The Agreement has been duly executed
and  delivered by it. It has  furnished to the  Purchaser a correct and complete
copy of its certificate of incorporation  and by-laws,  including all amendments
thereto.

     (c) No  authorization  or approval or other  action by, and no notice to or
filing with, any Governmental Entity is required for the due execution, delivery
and  performance  by it of the  Agreement or any other  document to be delivered
thereunder.

     (d) The Agreement  constitutes the legal,  valid and binding  obligation of
it,  enforceable  against it in accordance with its terms,  except as limited by
bankruptcy, insolvency, moratorium, fraudulent conveyance or other laws relating
to the  enforcement  of creditors'  rights  generally and general  principles of
equity (regardless of whether enforcement is sought at equity or law).

     (e) It has  all  power  and  authority,  and  has  all  permits,  licenses,
accreditations,   certifications,   authorizations,   approvals,   consents  and
agreements of all Insurers,  Governmental  Entities,  accreditation agencies and
any other Person (including without limitation, accreditation by the appropriate
Governmental Entities and industry  accreditation agencies and accreditation and
certifications as a provider of healthcare  services eligible to receive payment
and compensation and to participate under Medicare,  Medicaid,  CHAMPUS/Champva,
Blue Cross/Blue Shield and other equivalent programs), necessary or required for
it (i) to own the assets (including Receivables) that it now owns, (ii) to carry
on its business as now  conducted,  except where  failure to have such  permits,
licenses,  agreements with third-party payors,  accreditation and certifications
(including,  without limitation,  accreditation by the appropriate  Governmental
Entities   and   industry   accreditation   agencies   and   accreditation   and
certifications as a provider of healthcare  services eligible to receive payment
and compensation and to participate under Medicare,  Medicaid,  CHAMPUS/Champva,
Blue Cross/Blue Shield and other equivalent  programs) would not have a Material
Adverse Effect.

                                      III-1

<PAGE>




     (f) It has  not  been  notified  by any  Insurer,  Governmental  Entity  or
instrumentality,   accreditation   agency  or  any  other  Person,   during  the
immediately  preceding  24 month  period,  that such party has  rescinded or not
renewed,  or is  reasonably  likely to rescind or not  renew,  any such  permit,
license,  accreditation,  certification,  authorization,  approval,  consent  or
agreement  granted  to it or to  which  it is a party  except  as  disclosed  in
Schedule III hereto.

     (g) As of the Initial Transfer Date, all conditions  precedent set forth in
Exhibit II have been fulfilled or waived in writing by the Purchaser,  and as of
each Transfer Date,  the  conditions  precedent set forth in paragraph 2 of such
Exhibit II shall have been fulfilled or waived in writing by the Purchaser.

     (h) The balance sheets of the Primary  Servicer and its  Subsidiaries as at
December 31, 1995,  and as at September  30, 1996 and the related  statements of
income and expense, cash flows and retained earnings of the Primary Servicer and
its  Subsidiaries  for the fiscal periods then ended,  copies of which have been
furnished  to the  Purchaser,  fairly  present the  financial  condition  of the
Primary  Servicer  and its  Subsidiaries  as at such date and the results of the
operations of the Primary  Servicer and its Subsidiaries for the period ended on
such date,  all in accordance  with GAAP,  and since December 31, 1995 there has
been no change resulting in a Material Adverse Effect.

     (i) There is no pending or, to the Primary Servicer's knowledge, threatened
action or proceeding or  injunction,  writ or  restraining  order  affecting the
Primary  Servicer  or any of its  Subsidiaries  before any  court,  Governmental
Entity or arbitrator  which could reasonably be expected to result in a Material
Adverse Effect,  and the Primary Servicer or any Subsidiary is not currently the
subject of, and has no present intention of commencing, an insolvency proceeding
or petition in bankruptcy.

     (j) Each Provider is the legal and beneficial  owner of the  Receivables in
each  Transferred  Batch  free and  clear of any  Lien  (other  than any Lien on
Accounts that is expressly subordinated in writing to the Lien created hereunder
in a manner  acceptable to the  Purchaser,  in its sole  discretion);  upon each
purchase or  contribution  of a Transferred  Batch,  the Purchaser shall acquire
valid  ownership  of  each  Receivable  in  such  Transferred  Batch  and in the
Collections with respect thereto prior to all other Liens thereon.  No effective
financing   statement  or  other  instrument  similar  in  effect  covering  any
Receivable or the  Collections  with respect thereto is on file in any recording
office,  except  those filed in favor of the  Purchaser,  DH-2 or any  permitted
assignee of DH-2 relating to the  Agreement,  and no competing  notice or notice
inconsistent  with the  transactions  contemplated  in the Agreement  remains in
effect with respect to any Obligor.

     (k) All Receivable Information, information provided in the application for
the program  effectuated by the Agreement,  and each other document,  report and
Transmission provided by the Primary Servicer or any Provider to the Daiwa Group
is or shall be  accurate in all  material  respects as of its date and as of the
date so  furnished,  and no such  document  contains or will  contain any untrue
statement  of a  material  fact or omits or will omit to state a  material  fact
necessary in order to make the statements contained therein, in the light of the
circumstances under which they were made, not misleading.

                                      III-2

<PAGE>




     (l) The  principal  place of business  and chief  executive  office of each
Provider and the office where such  Provider  keeps its records  concerning  the
Receivables are located at the respective  address  referred to on the signature
pages of the Agreement and there have been no other such  locations for the four
immediately prior months.

     (m) Each purchase of a Purchased  Batch will constitute a purchase or other
acquisition of notes,  drafts,  acceptances,  open accounts  receivable or other
obligations  representing  part  or all  of  the  sales  price  of  merchandise,
insurance or services  within the meaning of Section  3(c)(5) of the  Investment
Company Act of 1940, as amended.

     (n) Each  Receivable  included in a Purchased  Batch is, as of the Transfer
Date of such Purchased Batch, an Eligible Receivable.

     (o) The provisions of the Agreement  create,  on the Initial Transfer Date,
legal  and valid  liens in all of the  Accounts  owned or held by the  Providers
(other than the Batch Receivables that have been sold to the Purchaser  pursuant
to the  provisions of the  Agreement)  in the  Purchaser's  favor,  and when all
proper  filings  and other  actions  necessary  to perfect  such liens have been
completed,  will  constitute  a  perfected  and  continuing  lien  on all of the
Accounts owned or held by the Providers  (other than the Batch  Receivables that
have been sold to the Purchaser  pursuant to the  provisions of the  Agreement),
having  priority  over  all  other  liens  on such  Accounts  of the  Providers,
enforceable against each Provider and all third parties.

     (p)  All  required  Notices  have  been  prepared  and  delivered  to  each
applicable  Governmental Entity and Insurer,  and all invoices now bear only the
appropriate  remittance  instructions  for payment  direction  to the  Purchaser
Lockbox,  the Purchaser Lockbox Account, the appropriate Provider Lockbox or the
appropriate Provider Lockbox Account, as the case may be.

     (q) No  Provider  has  changed  its  principal  place of  business or chief
executive office in the last five years.

     (r) The exact name of each Provider is as set forth on the signature  pages
of the Agreement and,  except as set forth on such signature page, such Provider
has not  changed  its name in the last  five  years  and,  except  as set  forth
opposite  such  Provider's  name on  Schedule V hereto,  during such period such
Provider has not used,  nor does such  Provider  now use, any other  fictitious,
assumed or trade name.

     (s) The Provider Lockbox Accounts are the only lockbox accounts  maintained
by the Providers with respect to Eligible Receivables.

     (t) With respect to itself or any of its  Subsidiaries,  since the Transfer
Date prior to the making of this representation, there exists no event which has
or is reasonably likely to have a Material Adverse Effect.


                                      III-3

<PAGE>




     (u) It is not in  violation  under any  applicable  statute,  rule,  order,
decree or regulation of any court,  arbitrator  or  governmental  body or agency
having  jurisdiction  over any  Provider  which  could have a  Material  Adverse
Effect.

     (v) It has filed on a timely  basis  all tax  returns  (federal,  state and
local) required to be filed and has paid, or made adequate provision for payment
of, all taxes,  assessments and other  governmental  charges due from it, unless
contested in good faith by appropriate  proceedings.  No tax lien has been filed
and is now  effective  against it or any of its  Properties,  except any Lien in
respect of taxes and other  charges  not yet due or  contested  in good faith by
appropriate proceedings.  To its knowledge,  there are no pending investigations
of it by any taxing authority or any pending but unassessed tax liability of it.
It does not have any obligation under any tax sharing agreement.

     (w) It is solvent and will not become  insolvent after giving effect to the
transactions  contemplated  by this  Agreement;  it has not  incurred  debts  or
liabilities  beyond its  ability to pay;  it will,  after  giving  effect to the
transaction  contemplated by this Agreement,  have an adequate amount of capital
to conduct its  business in the  foreseeable  future;  the sales of  Receivables
hereunder are made in good faith and without intent to hinder,  delay or defraud
its present or future creditors.

     (x) The  Provider  Government  Lockbox is the only post  office box and the
Provider  Government  Lockbox Account is the only lockbox account  maintained by
the Providers for Receivables,  the Obligors of which are Governmental Entities;
and no  direction  of any  Provider  is in effect  directing  Obligors  to remit
payments on Proposed Eligible Receivables or Batch Receivables other than to the
applicable  Purchaser Lockbox,  Purchaser Lockbox Account,  Provider Lockbox, or
Provider Lockbox Account.

     (y) Each  pension  plan or profit  sharing  plan to which it is a party has
been fully funded in accordance with its obligations as set forth in such plan.

     (z) To its knowledge, there are no pending civil or criminal investigations
by any Governmental Entity involving it or its officers or directors and neither
it nor any of its officers or directors has been involved in, or the subject of,
any civil or criminal investigation by any Governmental Entity.

     (aa) The primary  business of each  Provider is the provision of healthcare
services, merchandise and/or equipment.

     (bb) The assets of each  Provider  are free and clear of any liens in favor
of the Internal  Revenue  Service,  any Employee  Benefit Plan or the PBGC other
than inchoate tax liens resulting from an assessment of such Provider.

     (cc) With respect to each  Employee  Benefit  Plan of it,  including to its
knowledge as to any Multiemployer  Plan, such Employee Benefit Plan has complied
and been administered in accordance with its terms and in substantial compliance
with all applicable  provisions of ERISA and the Internal  Revenue Code of 1986,
as amended; neither it nor any ERISA Affiliate has been notified

                                      III-4

<PAGE>




by the  sponsor  of a  Multiemployer  Plan  that such  Multiemployer  Plan is in
reorganization or has been terminated,  within the meaning of Title IV of ERISA;
and it has no material unpaid liability for any Employee Benefit Plan.

     (dd)  None  of the  Proposed  Eligible  Receivables  or  Batch  Receivables
constitutes or has constituted an obligation of any Subsidiary,  parent or other
Person which is its Affiliate.

     (ee) The  Obligor  of each  Proposed  Eligible  Receivable  and each  Batch
Receivable has not been the Obligor of any Defaulted  Receivables in the past 12
months  (other than,  for the purpose of this clause,  as a result of good faith
disputes).

     (ff) No transaction  contemplated under this Agreement requires  compliance
with any bulk sales act or similar law.

     (gg) It has, or has the right to use, valid provider identification numbers
and licenses to generate the Receivables.

     (hh) It  shall  treat  each  sale of  Receivables  hereunder  as a sale for
federal and state income tax, reporting and accounting  purposes and shall treat
each  contribution  of Receivables  hereunder as a contribution  for federal and
state income tax, reporting and accounting purposes.

     (ii) It is not engaged principally,  or as one of its important activities,
in the business of extending  credit for the purpose of  purchasing  or carrying
margin  stock  (within the meaning of  Regulation  G, T, U, or X of the Board of
Governors  of the Federal  Reserve  System),  and no part of the proceeds of any
extension of credit under this  Agreement  will be used to purchase or carry any
such margin stock or to extend credit to others for the purpose of purchasing or
carrying margin stock.

     (jj) With respect to each Transferred  Batch,  each Provider shall receive,
for its own capital account,  its  proportional  share (based on such Provider's
portion  of the  Receivables  contributed  to the  Purchaser)  of the  aggregate
Expected Net Value of the Transferred Batch.

     (kk) Each Receivable  that is an Unbilled  Receivable will be, or has been,
billed to the  Obligor  of such  Receivable  within 45 days of the Last  Service
Date.

     (ll)  Commencing  January 1, 1997,  only the New Patient  Consent Forms are
being  obtained  from each  patient and  resident  receiving  services  from the
Providers.


                                      III-5

<PAGE>




                                   EXHIBIT IV

                                    COVENANTS

     Until  the later of the  Facility  Termination  Date and the Final  Payment
Date, each Provider agrees as follows:

     (a) Compliance with Laws, etc. It will comply in all material respects with
all applicable laws, rules, regulations and orders and preserve and maintain its
corporate existence, rights, franchises,  qualifications,  and privileges except
to the  extent  that  the  failure  so to  comply  with  such  laws,  rules  and
regulations or the failure so to preserve and maintain such  existence,  rights,
franchises,  qualifications,  and  privileges  would not  result  in a  Material
Adverse Effect.

     (b) Offices, Records and Books of Account. It will keep its principal place
of business and chief executive office and the office where it keeps its records
concerning  the  Receivables  at the  address  set  forth  under its name on the
signature  pages to the Agreement or, upon 30 days' prior written  notice to the
Purchaser,  at any other locations in jurisdictions where all actions reasonably
requested by the  Purchaser  or  otherwise  necessary to protect and perfect the
Purchaser's interest in the Receivables have been taken and completed.  It shall
keep its books and accounts in accordance  with  generally  accepted  accounting
principles  and shall make a notation on its books and  records,  including  any
computer  files, to indicate which  Receivables  have been sold to the Purchaser
and the  security  interest of the  Purchaser  in its  Accounts  not sold to the
Purchaser.  It  shall  maintain  and  implement   administrative  and  operating
procedures  (including,  without  limitation,  an  ability to  recreate  records
evidencing  Receivables and related contracts in the event of the destruction of
the originals thereof), and keep and maintain all documents,  books, records and
other  information  reasonably  necessary or advisable for  collecting all Batch
Receivables (including, without limitation, records adequate to permit the daily
identification  of each Batch  Receivable and all Collections of and adjustments
to each existing Batch Receivable) and for providing the Receivable Information.

     (c)  Performance  and  Compliance  with Contracts and Credit and Collection
Policy.  It will,  at its expense,  timely and fully perform and comply with all
material provisions,  covenants and other promises required to be observed by it
under the  contracts  related  to the Batch  Receivables,  and  timely and fully
comply in all material  respects with the Credit and Collection Policy in regard
to each Batch Receivable and the related contract, and it shall maintain, at its
expense,  in full operation each of the bank accounts and lockboxes  required to
be  maintained  under  the  Agreement.  It shall  not do  anything  to impede or
interfere with the collection by the Purchaser or the Master Servicer, on behalf
of the Purchaser, of the Batch Receivables.

     (d) Notice of Breach of Representations  and Warranties.  It shall promptly
(and in no event later than one Business Day following actual knowledge thereof)
inform the  Purchaser  and the Master  Servicer  of any breach of  covenants  or
representations and warranties hereunder,  including,  without limitation,  upon
discovery that a Receivable ceases to be an Eligible Receivable.


                                      IV-1

<PAGE>




     (e) Sales,  Liens,  etc. It will not sell,  assign (by  operation of law or
otherwise) or otherwise  dispose of, or create or suffer to exist any Liens upon
or with  respect  to, its  Accounts,  or upon or with  respect to any account to
which any  Collections of any Batch  Receivable are sent, or assign any right to
receive  income in respect  thereof  except (i) it may grant a Lien on  Accounts
that is expressly  subordinated  in writing to the Lien  created  hereunder in a
manner  acceptable to DH-2, in its sole discretion and (ii) those Liens in favor
of the Purchaser, DH-2 or any assignee of DH-2 relating to the Agreement.

     (f) Extension or Amendment of Batch Receivables.  It shall not amend, waive
or otherwise  permit or agree to any  deviation  from the terms or conditions of
any Batch Receivable except in accordance with the Credit and Collection Policy.

     (g) Change in Business or Credit and  Collection  Policy.  It will not make
any  change  in the  Credit  and  Collection  Policy  or make any  change in the
character  of its business  that,  in either  event,  could result in a Material
Adverse  Effect.  It will not make any other material  changes in the Credit and
Collection Policy without the prior written consent of the Purchaser.

     (h) Audits and  Visits.  It will,  at any time and from time to time during
regular business hours as requested by the Purchaser,  permit the Purchaser,  or
its agents or  representatives  (including the Master Servicer),  (i) to examine
and  make  copies  of and  abstracts  from  all  books,  records  and  documents
(including,  without limitation,  computer tapes and disks) in its possession or
under its control relating to Batch Receivables  including,  without limitation,
the related  contracts,  and (ii) to visit its offices  and  properties  for the
purpose of  examining  such  materials  described  in clause  (i) above,  and to
discuss matters  relating to Batch  Receivables or its performance  hereunder or
under the contracts  with any of its officers or employees  having  knowledge of
such matters.  It shall permit the Master Servicer to have at least one agent or
representative  physically  present in its  administrative  office during normal
business hours to assist it in performing its  obligations  under the Agreement,
including its  obligations  with respect to the collection of Batch  Receivables
pursuant to Article I of the Agreement.

     (i) Change in Payment  Instructions.  It will not  terminate  the  Provider
Lockboxes, the Provider Lockbox Accounts, the Purchaser Lockbox or the Purchaser
Lockbox Account, or make any change or replacement in the instructions contained
in any  invoice,  Notice or  otherwise,  or regarding  payments  with respect to
Receivables to be made to it, the Purchaser or the Master Servicer,  except upon
the prior and express direction of the Program Manager or the Purchaser.

     (j) Reporting  Requirements.  It will provide to the Purchaser (in multiple
copies, if requested by the Purchaser) the following:

     (i) as soon as  available  and in any event within 45 days after the end of
each of the first three  quarters  of each fiscal year of the Primary  Servicer,
consolidated  balance sheets of the Primary  Servicer and its Subsidiaries as of
the end of such quarter and  consolidated  statements of income,  cash flows and
retained  earnings of the Primary  Servicer and its  Subsidiaries for the period
commencing at the beginning of the current fiscal year and

                                      IV-2

<PAGE>




ending with the end of such quarter, certified by the chief financial officer of
the Primary Servicer;

     (ii) as soon as available  and in any event within 90 days after the end of
each  fiscal year of the Primary  Servicer,  a copy of the audited  consolidated
financial statements (together with explanatory notes thereon) and the auditor's
report  letter  for such year for the  Primary  Servicer  and its  Subsidiaries,
containing  financial  statements for such year audited by KPMG Peat Marwick LLP
or other independent public accountants acceptable to the Purchaser;

     (iii) as soon as available and in any event within 45 days after the end of
each fiscal quarter of the Primary Servicer,  an officer's certificate as to its
performance  under and  compliance  with this  Agreement  during  the  preceding
quarter;

     (iv) on or  before  the  15th  of  each  month,  monthly  and  year-to-date
statistical and financial  reports,  including  volume and time business reports
(to be requested by the  Purchaser) and unaudited  consolidated  profit and loss
reports, from the chief financial officer of the Primary Servicer;

     (v) promptly and in any event within ten days after the  occurrence of each
Event of Termination or event which, with the giving of notice or lapse of time,
or both,  would  constitute  an Event of  Termination,  a statement of the chief
financial officer of the Primary Servicer setting forth details of such Event of
Termination  or event,  and the action that it or such  applicable  Provider has
taken and proposes to take with respect thereto;

     (vi) promptly  after the sending or filing  thereof,  copies of all reports
and  registration  statements that the Primary  Servicer or any Subsidiary files
with the Securities and Exchange  Commission or any national securities exchange
and official  statements that the Primary  Servicer or any Subsidiary files with
respect  to the  issuance  of  tax-exempt  indebtedness  and  after  an Event of
Termination or Servicer  Termination Event,  copies of all reports (if any) that
the Primary Servicer or any Subsidiary sends to any of its security holders;

     (vii) promptly after the filing or receiving thereof, copies of all reports
and notices that the Primary  Servicer or any  Affiliate  files under ERISA with
the Internal Revenue Service or the PBGC or the U.S. Department of Labor or that
the Primary Servicer or any Affiliate receives from any of the foregoing or from
any  Multiemployer  Plan to which the Primary  Servicer or  Affiliate is or was,
within the  preceding  five  years,  a  contributing  employer,  in each case in
respect of the assessment of withdrawal liability or an event or condition which
could,  in the  aggregate,  result in the imposition of liability on the Primary
Servicer and/or any such Affiliate in excess of $10,000;

     (viii) at least ten  Business  Days prior to any  change in any  Provider's
name,  a notice  setting  forth  the new name and the  proposed  effective  date
thereof;

                                      IV-3

<PAGE>




     (ix) promptly (and in no event later than one Business Day following actual
knowledge or receipt thereof),  written notice in reasonable  detail, of (w) any
Lien asserted or claim made against a Batch Receivable,  (x) the occurrence of a
Servicer  Termination  Event,  (y) the occurrence of any other event which could
have a  Material  Adverse  Effect on the value of a Batch  Receivable  or on the
interest of the  Purchaser in a Batch  Receivable or (z) the results of any cost
report  or  similar  audits  being  conducted  by any  federal,  state or county
Governmental Entity or its agents or designees;

     (x) at least 30 days  prior to the  commencement  of each  fiscal  year,  a
consolidated  and  consolidating   operating  plan  (together  with  a  complete
statement  of the  assumptions  on which  such  plan is  based)  of the  Primary
Servicer and its  Subsidiaries  approved by its Board of Directors,  which shall
include monthly budgets for the prospective year in reasonable detail acceptable
to the Purchaser and will integrate  operating  profit and cash flow projections
and personnel, capital expenditures, and facilities plans;

     (xi)  promptly upon receipt  thereof,  a copy of any  management  letter or
written report submitted to the Primary Servicer by independent certified public
accountants with respect to the Subsidiaries,  business, condition (financial or
otherwise), operations, prospects, or Properties of the Primary Servicer;

     (xii) no later than five (5) days after the commencement  thereof,  written
notice of all actions,  suits, and proceedings before any Governmental Authority
or arbitrator  affecting  any Provider  which,  if determined  adversely to such
Provider, could have a Material Adverse Effect;

     (xiii)  promptly after the furnishing  thereof,  copies of any statement or
report  furnished by a Provider to any other party  pursuant to the terms of any
indenture, loan, or credit or similar agreement and not otherwise required to be
furnished to the Purchaser pursuant to this Agreement;

     (xiv) as soon as  possible  and in any  event  within  five (5) days  after
becoming  aware of the  occurrence  thereof,  written  notice of any matter that
could reasonably be expected to result in a Material Adverse Effect;

     (xv) as soon  as  available,  (A)  one  copy of each  financial  statement,
report,  notice or proxy  statement  sent by the Primary  Servicer or any of its
Subsidiaries to its  stockholders  generally,  (B) and one copy of each regular,
periodic or special report,  registration  statement, or prospectus filed by the
Primary  Servicer  or  any  Subsidiary  with  any  securities  exchange  or  the
Securities  and Exchange  Commission or any successor  agency or the  Bankruptcy
Court,  and (C) all press  releases and other  statements  made available by the
Primary  Servicer to the public  concerning  developments in the business of the
Primary Servicer or any Subsidiary;


                                      IV-4

<PAGE>




     (xvi) within the sixty (60) day period prior to the end of each fiscal year
of the Primary Servicer, a report satisfactory in form to the Purchaser, listing
all material insurance coverage  maintained as of the date of such report by the
Primary Servicer and its Subsidiaries and all material  insurance  planned to be
maintained by the Primary Servicer and its Subsidiaries in the subsequent fiscal
year; and

     (xvii) such other  information  respecting the Receivables or the condition
or operations, financial or otherwise, of the Primary Servicer or any Subsidiary
as the Purchaser may from time to time reasonably request.

     (k)  Notice  of  Proceedings;  Overpayments.  The  Primary  Servicer  shall
promptly  notify  the  Master  Servicer  in  the  event  of  any  action,  suit,
proceeding,  dispute, set-off, deduction, defense or counterclaim that is or may
be  asserted by an Obligor  with  respect to any Batch  Receivable.  The Primary
Servicer  shall cause each Provider to make any and all payments to the Obligors
necessary to prevent the Obligors from offsetting any earlier overpayment to any
Provider against any amounts the Obligors owe on any Batch Receivables.

     (l) Officer's Certificate. On the date the financial statements referred to
in clause (ii) above are to be  delivered  in each fiscal year after the Initial
Transfer  Date,  the chief  financial  officer of each Provider  shall deliver a
certificate  to  the  Purchaser,   stating  that,  as  of  such  date,  (i)  all
representations  and  warranties  are true  and  correct,  (ii)  the  conditions
precedent  set forth in paragraph 2 of Exhibit II have been  fulfilled or waived
in writing by the Purchaser, and (iii) no Group-Wide Event of Termination exists
and is continuing.

     (m) Further Instruments, Continuation Statements. Each
Provider  shall,  at its  expense,  promptly  execute  and  deliver  all further
instruments and documents,  and take all further action that the Program Manager
or the Purchaser may reasonably request, from time to time, in order to perfect,
protect or more fully  evidence the full and  complete  transfer of ownership of
the Batch  Receivables,  or to enable the  Purchaser  or the Program  Manager to
exercise or enforce  the rights of the  Purchaser  hereunder  or under the Batch
Receivables.  Without  limiting the generality of the  foregoing,  each Provider
will upon the request of the Program Manager execute and file such UCC financing
or continuation  statements,  or amendments thereto or assignments  thereof, and
such other  instruments  or  notices,  as may be, in the  opinion of the Program
Manager,  necessary or appropriate.  Each Provider hereby authorizes the Program
Manager or its designees,  upon two Business  Days' notice,  to file one or more
financing or  continuation  statements  and amendments  thereto and  assignments
thereof,  relative  to  all or any of the  Batch  Receivables  now  existing  or
hereafter arising without the signature of such Provider where permitted by law.
If a Provider fails to perform any of its  agreements or  obligations  under the
Agreement,  the  Program  Manager  may (but  shall not be  required  to)  itself
perform, or cause performance of, such agreement or obligation, and the expenses
of the Program Manager incurred in connection  therewith shall be payable by the
Providers.


                                      IV-5

<PAGE>




     (n)  Taxes.  The  Providers  shall  pay any and all taxes  relating  to the
transactions contemplated under this Agreement, including but not limited to the
sale, transfer and assignment of each Batch Receivable.

     (o)  Deviation  from Terms of Batch  Receivable,  etc. No  Provider  shall,
without the prior written consent of the Purchaser:

     (i) other than in connection  with the  repurchase of a Denied  Receivable,
compromise,  adjust,  extend,  satisfy,  subordinate,  rescind,  set off, waive,
amend, or otherwise  modify, or permit or agree to any deviation from, the terms
and conditions of any Batch Receivable, or materially or adversely amend, modify
or waive any term or condition of any contract related thereto;

     (ii) (x) amend,  modify,  supplement  or delete in any way or to any extent
any provision for  uncollectible  accounts and free care applicable to any Batch
Receivable  or (y) amend,  modify or  supplement in any way or to any extent any
financial category or change in any way or to any extent the manner in which any
financial category is treated or reflected in a Provider's records;

     (iii)  materially  or adversely  alter or modify (x) its claims  processing
system, or (y) its third party billing system, as applicable; or

     (iv) change,  modify or rescind any  direction  contained in any invoice or
previously delivered Notice.

     (p)  Purchaser's  Ownership of Batch  Receivables.  It shall not prepare or
permit to be prepared  any  financial  statements  which  shall  account for the
transactions  contemplated  hereby in a manner which is, or in any other respect
account  for  the  transactions  contemplated  hereby  in  a  manner  which  is,
inconsistent with the Purchaser's ownership of the Batch Receivables.

     (q) Merger,  Consolidation.  It shall not merge with or into or consolidate
with or into, another Person, or convey, transfer, lease or otherwise dispose of
all  or  substantially  all  of its  assets  (whether  now  owned  or  hereafter
acquired).

     (r) No  "Instruments".  It shall not take any  action  which  would  allow,
result in or cause any Transferred  Batch or Batch Receivable to be evidenced by
an "instrument" within the meaning of the UCC of the applicable jurisdiction.

     (s) Master Servicer  Certificate.  On or before the thirtieth  calendar day
after the Initial  Transfer Date, the Purchaser shall receive a certificate from
the Master Servicer stating that all computer  linkups and interfaces  necessary
or  desirable,  in the  judgment  of the  Master  Servicer,  to  effectuate  the
transactions  and  information  transfers  contemplated  hereunder,   are  fully
operational to the satisfaction of the Master Servicer.


                                      IV-6

<PAGE>




     (t)  Implementation of New Patient Consent Forms. As soon as possible after
the Initial  Transfer Date and in any event no later than December 31, 1996, the
Purchaser shall receive a certificate  from an officer of each Provider  stating
that the New  Patient  Consent  Forms  are the  only  forms  being  used by such
Provider and that all  reasonable  steps have been and are being taken to obtain
New Patient  Consent Forms from patients and residents  currently being provided
services by such Provider.

     (u) Deviation from New Patient Consent Form. No Provider shall, without the
prior written consent of the Purchaser,  substitute,  alter, modify or change in
any way the New Patient Consent Form applicable to it.

     (v) Implementation of New Invoices. Each Provider shall take all reasonable
steps to ensure that all invoices rendered or dispatched on or after the Initial
Transfer Date contain only the remittance instructions required under Article II
of this Agreement.

     (w)  Assumed  Name  Certificates.  On or  before  December  31,  1996,  the
Purchaser  shall receive  copies of all  certificates  filed by the Providers in
each  applicable  jurisdiction  regarding the use of each of the trade names set
forth opposite each Provider's name on Schedule V attached hereto.


                                      IV-7

<PAGE>




                                    EXHIBIT V

                              EVENTS OF TERMINATION

     Each of the following  shall be an "Event of  Termination"  with respect to
each  individual  Provider and, if any Event of  Termination  relates either (in
each case, a "Group-Wide  Event of  Termination")  to the Primary Servicer or to
Providers  responsible  in the  aggregate  for the sale or  contribution  to the
Purchaser of more than 25% of the Batch  Receivables  (whether or not purchased)
in the prior 90 days (or the  number of days from the date of the  Agreement  to
the  date of such  Event of  Termination,  if less  than 90  days)  ("Group-Wide
Providers"), such Event of Termination shall relate to each Provider:

     (a) The Servicer,  in its capacity as agent for the  Purchaser  pursuant to
Section  1.05(b),  shall  fail to  perform  or  observe  any term,  covenant  or
agreement  included  in the  Primary  Servicer  Responsibilities  (other  than a
Servicer  Termination Event resulting from the events described in paragraph (g)
of this Exhibit) and such failure shall remain unremedied for fifteen (15) days,
or the  Servicer  or any  Provider  shall  fail to make when due any  payment or
deposit to be made by it under the Agreement.

     (b) Any Provider or the Servicer (i) fails to transfer any servicing rights
and  obligations  with  respect  to  the  Batch  Receivables  to  any  successor
designated pursuant to Section 1.05(b) of the Agreement,  (ii) fails to make any
payment  required under the Agreement  (unless such payment  obligation has been
fulfilled in full pursuant to the Purchaser's  set-off rights under Section 4.03
of the  Agreement)  or (iii)  sends a  "Revocation  Order"  (as  defined  in the
Depositary  Agreement)  or makes any  change  or  replacement  in the  "Standing
Revocable Instruction" (as defined in the Depositary Agreement).

     (c) Any representation or warranty (other than those
representations  and  warranties (i) with respect to the purchase of Receivables
that are covered by paragraph (f) of this Exhibit and (ii) with respect to Batch
Receivables,  the Repurchase Price with respect thereto is paid to the Purchaser
in the manner set forth in Article IV of this  Agreement  within  five  Business
Days  following  demand  therefor) made or deemed made by a Provider under or in
connection  with the  Agreement  or any  information  or report  delivered  by a
Provider  pursuant to the Agreement shall prove to have been incorrect or untrue
in any material respect when made or deemed made or delivered.

     (d) Any  Provider  fails to perform or observe any other term,  covenant or
agreement contained in the Agreement on its part to be performed or observed and
any such  failure  shall remain  unremedied  for three  Business  Days after the
earlier of (i) the discovery  thereof by such  Provider and (ii) written  notice
thereof  shall have been given to such  Provider or the Primary  Servicer by the
Purchaser;  unless such  Provider is removed as a Provider  in  accordance  with
Section 5.19(b) after the earlier of clauses (i) and (ii).


                                       V-1

<PAGE>




     (e) Any Provider or any of its Subsidiaries shall fail to pay any principal
of or  premium  or  interest  on any of its Debt when the same  becomes  due and
payable  (whether by  scheduled  maturity,  required  prepayment,  acceleration,
demand or otherwise), and such failure shall continue after the applicable grace
period, if any, specified in the agreement or instrument  relating to such Debt;
or any other event shall occur or condition  shall exist under any  agreement or
instrument  relating to any such Debt and shall  continue  after the  applicable
grace period, if any,  specified in such agreement or instrument,  if the effect
of such event or condition is to accelerate,  or to permit the  acceleration of,
the  maturity  of such Debt;  or any such Debt shall be  declared  to be due and
payable, or required to be prepaid (other than by a regularly scheduled required
prepayment),  redeemed,  purchased  or defeased,  or an offer to repay,  redeem,
purchase or defease  such Debt shall be required to be made,  in each case prior
to the stated maturity thereof.

     (f) Any purchase of a Purchased  Batch pursuant to the Agreement  shall for
any reason  (other than pursuant to the terms hereof) fail or cease to create or
fail or cease to be a valid  and  perfected  ownership  interest  in each  Batch
Receivable in such Purchased Batch and the Collections with respect thereto free
and clear of all Liens (other than Liens  referred to in clauses (i) and (ii) of
paragraph  (e) of  Exhibit  IV)  unless,  as to any such Batch  Receivable,  the
Repurchase Price with respect thereto is paid to the Purchaser in the manner set
forth in Article IV of the Agreement  within five Business Days following demand
therefor.

     (g) Any Provider or any of its  Subsidiaries  shall  generally  not pay its
debts as such debts  become due, or shall admit in writing its  inability to pay
its debts  generally,  or shall  make a general  assignment  for the  benefit of
creditors; or any proceeding shall be instituted by or against a Provider or any
of its Subsidiaries seeking to adjudicate it a bankrupt or insolvent, or seeking
liquidation, winding up, reorganization,  arrangement,  adjustment,  protection,
relief,  or composition of it or its debts under any law relating to bankruptcy,
insolvency or  reorganization  or relief of debtors,  or seeking the entry of an
order for relief or the appointment of a receiver,  trustee,  custodian or other
similar  official for it or for any substantial part of its Property and, in the
case of any such  proceeding  instituted  against it (but not instituted by it),
either such proceeding  shall remain  undismissed or unstayed for a period of 30
days,  or any of the  actions  sought  in such  proceeding  (including,  without
limitation,  the entry of an order for relief  against,  or the appointment of a
receiver,  trustee,  custodian  or other  similar  official  for,  it or for any
substantial  part of its  Property)  shall  occur;  or a Provider  or any of its
Subsidiaries  shall take any action to  authorize  any of the  actions set forth
above in this paragraph (g).

     (h) As of any date of  determination,  any  Provider  is found to have been
overpaid by Governmental  Entities by 8% or more during any period covered by an
audit conducted by the HCFA and such overpayment is not repaid within 30 days of
the earlier of receipt of a notice by, or the knowledge of, such Provider.

     (i) There shall have occurred any Material  Adverse Effect since  September
30, 1996.

     (j) A Provider  or the Primary  Servicer  shall have  consummated,  or have
entered into any transaction  which shall result in the  consummation of (i) the
merger or consolidation of such

                                       V-2

<PAGE>




Provider or the Primary  Servicer,  (ii) the acquisition of all or a substantial
portion of the assets of any Person, (iii) the transfer, sale, assignment, lease
or other  disposition of all or a substantial  portion of such Provider's or the
Primary Servicer's assets or Properties,  (iv) a change in the general nature of
such  Provider's  or the  Primary  Servicer's  business,  or (v)  the  sale of a
controlling  interest,  directly or indirectly,  in such Provider or the Primary
Servicer.

     (k)  Judgments  or orders for  payment of money  (other than  judgments  or
orders in respect of which  adequate  insurance  is  maintained  for the payment
thereof)  against the  Providers in excess of $500,000 in the  aggregate  remain
unpaid, unstayed on appeal,  undischarged,  unbonded or undismissed for a period
of 30 days or more.

     (l) Any governmental authority (including, without limitation, the Internal
Revenue  Service or the PBGC)  files a notice of a Lien  against the assets of a
Provider other than a Lien (i) that is limited by its terms to assets other than
Receivables and (ii) that does not result in a Material Adverse Effect.

     (m)  Any  Provider  does  not  maintain,  keep,  and  preserve  all  of its
Properties  necessary  or useful in the proper  conduct of its  business in good
repair,  working order, and condition (ordinary wear and tear excepted) and make
all necessary repairs,  renewals,  replacements,  betterments,  and improvements
thereof.

     (n) Any Provider does not pay or discharge at or before  maturity or before
becoming delinquent (i) all taxes, levies, assessments, and governmental charges
imposed  on it or its income or  profits  or any of its  Property,  and (ii) all
lawful claims for labor, material, and supplies,  which, if unpaid, might become
a Lien upon any of its Property.

     (o) Any Provider does not keep insured by  financially  sound and reputable
insurers all Property of a character usually insured by corporations  engaged in
the same or similar  business  similarly  situated against loss or damage of the
kinds and in the amounts  customarily  insured against by such  corporations and
carry such other  insurance  as is usually  carried by such  corporations.  Each
policy  referred to in this  Subsection  (o) shall  provide  that it will not be
canceled, amended, or reduced except after not less than thirty (30) days' prior
written  notice  to the  Purchaser  and DH-2 and  shall  also  provide  that the
interests of the Purchaser  shall not be invalidated by any act or negligence of
a Provider.  Any Provider does not advise the  Purchaser  promptly of any policy
cancellation,  reduction,  or  amendment.  Any  insurance  policy for  property,
casualty,  liability and business  interruption coverage for a Provider does not
name  DH-2 as  assignee  of the  Purchaser  as loss  payee  (as the  Purchaser's
interests may appear) or an additional insured, as appropriate.

     (p) Any Provider  does not  maintain  proper books of record and account in
which full,  true and correct  entries in  conformity  with GAAP are made of all
dealings and transactions in relation to its business and activities.


                                       V-3

<PAGE>




     (q) Any  Provider  does not comply in all  material  respects  with (i) any
document  directly relating to the  responsibilities  of such Provider under the
Agreement  or (ii) any  agreement,  contract,  or  instrument  that results in a
Material Adverse Effect.

     (r) Any Provider does not comply with all minimum funding  requirements and
all other material requirements of ERISA, if applicable,  so as not to give rise
to any liability thereunder.

     (s) Any Provider  engages in any line or lines of business  activity  other
than the businesses in which it is engaged on the date hereof.

     (t) The Loss-to-Liquidation Ratio in any four consecutive calendar weeks to
exceeds 5%.

     (u) The Delinquency Ratio in any four consecutive calendar weeks to exceeds
10%.

     (v) An "Event of Default"  (as defined in the Loan  Agreement)  shall occur
under the Loan Agreement.

     (w) Any provision of this Agreement  shall for any reason cease to be valid
and binding on a Provider or a Provider shall so state in writing.


                                       V-4

<PAGE>




                                   EXHIBIT VI

                             RECEIVABLE INFORMATION

                  The following  information shall, as appropriate,  be provided
by each Provider to the Master  Servicer with respect to each Batch  Receivable,
together  with such  other  information  and in such form as may  reasonably  be
requested  from time to time by the Master  Servicer and as, in accordance  with
applicable  law, may be disclosed  and/or  released to the Master  Servicer (the
"Receivable Information"):

     (i) patient demographic information;

     (ii) insured party demographic and other policy-related information;

     (iii) Provider services classification  information (i.e., D.R.G. and other
like  information  established  by the  Provider  from time to time to  classify
services rendered at the Provider's institution);

     (iv)  Obligor  required  information  (i.e.,  information  provided  in the
ordinary  course of business to any specified  Obligor or any other  information
required  to be provided to an Obligor  pursuant to any  agreement,  contract or
other arrangement with such Obligor); and

     (v) billing information (i.e., all information
         provided  by the  Provider  on  invoices  to  Obligors  and  any  other
         information  required  to  be  provided  pursuant  to  the  Credit  and
         Collection  Policy and, to the extent the Transmission  will not be via
         computer interface,  including a copy of the admitting face sheet, HCFA
         Form and a detailed copy of the bill).

                                      VI-1

<PAGE>




                                  EXHIBIT VII-A

                     FORM OF NOTICE TO GOVERNMENTAL ENTITIES

                     [Letterhead of the applicable Provider]
                                                                         [Date]
[Name and Address
of Governmental Entity]

                  Re:      Change of Account and Address

To Whom it May Concern:

     Please be advised that we have opened a new bank  account at  _____________
and a  post-office  box with respect to such bank  account.  Accordingly,  until
further notice, we hereby request that:

                  (1)   All wire transfers be made directly into our account at:

                        ======================
                        ----------------------
                        Account #_______________
                        ABA #_____________________
                        Confirm Phone Number:  _______________
                        Attention:  ___________________

                  (2)   All  Explanations  of Benefits,  remittance  advices and
                        other forms of payment, including checks, be made to our
                        post office box located at:

                        =================
                        -----------------
                        Reference: Account #____________

                  Thank you for your cooperation in this matter.

                              [Applicable Provider]

                             By:____________________
                                [Authorized Officer]



                                     VII-A-1

<PAGE>




                                  EXHIBIT VII-B

                           FORM OF NOTICE TO INSURERS

                     [Letterhead of the applicable Provider]
                                                                  [Date]
[Name and Address
of Insurer]

                  Re:      Change of Account and Address

To Whom it May Concern:

     Please be advised that we (the  "Provider") are selling and contributing to
CCA Funding LLC (the  "Purchaser"),  an  affiliated  company,  our  existing and
future  receivables  payable by you to us; and the  Purchaser is  assigning  the
aforementioned  existing and future  arising  receivables as collateral to Daiwa
Healthco-2 LLC (the "Lender"). Accordingly, you are hereby directed to make:

                  (1)      All wire transfers directly to the following account:

                           =======================
                           -----------------------
                           Account #_______________
                           ABA #_____________________
                           Confirm Phone Number:  _______________
                           Attention:  ___________________

                  (2)      All Explanation of Benefits,  remittance  advices and
                           other  forms of  payment,  including  checks,  to the
                           following address:

                           ======================
                           Reference:  DAIWA HEALTHCO-2 LLC

     The foregoing directions shall apply to all existing receivables payable to
us and (until further written  notice) to all receivables  arising in the future
and may not be revoked except by a writing executed by the Purchaser.




                                     VII-B-1

<PAGE>




     Please acknowledge your receipt of this notice by signing the enclosed copy
of this letter and returning it in the enclosed envelope.

                  Thank you for your cooperation in this matter.

                                            [Applicable  Provider]


                                            By:____________________
                                               [Authorized Officer]


CCA FUNDING LLC


By:____________________
   [Authorized Officer]

Receipt Acknowledged:
[Name of Insurer]


By:  ____________________
         Title:

                                     VII-B-2

<PAGE>




                                  EXHIBIT VIII

                        PRIMARY SERVICER RESPONSIBILITIES

     Each Provider shall be responsible for the following
administration    and   servicing    obligations    (the    "Primary    Servicer
Responsibilities") which shall be performed by the Primary Servicer on behalf of
the Providers  until such time as a successor  servicer  shall be designated and
shall accept appointment pursuant to Section 1.05(b) of the Agreement:

     (a) Servicing Standards and Activities.  Each Provider agrees to administer
and service the Batch  Receivables  sold or contributed by such Provider in each
Transferred  Batch (i) to the extent  consistent with the standards set forth in
clauses (b) (i)  through  (iv) below,  with the same care that it  exercises  in
administering and servicing similar receivables for its own account, (ii) within
the  parameters  of services set forth in paragraph (b) of this Exhibit VIII, as
such parameters may be modified by mutual written agreement of the Purchaser and
the Providers, (iii) in compliance at all times with applicable law and with the
agreements,  covenants,  objectives,  policies and  procedures  set forth in the
Agreement,  and  (iv)  in  accordance  with  industry  standards  for  servicing
healthcare  receivables  unless such standards  conflict with the procedures set
forth in  paragraph  (b) of this Exhibit  VIII in which case the  provisions  of
paragraph  (b)  shall  control.  The  Providers  shall  establish  and  maintain
electronic data processing services for monitoring, administering and collecting
the Batch  Receivables  in accordance  with the  foregoing  standards and shall,
within three (3) Business Days of the deposit of any checks, other forms of cash
deposits, EOB's or other written matter into a Lockbox, post such information to
its electronic data processing services.

     (b) Parameters of Primary Servicing. The Primary Servicer  Responsibilities
shall be performed within the following parameters:

     (i)  Subject to the review and  authority  of the  Purchaser  and except as
otherwise provided herein,  each Provider shall have full power and authority to
take all actions that it may deem  necessary  or  desirable,  consistent  in all
material  respects with its existing policies and procedures with respect to the
administration  and servicing of accounts  receivable,  in  connection  with the
administration  and  servicing  of  Batch  Receivables.   Without  limiting  the
generality of the  foregoing,  each Provider  shall,  in the  performance of its
servicing obligations  hereunder,  act in accordance with all legal requirements
and subject to the terms and conditions of the Agreement.  Each Provider  agrees
that the  Primary  Servicing  Fee has been  calculated  to cover  all  costs and
expenses incurred in the performance of its servicing  obligations hereunder and
no other reimbursement of costs and expenses shall be payable to the Servicer.

     (ii) A Provider  shall not be  entitled  to sue to  enforce or collect  any
Batch Receivable  without the prior written consent of the Purchaser unless such
Provider shall have  repurchased  such Batch  Receivable in accordance  with the
Agreement.

                                     VIII-1

<PAGE>




     (iii) No  Provider  shall  change  in any  material  respect  its  existing
policies and  procedures  with respect to the  administration  and  servicing of
accounts receivable  (including,  without  limitation,  the amount and timing of
write-offs) without the prior written consent of the Purchaser.

     (iv) Each Provider will be responsible for the monitoring and collection of
the Batch Receivables,  including, without limitation,  contacting Obligors that
have not made payment on their respective Batch Receivables within the customary
time period for such Obligor,  and resubmitting any claim rejected by an Obligor
due to incomplete information.

     (v) If a  Provider  determines  that a  payment  with  respect  to a  Batch
Receivable  has been received  directly by a patient or any other  Person,  such
Provider  shall  promptly  advise  the  Purchaser,  and the  Purchaser  shall be
entitled  to presume  that the reason such  payment was made to such  patient or
other  Person  was  because of a breach of  representation  or  warranty  in the
Agreement with respect to such Batch Receivable (such as, by way of example, the
forms related to such Batch  Receivable  not being  properly  completed so as to
provide  for  direct  payment  by the  Obligor to such  Provider),  unless  such
Provider  shall  demonstrate  that such is not the case. In the case of any such
Batch  Receivable  which  is  determined  not to be a  Denied  Receivable,  each
Provider  shall  promptly  demand that such  patient or other  Person  remit and
return such funds.  If such funds are not  promptly  received by the  applicable
Provider, such Provider shall take all reasonable steps to obtain such funds.

     (vi) Notwithstanding anything to the contrary contained herein, no Provider
may amend, waive or otherwise permit or agree to any deviation from the terms or
conditions  of any Batch  Receivable in any material  respect  without the prior
consent of the Purchaser.

     (c) Aged Term Servicing.  The parties hereby agree that at such time as any
Batch  Receivable  is unpaid for more than 120 days after the Last Service Date,
the applicable Provider shall, upon the request of the Purchaser,  turn over all
of its Primary  Servicer  Responsibilities  under this Agreement with respect to
such Batch  Receivable to a successor  servicer  selected by the Purchaser,  and
such servicer shall thereafter service such Batch Receivable.

     (d) Termination of Primary Servicer Responsibilities; Cooperation. Upon the
occurrence  of a Servicer  Termination  Event,  the  Purchaser  may,  by written
notice,  terminate each Provider's Primary Servicer  Responsibilities,  in which
event  the  Providers  shall  immediately   transfer  to  a  successor  servicer
designated by the Purchaser all records,  computer access and other  information
as shall be necessary or desirable,  in the judgment of such successor servicer,
to perform such responsibilities.  The Providers shall otherwise cooperate fully
with such successor servicer.

     (e) Primary  Servicing  Fee. Upon the transfer of servicing with respect to
any Purchased  Receivable  pursuant to this  Agreement,  the Providers  shall no
longer be paid the Primary Servicing Fee relating to such Purchased Receivables,
which will be paid to the  successor  Person  performing  the  Primary  Servicer
Responsibilities.

                                     VIII-2

<PAGE>




                                   EXHIBIT IX

                           SERVICER TERMINATION EVENTS

         Each of the following shall be a "Servicer Termination Event":

                  (a) An event has occurred and is continuing  that  constitutes
an Event of Termination or that would constitute an Event of Termination but for
the requirement that notice be given or time elapse or both.

                  (b) The Servicer is not performing,  or becomes unable (in the
commercially  reasonable  determination of the Purchaser) to perform,  fully the
Primary Servicer Responsibilities set forth in Exhibit VIII hereof.

                  (c)  A  Provider  is  unable  to  maintain  the   Transmission
interface  described  in Exhibit X to the  complete  satisfaction  of the Master
Servicer, or the electronic information servicing capabilities of a Provider are
not functioning for a period of more than three consecutive Business Days.

                  (d) Any Provider has sent multiple Transmissions to the Master
Servicer in a manner that is not in compliance with the specifications set forth
in Exhibit X hereof.

                  (e) The Purchaser, in its sole judgement, which judgment shall
be  commercially  reasonable,  is not  satisfied  with  the  performance  by any
Provider of the Primary Servicer  Responsibilities  or the Servicer on behalf of
the Providers with respect to the Batch Receivables.

                  (f) If, at any date,  the aggregate  Expected Net Value of all
Delinquent  Receivables that became  Delinquent  during the prior 3 months is in
excess of 20% of the aggregate Expected Net Value of all Receivables sold by the
Providers to the Purchaser during the prior 3 months  (regardless of whether the
Denied  Receivables are  repurchased by the Providers  pursuant to Article IV of
the Agreement).

                  (g) As of any date after the Initial  Transfer  Date,  (i) the
dollar-weighted  average days outstanding with respect to all outstanding  Batch
Receivables  on such  date  and on the  same  day of  each of the two  preceding
calendar  months  (or if there  is no  corresponding  day in any such  preceding
month,  the last day of such month) is greater than 65 days, or (ii) the average
over  the  preceding  90-  day  period  of  the  dollar-weighted   average  days
outstanding with respect to all outstanding Batch Receivables on each day during
such period is greater than 60 days.

                  (i) As of any date,  after the Initial Transfer Date more than
25% of all outstanding Batch Receivables (excluding Denied Receivables) are aged
more than 120 days but less than 180 days from the respective Last Service Dates
of such Batch Receivables.


                                      IX-1

<PAGE>




                  (j) As of any date,  Collections on all Batch Receivables that
have been  liquidated or written off during the then most recent 13 week period,
are less than 50% of the  aggregate  gross value  (billed  amount) of such Batch
Receivables.

                                                     IX-2

<PAGE>




                                    EXHIBIT X

               INTERFACE BETWEEN MASTER SERVICER AND THE PROVIDERS

1.       The Master  Servicer  will convey  appropriate  data  requirements  and
         instructions to the Providers to establish a computer interface between
         the Providers' systems and the Master Servicer's receivables monitoring
         system.  The  interface  will  permit  the Master  Servicer  to receive
         electronically the Providers' accounts  receivable data,  including the
         Receivable   Information,   billing  data  and   collection  and  other
         transaction data relating to the Receivables.

2.       The Providers shall give the Master Servicer and the Purchaser at least
         ten Business  Days'  notice of any coding  changes or  electronic  data
         processing system modifications made by any Provider which could affect
         the Master  Servicer's  processing or  interpretation  of data received
         through the interface.

3.       The  Master  Servicer  shall  have no  responsibility  to  return  to a
         Provider any information which the Master Servicer receives pursuant to
         the computer interface.

4.       Each Provider will prepare daily accounts receivable data files of all
         transaction types for all of the Providers' sites that are included in
         the funding  program.  The weekly cutoff will occur at a predetermined
         time each week,  and the weekly  cutoff date for all of the sites must
         occur at exactly the same time.  The cutoff date that will be selected
         will be at the end of business for a specific  day of the week,  or in
         other words, at the end of the Providers'  transaction posting process
         for that day. Each Provider  will  temporarily  maintain a copy of the
         accounts  data  files in the event  that the data is  degraded  during
         transmission, and needs to be re-transmitted.

         The Master  Servicer  will be  responsible  for the  management  of the
         hardware, communications and software used in the funding transaction.

5.       The Master  Servicer's  data center will receive the Receivable  files,
         and  immediately  confirm  that the  files  have  been  passed  without
         degradation  of data by  balancing  the  detailed  items to the control
         totals that  accompany the files.  Any problems in this process will be
         immediately  reported to the Providers so that the Receivable  file can
         be re-transmitted, if necessary.

6.       Once the receipt of the Receivable data has been confirmed,  the Master
         Servicer  will  perform  certain  tests and  edits to ensure  that each
         Receivable meets the specified eligibility criteria for purchase by the
         Purchaser.  Compliance with  concentration  limits will be verified and
         the Master  Servicer  will  notify the  Program  Manager to  initiate a
         Receivable  purchase  using  the  Receivable  file  received.  Upon the
         successful completion of a purchase,  the Master Servicer will generate
         a one-line trial balance  (listing all purchased  accounts)  confirming
         the Receivables  that have been purchased.  A copy of the trial balance
         will be forwarded to each

                                       X-1

<PAGE>




         Provider,  to the Primary Servicer, to the Purchaser and to the Program
         Manager to confirm the purchase.

7.        The Providers' sites will continue to post daily transactions to their
          respective  Receivable files. The Providers' Receivable files for each
          of the eligible  sites will include all  transactions  posted  through
          that  day.  The  Providers  will  create a  transaction  report  and a
          Receivable file for each of the eligible sites. The transaction report
          will contain all transactions posted to the respective site Receivable
          file for the specified  period (and will indicate the respective  site
          and the number of items and total dollars on each  transaction  report
          for control purposes).  The Receivable file will contain balances that
          reflect the transactions  posted on the Providers' systems through the
          end of business of the specified period.

         Each  Provider  will  transmit the billing,  transaction,  and the most
         current  Receivable  data files to the Master  Servicer's  data  center
         according to the  established  schedule.  The Providers and the Primary
         Servicer should,  again,  maintain the backup of each of these files in
         the event that a re-transmission is necessary.

8.        The Master  Servicer's  data center will  confirm  that the files have
          been received intact, and will immediately communicate any problems to
          the  Providers  in order to  initiate a re-  transmission.  The Master
          Servicer  will  then  post  the  transaction  files  to  the  accounts
          receivable  for the  previously  purchased  accounts  that the  Master
          Servicer  is  maintaining,   and  consequently   update  the  affected
          balances.  Upon completion of the posting process, the Master Servicer
          will generate  summary reports of the posting process that the Program
          Manager will use to complete  various funding  activities.  The Master
          Servicer  summary  reports will reference the  Providers'  transaction
          codes and activity to codes that are common to the funding program.

9.       The Master Servicer will then compare the updated accounts  balances on
         the Master  Servicer's  system to the  corresponding  account  balances
         reflected on the Receivable  file. The Master Servicer expects that the
         balances  for  the  funded  Receivables  will  be  congruent,  and  any
         discrepancies  will be  immediately  examined and resolved  through the
         cooperative effort of the Master Servicer and the Provider.  The Master
         Servicer shall produce  discrepancy  reports  (e.g.,  "Funding Only" or
         "Out of Balance"  reports) and the Providers shall respond  promptly to
         such reports.

10.      Once  the   reconciliation   process   has  been   completed   and  any
         discrepancies between the Master Servicer and the Providers' Receivable
         files resolved  through the  discrepancy  report  process  described in
         paragraph 9 above, the Master Servicer will then process the Receivable
         file and advise the Purchaser  that it may purchase any new  Receivable
         that is eligible. The Master Servicer will then proceed through exactly
         the same process described in paragraph 6 above.

                     [ADD ATTACHMENT 1 WITH INTERFACE DATA]

                                       X-2

<PAGE>




                                  EXHIBIT XI-A

                     FORM OF OPINION OF PROVIDERS' COUNSELS
                    WITH RESPECT TO THE PATIENT CONSENT FORMS

RJE Data Processing, Inc.
2513 West Peterson
Chicago, Illinois 60659

Daiwa Healthco-2 LLC
c/o Lord Securities Corporation
2 Wall Street
New York, NY 10005

Ladies and Gentlemen:

                  As [special local] counsel to COMMUNITY CARE OF AMERICA,  INC.
(the "CCA"),  a Delaware  corporation  and to [each of the  Providers  listed on
Schedule 1 attached hereto] (the "Providers"), we have examined the following in
connection  with  the  proposed  sale by the  Providers  of  certain  healthcare
receivables  (the  "Receivables")  to CCA FUNDING LLC (the  "Purchaser") and the
assignment  of  those  Receivables  by the  Purchaser  to DAIWA  HEALTHCO-2  LLC
("DH-2"):

     (a) A copy of the Healthcare  Receivables  Purchase and Transfer  Agreement
(the "RPA") among CCA, the Providers and the Purchaser;

     (b) A copy of the Loan and  Security  Agreement  (the  "LSA")  between  the
Purchaser and DH-2 (terms not otherwise  defined  herein shall have the meanings
provided in the RPA);

     (c) A sample of the  Receivables  proposed to be sold by the  Providers and
assigned by the Purchaser;

     (d) Each patient  consent form used by each Provider (the "Patient  Consent
Form"), copies of which are attached hereto as Exhibit A; and

     (e) Such other  documents,  statutes,  regulations and materials as we have
deemed necessary to deliver the opinion set forth herein.

     This opinion is being  delivered  pursuant to clause 1(i) of the conditions
precedent listed on Exhibit II of the RPA.

     Based  upon  the  foregoing  examination,  we are of the  opinion  that the
Patient  Consent  Forms are  sufficient to permit the lawful  disclosure  and/or
release of relevant medical information

                                    XI-A-1

<PAGE>




and documents which have been redacted to remove patient-specific diagnostic and
procedural  information  or diagnosis to the Purchaser,  DH-2,  any  third-party
servicer  acting for the  Purchaser or DH-2  pursuant to the RPA or LSA (whether
such servicer is performing the Primary Servicer  Responsibilities  or providing
data processing services with respect to the Receivables,  and including without
limitation the Master  Servicer),  and any person  guarantying  such  servicer's
obligations.

                  In order to disclose  and/or  release the full  complement  of
information  regarding  services  rendered  to a patient or resident in [name of
locale],  the Provider should obtain a patient consent form in the form attached
hereto as Exhibit B (the "New Patient  Consent Form") from each new and existing
patient and resident. Subject to the proper completion and execution of such New
Patient  Consent Form by each patient and  resident,  we are of the opinion that
the New  Patient  Consent  Form is  sufficient  to permit the lawful  disclosure
and/or release of medical information and documents to the Purchaser,  DH-2, any
third-party servicer acting for the Purchaser or DH-2 pursuant to the RPA or LSA
(whether such servicer is performing the Primary  Servicer  Responsibilities  or
providing  data  processing  services  with  respect  to  the  Receivables,  and
including without  limitation the Master Servicer),  and any person  guarantying
such servicer's obligations.

                                                              Very truly yours,

                                     XI-A-2

<PAGE>




                                  EXHIBIT XI-B

              FORM OF OPINION OF PROVIDER'S AND PURCHASER'S COUNSEL
                    WITH RESPECT TO CERTAIN CORPORATE MATTERS

                                [TO BE ATTACHED]

                                     XI-B-1

<PAGE>




                                   EXHIBIT XII

                          FORM OF DEPOSITARY AGREEMENT


                                [TO BE ATTACHED]





                                      XII-1

<PAGE>




                                   SCHEDULE I


                              ADDRESSES FOR NOTICE



If to the Program Manager:

                                    Daiwa Securities America Inc.
                                    Financial Square
                                    32 Old Slip
                                    New York, New York 10005-3538
                                    Attention: Chief Financial Officer
                                    Tel:    (212) 612-6290
                                    Fax:    (212) 612-7122


If to the Master Servicer:

                                    RJE Data Processing, Inc.
                                    2513 West Peterson
                                    Chicago, Illinois 60659
                                    Attention: Jack Callahan, President
                                    Tel:     (312) 561-6966
                                    Fax:     (312) 878-6355


<PAGE>



                                   SCHEDULE II


                          CREDIT AND COLLECTION POLICY



                                [TO BE ATTACHED]


<PAGE>




                                  SCHEDULE III


                               LICENSE REVOCATIONS




The following  facilities have been  decertified  from the Medicaid and Medicare
Programs during the past 24 months:

(1)               Community Care of America at Toledo (Toledo, Iowa)
                  Community  Care  of  America   voluntarily   decertified  this
                  facility  from  both  the  Medicare  and Iowa  state  Medicaid
                  programs on March 8, 1996. The company has been recertified to
                  participate in both programs effective  September 20, 1996 and
                  November 20, 1996 respectively.

(2)               Community  Care of America at Council  Bluffs  North  (Council
                  Bluffs,  Iowa) This  facility  was  decertified  from both the
                  Medicare and Iowa state  Medicaid  programs on April 17, 1996.
                  The  company  has  been  recertified  to  participate  in both
                  programs effective July 1, 1996.



<PAGE>




                                   SCHEDULE IV


                               LOCKBOX INFORMATION



Provider Ancillary Lockbox:
                                    CCA - Self-pay
                                    Post Office Box 710278
                                    Cincinnati, Ohio 45271-0278

Provider Ancillary Lockbox Account:
                                    CCA - Self-pay
                                    Account #00109-98906
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039

Provider Government Lockbox:
                                    CCA - Governmental
                                    Post Office Box 710275
                                    Cincinnati, Ohio 45271-0275

Provider Government Lockbox Account:
                                    CCA - Governmental
                                    Account #00109-98891
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039

Purchaser Lockbox:
                                    Post Office Box 710276
                                    Cincinnati, Ohio 45271-0276

Purchaser Lockbox Account:
                                    Account # 50020-61106
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039

<PAGE>



<TABLE>
<S>                                                                                  <C>

                                   SCHEDULE V


                              LIST OF THE PROVIDERS

Provider                            Trade Names                                      State of Incorporation
- --------                            -----------                                      ----------------------

ECA Holdings, Inc.                                                                    Delaware
                               Active Care
                               Community Care of America at Canon City
                               Community Care of America at Delta
                               Community Care of America at Grand Junction
                               Community Care of America at Paonia
                               Community Care of America at Prospect Lake
                               Family Physicians Health
                               La Villa Grande
                               Springs Village Care Center
                               Community Care of America at Clarinda
                               Community Care of America at Mediapolis
                               Community Care of America at Muscatine
                               Community Care of America at Toledo
                               Community Care of America at Winterset
                               Community Care of America at Council Bluffs North
                               Community Care of America at Council Bluffs South
                               Community Care of America at Pacific Junction
                               Community Care of America at Glenwood
                               Community Care of America at Brighton Place
                               Community Care of America at Smith Center
                               Community Care of America at Highland Park
                               Community Care of America at Arma
                               Community Care of America at Central Topeka
                               Community Care of America at Ellinwood
                               Community Care of America at Tarkio
                               Community Care of America at Oak Grove
                               Community Care of America at Grand Island
                               Community Care of America at Laramie
                               Community Care of America at Saratoga
                               Community Care of America at Worland

CCA of Midwest, Inc.                                                                    Delaware
                               Community Care of America at Palmer


Doc #RPA.WPD                                                                                                   RPTA

<PAGE>




Community Care of Nebraska, Inc.                                                        Delaware
                                    Community Care of America at Ainsworth
                                    Community Care of America at Ashland
                                    Community Care of America at Aurora
                                    Community Care of America at Blue Hill
                                    Community Care of America at Central City
                                    Community Care of America at Edgar
                                    Community Care of America at Exeter
                                    Community Care of America at Gretna
                                    Community Care of America at Sutherland
                                    Community Care of America at Utica
                                    Community Care of America at Waverly

Community Care of Georgia, Inc.                                                         Delaware
                                    Smith Hospital

Community Care of America of Alabama, Inc.                                              Delaware
                                    Family Care Medical Center of Arcadia
                                    Georgiana Doctor's Hospital
                                    Greensboro Health Care Center
                                    Livingston Nursing Home
                                    Reliable Home Health Services, d/b/a
                                            Georgiana Home Health Agency
                                    Rural Health Clinic, d/b/a
                                            Georgiana Health Clinic
                                    H.P. Kinsey, M.D., sole proprietorship d/b/a
                                            The Evergreen Clinic
                                    Southgate Village
                                    Voreis Clinic

ECA Properties, Inc.                                                                    Delaware
                                    Grandview Manor

Luling/SCC, Inc.                                                                        Georgia
                                    Community Care of America at Luling

Dublin/SCC, Inc.                                                                        Georgia
                                    Community Care of America at Dublin

Marietta/SCC, Inc.                                                                      Georgia
                                    Community Care of America at Marietta

Macon/SCC, Inc.                                                                         Georgia
                                    Community Care of America at Macon



<PAGE>




College Park/SCC, Inc.                                                                  Georgia
                                    Community Care of America at College Park

Glenwood/SCC, Inc.                                                                      Georgia
                                    Community Care of America at Connor

Quality Care of Columbus, Inc.                                                          Nebraska
                                    Community Care of America at Columbus

Quality Care of Lyons, Inc.                                                             Nebraska
                                    Community Care of America at Lyons

W.S.T. Care, Inc.                                                                       Nebraska
                                    Community Care of America at Milford


</TABLE>




                           LOAN AND SECURITY AGREEMENT

                          Dated as of December 23, 1996


                                     Between



                                 CCA FUNDING LLC
                                   as Borrower





                                       and






                              DAIWA HEALTHCO-2 LLC
                                    as Lender





<PAGE>


<TABLE>
                                TABLE OF CONTENTS
<S>                                                                                                                       <C>


                                                                                                                          Page

                                   ARTICLE I.
             COMMITMENT; AMOUNTS AND TERMS OF THE REVOLVING ADVANCES

       ss. 1.01.                    Revolving Advances.......................................................................1
       ss. 1.02.                    Revolving Commitment and Borrowing Limit.................................................1
       ss. 1.03.                    Notice of Borrowing; Borrower's Certificate..............................................2
       ss. 1.04.                    Termination of Revolving Commitment......................................................2
       ss. 1.05.                    Interest and Non-Utilization Fee.........................................................2
       ss. 1.06.                    Renewals.................................................................................3
       ss. 1.07.                    Computation of Interest..................................................................4
       ss. 1.08.                    Procedures for Payment...................................................................4
       ss. 1.09.                    Indemnities..............................................................................5
       ss. 1.10.                    Telephonic Notice........................................................................6
       ss. 1.11.                    Maximum Interest.........................................................................6

                                   ARTICLE II.
                           COLLECTION AND DISTRIBUTION
       ss. 2.01.                    Collections on the Receivables...........................................................7
       ss. 2.02.                    Distribution of Funds....................................................................7
       ss. 2.03.                    Distribution of Funds at the Maturity Date or Upon an Event of Default
                   ..........................................................................................................7
         ss. 2.04.                    Distributions to the Borrower Generally..................................................8
         ss. 2.05.                    Avoidance of Breakage Costs..............................................................8

                                  ARTICLE III.
                   REPRESENTATIONS AND WARRANTIES; COVENANTS;
                                EVENTS OF DEFAULT
       ss. 3.01.                    Representations and Warranties; Covenants................................................8
       ss. 3.02.                    Events of Default; Remedies..............................................................8
       ss. 3.03.                    Attorney-in-Fact.........................................................................9

                                   ARTICLE IV.
                                    SECURITY
       ss. 4.01.                    Grant of Security Interest...............................................................9

                                   ARTICLE V.
                                  MISCELLANEOUS
       ss. 5.01.                    Amendments, etc..........................................................................9
       ss. 5.02.                    Notices, etc............................................................................10

                                        i

<PAGE>


       ss. 5.03.                    Assignability...........................................................................10
       ss. 5.04.                    Further Assurance.......................................................................10
       ss. 5.05.                    Costs and Expenses; Collection Costs....................................................11
       ss. 5.06.                    Confidentiality.........................................................................11
       ss. 5.07.                    Term and Termination; Early Termination Fee.............................................12
       ss. 5.08.                    No Liability of Lender..................................................................13
       ss. 5.09.                    Entire Agreement; Severability..........................................................14
       ss. 5.10.                    GOVERNING LAW...........................................................................14
       ss. 5.11.                    WAIVER OF JURY TRIAL, JURISDICTION AND VENUE............................................14
       ss. 5.12.                    Execution in Counterparts...............................................................14
       ss. 5.13.                    No Proceedings..........................................................................14

 EXHIBITS

Exhibit I                 Definitions
Exhibit II                Conditions of Purchases
Exhibit III               Representations and Warranties
Exhibit IV                Covenants
Exhibit V                 Events of Default
Exhibit VI                Eligibility Criteria
Exhibit VII-A             Form of Borrowing Base Certificate
Exhibit VII-B             Form of Borrower's Certificate
Exhibit VIII              Form of Depositary Agreement
Exhibit IX-A              Form of Opinion of Counsel
Exhibit IX-B              Form of Opinion of Counsel

 SCHEDULES

Schedule I                Addresses for Notices
Schedule II               Credit and Collection Policy
Schedule III              License Revocations
Schedule IV               Lockbox Information


                                     ii

</TABLE>

                  LOAN AND  SECURITY  AGREEMENT,  dated as of December __, 1996,
between CCA FUNDING LLC, a Delaware limited liability company (together with its
successors and assigns,  the  "Borrower")  and DAIWA  HEALTHCO-2 LLC, a Delaware
limited  liability  company  (together  with its  successors  and  assigns,  the
"Lender"), agree as follows:

                  Certain terms that are  capitalized  and used  throughout this
Agreement are defined in Exhibit I to this Agreement.  References  herein and in
the Exhibits and Schedules hereto to the "Agreement" refer to this Agreement, as
amended, restated, modified or supplemented from time to time in accordance with
its terms.

                  The Borrower (i) is a Delaware limited liability company owned
by CCA and the  Providers,  (ii) has  acquired  heathcare  receivables  from the
Providers pursuant to the RPA or by contribution to the capital of the Borrower,
as  determined  from time to time by the Borrower and the  Providers,  and (iii)
wishes to borrow  funds  from the Lender on a  continuing  and  revolving  basis
secured by healthcare receivables acquired from the Providers.

                  The Lender is prepared to make revolving loans secured by such
healthcare  receivables  on the terms and  subject to the  conditions  set forth
herein.

                  Accordingly, the parties agree as follows:

                                   ARTICLE I.
             COMMITMENT; AMOUNTS AND TERMS OF THE REVOLVING ADVANCES

     ss.  1.01.  Revolving  Advances.  (a)  The  Lender  agrees  to  lend to the
Borrower,  subject to and upon the terms and conditions herein set forth, on any
Funding  Date,  such  amounts as may be  requested  by the  Borrower  (each such
borrowing,  a "Revolving  Advance" and the outstanding  principal balance of all
Revolving Advances from time to time, the "Revolving Loan").

                  (b) Each  Revolving  Advance  shall be in a minimum  amount of
$100,000 or an integral multiple thereof and shall be made on the date specified
in the Written Notice or telephonic  notice confirmed in writing as described in
Section 1.03 hereof.

     ss. 1.02.  Revolving  Commitment  and  Borrowing  Limit.  (a) The aggregate
unpaid principal amount of the Revolving Advances  outstanding at any time shall
not exceed an amount equal to the lesser of (i)  $15,000,000  (such  amount,  or
such  greater  amount  after  giving  effect  to an  increase  pursuant  to  the
provisions of Section 1.02(d) hereof, the "Revolving Commitment"),  and (ii) the
Borrowing  Base as of such time (the lesser of (i) and (ii) being the "Borrowing
Limit").

                  (b)  Subject to the  limitations  of  Article  II hereof,  the
Borrower  may borrow,  repay  (without  premium or  penalty)  and  reborrow  the
Revolving  Loan.  The  Revolving  Loan shall not exceed in  aggregate  principal
amount at any one time outstanding, and the Lender shall not have any obligation
to make any Revolving  Advance which shall result in the Revolving Loan being in
excess of, the Revolving Commitment.


                                        1

<PAGE>



                  (c) If at any time the  outstanding  principal  amount  of the
Revolving  Loan exceeds the  Borrowing  Limit at such time,  the Borrower  shall
promptly, in accordance with Article II hereof,  eliminate such excess by paying
an amount equal to such excess until such excess is eliminated in full.

                  (d) The  Borrower  may request  that the Lender  increase  the
Revolving Commitment,  and the Lender, in its sole discretion upon such request,
may decide to increase the  Revolving  Commitment,  provided  that the Revolving
Commitment,  as so increased,  shall in no event exceed  $20,000,000.  Each such
increase  shall be in an amount equal to $1,000,000  or an integral  multiple of
$1,000,000 in excess thereof and the Borrower shall,  upon the effective date of
such  increase,  pay to the Lender a fee in an amount equal to 1.00% of any such
increase.

                  (e)  The  Borrower   may  elect  to  decrease  the   Revolving
Commitment;  provided,  that (i) such  decrease  shall be in an amount  equal to
$1,000,000  or an integral  multiple  of  $1,000,000  in excess  thereof and the
Borrower shall,  upon the effective date of such decrease,  pay to the Lender an
amount equal to 1.25% of any such  decrease,  and (ii) following the delivery of
such decrease  request,  the Borrower shall not request any increase pursuant to
Section 1.02(d).

     ss.  1.03.  Notice  of  Borrowing;  Borrower's  Certificate.  Whenever  the
Borrower desires to make a borrowing of a Revolving Advance,  the Borrower shall
give the  Lender not later than  11:00  a.m.  (New York  time),  on the day of a
proposed  Revolving  Advance prior Written  Notice or telephonic  notice from an
Authorized  Representative  confirmed promptly in writing (which notice shall be
irrevocable)  of its  desire to make a  borrowing  of a  Revolving  Advance on a
Funding  Date.  Each  notice of  borrowing  under  this  Section  1.03  shall be
substantially   in  the  form  of  Exhibit  VII-B  hereto  (each  a  "Borrower's
Certificate")  and  specify  the date on which the  Borrower  desires  to make a
borrowing  of a Revolving  Advance  (which in each  instance  shall be a Funding
Date), the amount of such borrowing,  and shall attach the most recent Borrowing
Base  Certificate to the Borrower's  Certificate to be delivered by the Borrower
to the Lender and set forth the Borrowing Base provided therein.

     ss. 1.04.  Termination of Revolving  Commitment.  On the Maturity Date, the
Revolving Commitment shall be cancelled automatically. In addition, prior to the
Maturity Date, the Borrower may terminate the Revolving  Commitment  pursuant to
Section 5.07(b).  Upon such cancellation,  the Revolving Advances (together with
all other  Lender  Debt) shall  become,  without  further  action by any Person,
immediately due and payable  together with all accrued  interest thereon to such
date plus any fees, premiums, charges or costs provided for hereunder.

     ss. 1.05. Interest and  Non-Utilization  Fee. (a) During the Special Period
or at any time the Revolving  Loan is greater than the Basic  Borrowing  Amount,
the Borrower shall pay interest on the unpaid principal amount of each Revolving
Advance made to it outstanding  from time to time on each Interest  Payment Date
(i) on the Basic Borrowing Amount (or any lesser  principal  amount  outstanding
from time to time), at an interest rate per annum equal to the LIBO Rate for the
Interest Period in effect for such Revolving Advance plus 2.00%, and (ii) on any
principal  amount  outstanding in excess of the Basic  Borrowing  Amount,  at an
interest rate per annum equal to the

                                        2

<PAGE>



LIBO Rate for the Interest Period in effect for such Revolving  Advance plus (x)
3.50%  plus,  during the Special  Period,  (y) (1) 0.50%  multiplied  by (2) the
number of monthly anniversaries to have occurred since the Initial Funding Date.

                  (b) Interest  Following the Expiration of the Special  Period.
Following the  expiration or termination of the Special Period and provided that
the  Revolving  Loan is equal to or less than the Basic  Borrowing  Amount,  the
Borrower  shall pay interest on the unpaid  principal  amount of each  Revolving
Advance made to it  outstanding  from time to time (i) on each Interest  Payment
Date, and (ii) on the Maturity Date (whether by  acceleration or otherwise) upon
demand,  in each case at an  interest  rate per annum equal to the LIBO Rate for
the Interest Period in effect for such Revolving Advance plus 2.00%.

                  (c) Default Interest. Notwithstanding anything to the contrary
contained  herein,  while any Event of Default is  continuing,  interest  on the
Revolving  Advances  shall be payable on demand at a rate per annum equal to two
percentage points (2.00%) in excess of the rate then otherwise applicable to any
Revolving Advance.

                  (d) LIBO Rate Determination.  The Lender, upon determining the
LIBO Rate shall promptly notify by telephone  (confirmed promptly in writing) or
in writing the Borrower of such rates. Such determination  shall, in the absence
of manifest error, be conclusive and binding upon the Borrower.

                  (e) Non-Utilization  Fee. The Borrower shall pay to the Lender
on the first Funding Date of each month a fee (the "Non-Utilization  Fee") equal
to 0.375% per annum on the average amount, calculated on a daily basis, by which
the Revolving  Commitment  exceeded the outstanding amount of the Revolving Loan
during the prior Month.

     ss. 1.06.  Renewals.  (a) The Borrower may, from time to time following the
Initial  Funding Date and prior to the Maturity Date,  renew all or a portion of
its outstanding Revolving Advances so long as the aggregate principal balance of
the portion of the Revolving Advance made to the Borrower being renewed, if any,
is $100,000 or an integral multiple of $100,000 in excess of $100,000; provided,
however, that the Borrower shall not be entitled to renew any Revolving Advance,
or portion thereof unless all accrued interest on the Revolving  Advance renewed
through the date of such renewal shall have been paid in full.

                  (b) Each renewal by the Borrower of an  outstanding  Revolving
Advance or portion thereof shall be made on notice to the Lender given not later
than 11:00 a.m. (New York time) on the date at least two Business Days' prior to
the last day of the Interest Period just ending for such Revolving Advance. Each
notice (which notice shall be  irrevocable)  by the Borrower of the renewal of a
Revolving  Advance or portion thereof,  shall be in writing or by telephone from
an Authorized  Representative of the Borrower  confirmed promptly in writing and
shall  specify the amount of such  renewal of the  Revolving  Advance or portion
thereof.  Notwithstanding the above, the Borrower shall not be entitled to renew
a Revolving  Advance or a portion  thereof,  if at the time of the  selection of
such renewal there shall exist a Default or an Event of Default.

                                        3

<PAGE>



                  (c) Any Revolving  Advance or portion  thereof as to which the
Lender shall not have received a proper notice of renewal as provided in Section
1.06(b)  hereof or notice of payment or  prepayment by 3:00 p.m. (New York time)
at least three  Business Days prior to the last day of the Interest  Period just
ending for such Revolving  Advance shall (whether or not any Default or Event of
Default has  occurred)  shall either be paid in full or if not paid in full,  at
the Lender's  sole and absolute  discretion,  may be  converted,  in whole or in
part, to a new Revolving Advance on the last day of the Interest Period.

     ss. 1.07. Computation of Interest. (a) Interest on the Revolving
Loan and fees and other amounts  calculated by the Lender on the basis of a rate
per annum  shall be  computed  on the  basis of actual days elapsed over a
360-day year.

                  (b)  Whenever  any payment to be made  hereunder  or under any
other  Document  shall be stated to be due and  payable  on a day which is not a
Business Day, such payment shall be made on the next succeeding Business Day and
such  extension of time shall in such case be included in computing  interest on
such payment; provided, however, that if such extension would cause a payment of
a Revolving  Advance to be made, or the last day of such  Interest  Period for a
Revolving  Advance to occur, in the next following Month,  such payment shall be
made and the last day of such Interest  Period shall occur on the next preceding
Business Day.

     ss. 1.08.  Procedures for Payment. (a) Each payment hereunder shall be made
not later  than  12:00  noon (New York City  time) on the day when due in lawful
money of the  United  States of  America  to the  Lender  without  counterclaim,
offset,  claim or  recoupment  of any kind and free and  clear of,  and  without
deduction  for,  any present or future  withholding  or other  taxes,  duties or
charges of any nature imposed on such payments or prepayments by or on behalf of
any Governmental Body thereof or therein, except for Excluded Taxes. If any such
taxes,  duties or charges are so levied or imposed on any payment to any Lender,
the Borrower will make  additional  payments in such amounts as may be necessary
so that the net amount  received by the Lender,  after  withholding or deduction
for  or on  account  of all  taxes,  duties  or  charges,  including  deductions
applicable to additional  sums payable under this Section 1.08, will be equal to
the amount  provided  for  herein.  Whenever  any taxes,  duties or charges  are
payable by the Borrower  with respect to any  payments  hereunder,  the Borrower
shall furnish promptly to the Lender information,  including certified copies of
official  receipts  (to the  extent  that the  relevant  governmental  authority
delivers such receipts), evidencing payment of any such taxes, duties or charges
so withheld or deducted.  If the Borrower fails to pay any such taxes, duties or
charges  when due to the  appropriate  taxing  authority or fail to remit to the
Lender the required information  evidencing payment of any such taxes, duties or
charges so withheld or deducted, the Borrower shall indemnify the Lender for any
incremental  taxes,  duties,  charges,  interest  or  penalties  that may become
payable by the Lender as a result of any such failure.

                  (b) Notwithstanding anything to the contrary contained in this
Agreement, the Borrower agrees to pay any present or future stamp or documentary
taxes, any intangibles tax or any other sales, excise or property taxes, charges
or similar levies now or hereafter assessed that arise from and are attributable
to any payment made hereunder or from the execution, delivery of, or

                                        4

<PAGE>



otherwise  with respect to, this  Agreement or other  Documents  and any and all
recording  fees  relating to any  Documents  securing  any Lender  Debt  ("Other
Taxes").

                  (c) The  Borrower  shall  indemnify  the  Lender  for the full
amount of any taxes, duties or charges other than Excluded Taxes and Other Taxes
(including,  without  limitation,  any taxes other than Excluded Taxes and Other
Taxes imposed by any  jurisdiction  on amounts  payable under this Section 1.08)
duly paid or  payable  by the Lender  and any  liability  (including  penalties,
interest   and   expenses)   arising   therefrom   or  with   respect   thereto.
Indemnification  payments  shall be made within 30 days from the date the Lender
makes written demand therefor.

                  (d) Without  prejudice to the survival of any other  agreement
of the  Borrower  hereunder,  the  agreements  and  obligations  of the Borrower
contained in this  Section  1.08 shall  survive the payment in full of principal
and interest hereunder and under the Notes indefinitely.

     ss. 1.09.  Indemnities.  (a) The Borrower  hereby  agrees to indemnify  the
Lender on demand  against any loss or expense  which the Lender or its branch or
Affiliate may sustain or incur as a  consequence  of: (i) any default in payment
or prepayment of the principal amount of any Revolving Advance made to it or any
portion thereof or interest accrued thereon, as and when due and payable (at the
due date thereof, by irrevocable notice of payment or prepayment, or otherwise);
(ii) the effect of the  occurrence  of any Event of Default  upon any  Revolving
Advance made to it; (iii) the payment or prepayment  of the principal  amount of
any Revolving  Advance made to it or any portion thereof,  on any day other than
the last  day of an  Interest  Period  or the  payment  of any  interest  on any
Revolving  Advance  made to it,  or  portion  thereof,  on a day  other  than an
Interest  Payment Date for such  Revolving  Advance;  or (iv) the failure by the
Borrower to accept or make a borrowing of a Revolving  Advance or a renewal of a
Revolving Advance after it has requested such borrowing,  conversion or renewal;
in each case  including,  but not limited to, any loss or expense  sustained  or
incurred in  liquidating  or employing  deposits from third parties  acquired to
effect or maintain such  Revolving  Advance or any portion  thereof.  The Lender
shall  provide  to the  Borrower  a  statement,  supported  when  applicable  by
documentary  evidence,  explaining  the  amount of any such loss or  expense  it
incurs, which statement shall be conclusive absent manifest error.

                  (b) The Borrower  hereby agrees to indemnify and hold harmless
the Lender and its Affiliates,  directors,  officers,  agents,  representatives,
counsel and employees and each other Person, if any,  controlling them or any of
its Affiliates  within the meaning of either Section 15 of the Securities Act of
1933,  as amended,  or Section  20(a) of the Exchange Act (each an  "Indemnified
Party"), from and against any and all losses, claims,  damages,  costs, expenses
(including  reasonable counsel fees and disbursements) and liabilities which may
be incurred by or asserted  against  such  Indemnified  Party with respect to or
arising out of the commitments  hereunder to make the Revolving Advances, or the
financings contemplated hereby, the other Documents,  the Collateral (including,
without limitation,  the use thereof by any of such Persons or any other Person,
the exercise by the Lender of rights and remedies or any power of attorney  with
respect  thereto,  and  any  action  or  inaction  of the  Lender  under  and in
accordance  with any Security  Document),  the use of proceeds of any  financial
accommodations  provided  hereunder,  any  investigation,  litigation  or  other
proceeding  brought  or  threatened  relating  thereto,  or the role of any such
Person or Persons in

                                        5

<PAGE>



connection with the foregoing whether or not they or any other Indemnified Party
is named as a party to any legal action or proceeding  ("Claims").  The Borrower
will not,  however,  be responsible to any  Indemnified  Party hereunder for any
Claims to the extent that a court having jurisdiction shall have determined by a
final  nonappealable  judgment  that any such Claim  shall have arisen out of or
resulted  solely  from  (a)(i)  actions  taken  or  omitted  to be taken by such
Indemnified  Party by  reason  of the bad  faith,  willful  misconduct  or gross
negligence  of any  Indemnified  Party,  or  (ii)  in  violation  of any  law or
regulation  applicable to such Indemnified Party (except to the extent that such
violation  is  attributable  to any breach of any  representation,  warranty  or
agreement  by or on behalf of the  Borrower,  CCA,  any Provider or any of their
respective  designees,  in each case,  as  determined  by a final  nonappealable
decision of a court of competent jurisdiction), or (b) a successful claim by CCA
or any Provider against such Indemnified  Party  ("Excluded  Claims").  Further,
should any employee of the Lender, in connection with such employee's employment
by the Lender,  be involved in any legal action or proceeding in connection with
the transactions contemplated hereby (other than relating to an Excluded Claim),
the Borrower  hereby agrees to pay to the Lender such per diem  compensation  as
the Lender shall request for each employee for each day or portion  thereof that
such employee is involved in  preparation  and testimony  pertaining to any such
legal action or proceeding. The Indemnified Party shall give the Borrower prompt
Written Notice of any Claim setting forth a description of those elements of the
Claim  of  which  such  Indemnified  Party  has  knowledge.  The  Lender,  as an
Indemnified Party shall be permitted  hereunder to select counsel to defend such
Claim at the expense of the Borrower and, if such Indemnified Party shall decide
to do so, then all such  Indemnified  Parties  shall  select the same counsel to
defend such Indemnified Parties with respect to such Claim;  provided,  however,
that if any such Indemnified Party shall in its reasonable opinion consider that
the  retention of one joint  counsel as aforesaid  shall result in a conflict of
interest, such Indemnified Party may, at the expense of the Borrower, select its
own counsel to defend such  Indemnified  Party with  respect to such Claim.  The
Indemnified  Parties  and  the  Borrower  and  their  respective  counsel  shall
cooperate with each other in all reasonable respects in any investigation, trial
and defense of any such Claim and any appeal arising therefrom.

     ss. 1.10.  Telephonic  Notice.  Without in any way limiting the  Borrower's
obligation  to  confirm  in  writing  any  telephonic  notice  of  a  borrowing,
conversion or renewal,  the Lender may act without  liability  upon the basis of
telephonic  notice believed by the Lender in good faith to be from an Authorized
Representative of the Borrower prior to receipt of written confirmation.

     ss. 1.11. Maximum Interest.  (a) No provision of this Agreement or any Note
shall  require the payment to any Lender or permit the  collection by any Lender
of  interest  in  excess  of the  maximum  rate of  interest  from  time to time
permitted  (after  taking  into  account  all  consideration  which  constitutes
interest) by laws  applicable to the Lender Debt and binding on any Lender (such
maximum rate being the Lender's "Maximum Permissible Rate").

                  (b) If the amount of interest  computed  without giving effect
to this Section 1.11 and payable on any interest  payment date in respect of the
preceding  interest  computation  period  would  exceed the  amount of  interest
computed in respect of such period at the Maximum  Permissible  Rate, the amount
of interest  payable to the Lender on such date in respect of such period  shall
be computed at the Maximum Permissible Rate.

                                        6

<PAGE>



                  (c) If at any time and from  time to time:  (i) the  amount of
interest payable to any Lender on any interest payment date shall be computed at
the Maximum Permissible Rate pursuant to the preceding  subsection (b); and (ii)
in respect of any subsequent interest  computation period the amount of interest
otherwise  payable  to the  Lender  would be less than the  amount  of  interest
payable to the Lender computed at the Maximum  Permissible Rate, then the amount
of  interest  payable  to the  Lender in  respect  of such  subsequent  interest
computation period shall continue to be computed at the Maximum Permissible Rate
until the amount of interest  payable to the Lender shall equal the total amount
of interest  which would have been  payable to the Lender if the total amount of
interest had been computed  without  giving  effect to the preceding  subsection
(b).

                                   ARTICLE II.
                           COLLECTION AND DISTRIBUTION

     ss. 2.01. Collections on the Receivables. The Lender shall be entitled with
respect to all Accounts,  (i) to receive and to hold as collateral  all Accounts
and all  Collections on Accounts in accordance  with the terms of the Depositary
Agreement,  and (ii) to have and to exercise  any and all rights (x) to collect,
record,  track and,  during the  continuance  of an Event of  Default,  take all
actions  to  obtain   Collections  with  respect  to  all  Accounts  payable  by
non-Governmental  Entities,  and  (y) to the  extent  permitted  by law and in a
manner  consistent with all applicable laws and regulations,  record,  track and
take all actions to obtain  Collections  with respect to all Accounts payable by
Governmental Entities.

     ss. 2.02.  Distribution of Funds. On each Funding Date, and provided,  that
(i) no  Event of  Default  is  continuing,  and (ii)  the  Borrower  shall  have
successfully  sent  by  Transmission  to the  Master  Servicer  all  information
required with respect to the  Receivables  for the period since the  immediately
prior Funding Date, the Lender shall distribute any and all Collections received
since the immediately prior Funding Date, together with interest thereon (at the
Overnight Rate established from time to time) from the date of receipt until the
Funding Date so distributed as follows:  FIRST, to the Lender, an amount in cash
equal to the Fee and Interest Shortfall, if any, until such amount has been paid
in full; SECOND, to the Lender, an amount in cash equal to the payment,  if any,
of principal on the Revolving  Loan due and payable on such Funding Date,  until
such amount has been paid in full; THIRD, to the Lender, an amount in cash equal
to the payment of any other Lender Debt due and payable on such Funding Date, if
any, until such amount has been paid in full; and FOURTH,  to the Borrower,  all
remaining  amounts  of  Collections,  together  with  interest  thereon  (at the
Overnight Rate established from time to time) from the date of receipt until the
Funding Date so distributed.

     ss. 2.03.  Distribution  of Funds at the Maturity  Date or Upon an Event of
Default.  At the Maturity Date or upon the occurrence and during the continuance
of an Event of  Default,  subject  to the  rights  and  remedies  of the  Lender
pursuant  to Section  3.02  hereof,  the  Lender  shall  distribute  any and all
Collections to the Lender as follows:  FIRST,  to the Lender,  an amount in cash
equal to any and all accrued fees and  collection  costs as set forth in Section
5.05, until such amount has been paid in full;  SECOND, to the Lender, an amount
in cash equal to all accrued and unpaid  interest on the Revolving Loans (at the
rate established under Section 1.05(b)) until such amount has

                                        7

<PAGE>



been  funded in full;  THIRD,  to the  Lender,  an  amount in cash  equal to the
principal  amount of the  Revolving  Loan,  until  such  amount is paid in full;
FOURTH,  to the  Lender,  an amount in cash  equal to the  payment  of any other
Lender Debt due and  payable on such  Funding  Date,  until such amount has been
paid in full; and FIFTH, to the Borrower, all remaining amounts of Collections.

     ss. 2.04.  Distributions  to the Borrower  Generally.  Distributions to the
Borrower on each Funding Date shall be deposited in an account designated by the
Borrower in writing to the Program Manager from time to time.

     ss. 2.05.  Avoidance of Breakage  Costs.  So long as no Default or Event of
Default is continuing, the Lender shall not apply out of the Collections, unless
requested in writing by the Borrower, any payment of principal to any portion of
a Revolving Loan until the last day of the respective Interest Period thereof or
the earlier  maturity of such portion of such Revolving Loan by  acceleration or
otherwise.

                                  ARTICLE III.
                   REPRESENTATIONS AND WARRANTIES; COVENANTS;
                                EVENTS OF DEFAULT

     ss. 3.01. Representations and Warranties;  Covenants. The Borrower makes on
the  Initial   Funding  Date  and  on  each   subsequent   Funding   Date,   the
representations  and  warranties  set forth in Exhibit  III  hereto,  and hereby
agrees to perform and observe the covenants set forth in Exhibit IV hereto.

     ss. 3.02.  Events of Default;  Remedies.  (a) If any Event of Default shall
occur and be continuing,  the Lender may, by notice to the Borrower, take either
or  both  of the  following  actions:  (x)  declare  the  Maturity  Date to have
occurred, and (y) without limiting any rights hereunder, replace the Borrower to
in its  performance  of any or all of the  "Primary  Servicer  Responsibilities"
under the RPA (which replacement may be effectuated  through the outplacement to
a qualified and  experienced  third-party of all back office  duties,  including
billing,  collection  and  processing   responsibilities,   and  access  to  all
personnel,   hardware   and   software   utilized   in   connection   with  such
responsibilities);  provided,  that,  with  respect  to the Event of  Default in
clause  (g) of  Exhibit V, the  Maturity  Date shall be deemed to have  occurred
automatically and without notice. Upon any such declaration or designation,  the
Lender  shall have,  in addition  to the rights and  remedies  which it may have
under this Agreement, all other rights and remedies provided after default under
the UCC and under other  applicable  law,  which  rights and  remedies  shall be
cumulative.

                  (b)  Right  of  Set-Off.   The  Borrower  hereby   irrevocably
authorizes and instructs the Lender to set-off the full amount of the any Lender
Debt due and payable against (i) any  Collections,  or (ii) the principal amount
of any  Revolving  Advance to be  financed  on or after  such  date.  No further
notification,  act or consent of any nature  whatsoever is required prior to the
right of the Lender to exercise  such right of  set-off;  provided,  however,  a
member of the Lender Group

                                        8

<PAGE>



shall notify the Borrower that a set-off pursuant to this Section 3.02 occurred,
the amount of such set-off and a description of the Lender Debt that was due and
payable.

     ss. 3.03. Attorney-in-Fact.  The Borrower hereby irrevocably designates and
appoints  the Lender,  the Master  Servicer  and each other Person in the Lender
Group,  to the  extent  permitted  by  applicable  law  and  regulation,  as the
Borrower's  attorneys-in-fact,  which  irrevocable  power of attorney is coupled
with an interest,  with  authority,  upon the continuance of an Event of Default
(and to the extent not prohibited  under  applicable law and regulations) to (i)
endorse  or sign  the  Borrower's  name to  financing  statements,  remittances,
invoices,  assignments, checks (other than payments from Governmental Entities),
drafts or other  instruments or documents in respect of the  Receivables and the
Receivables,  (ii) notify Insurers to make payments on the Receivables  directly
to the  Lender,  and  (iii)  bring  suit in the  Borrower's  name and  settle or
compromise  such  Receivables  as the Lender or the Master  Servicer may, in its
discretion, deem appropriate.

                                   ARTICLE IV.
                                    SECURITY

     ss. 4.01. Grant of Security  Interest.  (a) As collateral  security for the
Borrower's  obligations  to pay the Lender Debt when due and payable  hereunder,
the Borrower  hereby grants to the Lender a first  priority Lien on and security
interest in and right of set-off  against all of the rights,  title and interest
of the Borrower in and to (i) the RPA, (ii) to the maximum  extent  permitted by
law, the Provider Lockboxes and the Provider Lockbox Accounts,  (iii) all of the
Borrower's  Accounts whether now owned or hereafter  acquired,  (iv) any and all
amounts  held in any  accounts  maintained  at  KeyBank in respect of any of the
foregoing or in  compliance  with any terms of this  Agreement,  (v) any and all
amounts held in any accounts  maintained at First Union National Bank of Florida
in  respect  of any of the  foregoing  or in  compliance  with any terms of this
Agreement,  and (vi) all  proceeds of the  foregoing.  This  Agreement  shall be
deemed to be a security agreement as understood under the UCC.

                  (b) The Borrower agrees to execute,  and hereby authorizes the
Lender to file, one or more financing  statements or continuation  statements or
amendments  thereto  or  assignments  thereof  in  respect  of the Lien  created
pursuant  to this  Section  4.01  which may at any time be  required  or, in the
opinion of the Lender,  be desirable,  and to do so without the signature of the
Borrower where permitted by law.


                                   ARTICLE V.
                                  MISCELLANEOUS

     ss. 5.01.  Amendments,  etc. (a) No amendment or waiver of any provision of
this Agreement or consent to any departure  therefrom by a party hereto shall be
effective  unless in a writing  signed by the Lender and the  Borrower  and then
such  amendment,  waiver or  consent  shall be  effective  only in the  specific
instance and for the specific purpose for which given. No failure on the part of
the Lender or the Borrower to exercise,  and no delay in  exercising,  any right
hereunder

                                       9

<PAGE>



shall operate as a waiver thereof;  nor shall any single or partial  exercise of
any right  hereunder  preclude  any other or  further  exercise  thereof  or the
exercise of any other right.

                  (b) The parties hereto agree to make any change,  modification
or  amendment to this  Agreement  as may be  requested  by Duff & Phelps  Credit
Rating Co. or any other  rating  agency  then  rating the  healthcare  financing
program of the Lender,  so long as any such  change,  modification  or amendment
does not materially adversely affect the parties hereto.

     ss.  5.02.  Notices,  etc. All notices and other  communications  hereunder
shall,  unless  otherwise  stated  herein,  be in  writing  (which  may  include
facsimile  communication)  and shall be faxed or  delivered,  (i) to each  party
hereto  (and DH-2  hereby  agrees  that  notices  to or for its  benefit  may be
delivered to the Program  Manager and such delivery to the Program Manager shall
be deemed  received  by DH-2),  at its  address  set forth under its name on the
signature  pages hereof or at such other  address as shall be designated by such
party in a Written Notice to the other parties  hereto,  and (ii) to the Program
Manager  and the  Master  Servicer  at the  addresses  set forth on  Schedule  I
attached hereto. Notices and communications by facsimile shall be effective when
sent (and shall be followed by hard copy sent by regular mail),  and notices and
communications sent by other means shall be effective when received.

     ss. 5.03.  Assignability.  (a) This Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective permitted successors
and assigns.

                  (b) Without the prior  consent of CCA (acting on behalf of the
Providers) and the Borrower (which consent shall not be unreasonably  withheld),
the Lender may not assign this  Agreement  and the  Lender's  rights,  title and
interest and obligations  contained herein  (including its security  interest in
the  Receivables)  (collectively,  "Lender  Position");  provided,  that (i) the
Lender   may   assign  the  Lender   Position   to   another   limited   purpose
bankruptcy-remote entity sponsored and managed by the Program Manager which does
not result in any increased  costs or  liabilities to the Borrower or diminution
of the  Borrower's  rights  hereunder  and which  agrees in  writing in a manner
reasonably  acceptable  to the  Borrower  to be bound by and  perform all of the
Lender's obligations  hereunder,  and (ii) the Borrower hereby acknowledges that
the Lender is granting  Daiwa  Finance  Corporation  a security  interest in the
Lender's Position, including without limitation, this Agreement.

                  (c) The  Borrower  may not assign  its  rights or  obligations
hereunder  or any  interest  herein  without  the prior  written  consent of the
Lender.

     ss. 5.04. Further  Assurance.  The Borrower shall, at its cost and expense,
upon the request of the Lender,  duly execute and  deliver,  or cause to be duly
executed and delivered,  to the Lender such further instruments and do and cause
to be done such further  acts as may be  necessary  or proper in the  reasonable
opinion of the Lender to carry out more  effectively the provisions and purposes
of this Agreement.


                                       10

<PAGE>



     ss. 5.05. Costs and Expenses;  Collection Costs. (a) The Borrower agrees to
pay on demand (i) all reasonable non-legal costs and expenses in connection with
the preparation,  execution and delivery of this Agreement;  (ii) the reasonable
fees and out-of-pocket expenses of counsels for the Lender and its Affiliates in
connection with this  transaction;  and (iii) all reasonable costs and expenses,
if any (including  reasonable counsel fees and expenses),  of the Lender and its
Affiliates in connection with any waiver, modification,  supplement or amendment
hereto, or the enforcement of this Agreement. The Borrower further agrees pay on
the  Initial  Funding  Date (and with  respect  to costs and  expenses  incurred
following the Initial  Funding Date,  within seven days of demand  therefor) (a)
all  reasonable  costs  and  expenses  incurred  by the  Lender  or its agent in
connection  with periodic  audits of the  Receivables  which audits,  other than
after an Event of Default, shall occur no more frequently than annually, (b) all
reasonable  costs and  expenses  incurred by the Master  Servicer or the Program
Manager to accommodate any significant coding or data system changes made by the
Borrower that would affect the transmission or  interpretation  of data received
through the interface, and (c) all reasonable costs and expenses incurred by the
Lender for additional time  (calculated at a rate of $100 per hour) and material
expenses  of  the  Master  Servicer  resulting  from a lack  of  cooperation  or
responsiveness  of the Borrrower to agreed-upon  protocol and schedules with the
Master  Servicer;  provided,  that the Borrower has been informed of the alleged
lack of cooperation or  responsiveness  and has been provided the opportunity to
correct such problems.

                  (b) In the event that the Lender  shall  retain an attorney or
attorneys to collect,  enforce,  protect,  maintain,  preserve or foreclose  its
interests with respect to this Agreement,  any other Documents, any Lender Debt,
any  Receivable  or the Lien on any  Collateral  or any other  security  for the
Lender  Debt or under any  instrument  or  document  delivered  pursuant to this
Agreement,  or in connection with any Lender Debt, the Borrower shall pay all of
the reasonable costs and expenses of such collection,  enforcement,  protection,
maintenance,  preservation or foreclosure, including reasonable attorneys' fees,
which amounts shall be part of the Lender Debt, and the Lender may take judgment
for all such amounts. The attorney's fees arising from such services,  including
those of any appellate proceedings,  and all expenses,  costs, charges and other
fees incurred by such counsel in any way or with respect to or arising out of or
in connection with or relating to any of the events or actions described in this
Section  5.05  shall be payable by the  Borrower  to the Lender on demand  (with
interest  accruing from the earlier of two Business Days  following (i) the date
of such  demand,  and (ii)  the  date  that  the  Borrower  became  aware of the
incurrence  of such  cost),  and  shall be  additional  obligations  under  this
Agreement.  Without  limiting the  generality of the  foregoing,  such expenses,
costs, charges and fees may include: recording costs, appraisal costs, paralegal
fees, costs and expenses; accountants' fees, costs and expenses; court costs and
expenses;  photocopying and duplicating expenses; court reporter fees, costs and
expenses;  long  distance  telephone  charges;  air  express  charges;  telegram
charges;  telecopier  charges;  secretarial  overtime charges;  and expenses for
travel,  lodging and food paid or incurred in connection with the performance of
such legal services.

     ss.  5.06.   onfidentiality.   (a)  The  Borrower  and  the  Lender  hereby
acknowledge that this Agreement and documents  delivered  hereunder or under the
RPA including, without limitation, any information relating to the Borrower, the
Lender or the Providers contain confidential and proprietary information. Unless
otherwise required by applicable law, the Borrower and the Lender

                                       11

<PAGE>



each hereby agrees to maintain the  confidentiality  of this  Agreement (and all
drafts and other documents delivered in connection therewith including,  without
limitation,  any  information  relating  to  the  Borrower,  the  Lender  or the
Providers  delivered  hereunder or under the RPA) in  communications  with third
parties  and  otherwise  and to  take  all  reasonable  action  to  prevent  the
unauthorized  use or  disclosure of and to protect the  confidentiality  of such
confidential  information;  provided, that, such confidential information may be
disclosed to (i) the  Borrower's  legal counsel and auditors and to the Provider
under the RPA and their  investors and  creditors,  and their  respective  legal
counsel and auditors,  (ii) the Program Manager,  the Person then fulfilling the
"Primary  Servicer  Responsibilities"  under the RPA,  each member of the Lender
Group,  investors in and  creditors of DH-2,  appropriate  rating  agencies with
respect to DH-2, and each of their respective legal counsel and auditors,  (iii)
any Person,  if such information  otherwise  becomes available to such Person or
publicly  available through no fault of any party governed by this Section 5.06,
(iv) any  Governmental  Entity  requesting  such  information  and (v) any other
Person with the written  consent of the other party,  which consent shall not be
unreasonably  withheld, and provided further that the Borrower and the Providers
shall not disclose such confidential  information to any financial adviser not a
party to this  Agreement,  except with the consent of Lender,  which will not be
unreasonably withheld.

                  (b) The  Borrower  understands  and agrees that the Lender may
suffer  irreparable harm if the Borrower  breaches its obligations under Section
5.06(a)  herein and that monetary  damages shall be inadequate to compensate the
Lender for such breach. Accordingly, the Borrower agrees that, in the event of a
breach by the Borrower of Section  5.06(a),  the Lender,  in addition and not in
limitation  of its  rights  and  remedies  under  law,  shall be  entitled  to a
temporary restraining order,  preliminary injunction and permanent injunction to
prevent or restrain any such breach.

                  (c) Lender hereby agrees to, and shall take  reasonable  steps
to cause each member of the Lender  Group to,  comply with all  applicable  laws
regarding  confidential  patient  information it receives in connection with the
transactions described in this Agreement.

     ss. 5.07. Term and Termination;  Early Termination Fee. (a) The obligations
of the Lender under this Agreement  shall continue in full force and effect from
the date hereof until the Maturity Date.  Upon the payment in full of all Lender
Debt,   the  Lender  shall  take  all  actions  and  deliver  all   assignments,
certificates,  releases, notices and other documents, at the Borrower's expense,
as the Borrower may reasonably request to effect such termination.

                  (b) The  Borrower  may  terminate  this  Agreement at any time
prior to the  Maturity  Date upon (i)  lapse of not less  than ten  days'  prior
Written  Notice  (which  shall be  irrevocable)  to the Lender of default of the
commitment by the Lender pursuant to Article I hereof to make Revolving Advances
and (ii)  payment in full of all Lender Debt,  including  all  applicable  fees,
charges,  premiums and costs, all as provided hereunder,  and in such occurrence
of  clauses  (i) and  (ii)  the  commitment  hereunder  shall  be  deemed  to be
terminated.


                                       12

<PAGE>



                  (c) Upon the  termination  of this  Agreement  (for any reason
other than the default  hereof by the Lender)  prior to the  Scheduled  Maturity
Date, the Borrower shall pay to the Lender an early termination fee amount equal
to 1.25% of the Revolving Commitment then in effect.

                  (d) The  termination  of this  Agreement  shall not affect any
rights of the Lender or any  obligations of the Borrower  arising on or prior to
the effective date of such termination, and the provisions hereof shall continue
to be  fully  operative  until  all  Lender  Debt  incurred  on or prior to such
termination have been paid and performed in full.

                  (e) Upon the  giving of  notice  of a  Default  or an Event of
Default of this Agreement,  all Lender Debt shall be due and payable on the date
of Default or the Event of Default  specified in such  notice.  Upon the (i) the
termination  of all  commitments  and  obligations  of the Lender,  and (ii) the
indefeasible  payment  in full of all Lender  Debt,  the  Lender  shall,  at the
Borrower's  request  and sole  cost and  expense,  execute  and  deliver  to the
Borrower such  documents as the Borrower  shall  reasonably  request to evidence
such termination.

                  (f) The Liens and rights granted to the Lender hereunder shall
continue  in full force and  effect,  notwithstanding  the  termination  of this
Agreement,  until all of the Lender Debt has been  indefeasibly  paid in full in
cash.

                  (g) All indemnities  representations,  warranties,  covenants,
waivers and agreements  contained herein shall survive termination hereof unless
otherwise provided.

                  (h)  Notwithstanding  the  foregoing,  if after receipt of any
payment  of all or any part of the  Lender  Debt,  the  Lender is for any reason
compelled to surrender such payment to any Person or entity because such payment
is determined to be void or voidable as a preference, an impermissible setoff, a
diversion of trust funds or for any other reason,  this Agreement shall continue
in full force  (except that the  Revolving  Commitment  of the Lender shall have
been  terminated),  and the Borrower shall be liable to, and shall indemnify and
hold the Lender  harmless for the amount of such payment  surrendered  until the
Lender shall have been finally and  irrevocably  paid in full. The provisions of
the  foregoing  sentence  shall  be and  remain  effective  notwithstanding  any
contrary  action  which may have been taken by the Lender in reliance  upon such
payment, and any such contrary action so taken shall be without prejudice to the
Lender's  rights  under  this  Agreement  and  shall  be  deemed  to  have  been
conditioned upon such payment having become final and irrevocable.

     ss.  5.08.  No  Liability of Lender.  (a) Neither  this  Agreement  nor any
document  executed in connection  herewith shall constitute an assumption by the
Lender of any obligation to an Obligor or a patient of the Borrower.

                  (b)  Notwithstanding  any other provision  herein, no recourse
under any obligation,  covenant, agreement or instrument of the Lender contained
herein or with respect  hereto shall be had against any Related  Person  whether
arising by breach of contract,  or otherwise at law or in equity  (including any
claim in  tort),  whether  express  or  implied,  it being  understood  that the
agreements  and other  obligations  of the Lender herein and with respect hereto
are solely its corporate

                                       13

<PAGE>



obligations;  provided, however, nothing herein above shall operate as a release
of any  liability  which may arise as a result of such  Related  Person's  gross
negligence  or willful  misconduct.  The  provisions  of this Section 5.08 shall
survive the termination of this Agreement.

     ss. 5.09. Entire Agreement;  Severability.  (a) This Agreement embodies the
entire agreement and understanding of the parties  concerning the subject matter
contained  herein.  This Agreement  supersedes any and all prior  agreements and
understandings between the parties, whether written or oral.

                  (b) If any  provision  of this  Agreement  shall  be  declared
invalid or unenforceable, the parties hereto agree that the remaining provisions
of this Agreement shall continue in full force and effect.

     ss. 5.10. GOVERNING LAW. THIS AGREEMENT SHALL BE GOVERNED BY, AND CONSTRUED
IN ACCORDANCE  WITH, THE LAW OF THE STATE OF NEW YORK (WITHOUT  GIVING EFFECT TO
THE CONFLICT OF LAWS PRINCIPLES THEREOF).

     ss. 5.11. WAIVER OF JURY TRIAL,  JURISDICTION AND VENUE. THE PARTIES HERETO
HEREBY WAIVE ALL RIGHTS TO A TRIAL BY JURY IN THE EVENT OF ANY  LITIGATION  WITH
RESPECT TO ANY MATTER RELATED TO THIS AGREEMENT,  AND HEREBY IRREVOCABLY CONSENT
TO THE  JURISDICTION OF THE STATE AND FEDERAL COURTS LOCATED IN NEW YORK COUNTY,
NEW YORK CITY, NEW YORK IN CONNECTION WITH ANY ACTION OR PROCEEDING  ARISING OUT
OF OR RELATING TO THIS  AGREEMENT.  IN ANY SUCH  LITIGATION,  THE PARTIES HERETO
WAIVE PERSONAL SERVICE OF ANY SUMMONS, COMPLAINT OR OTHER PROCESS AND AGREE THAT
SERVICE  THEREOF MAY BE MADE BY CERTIFIED  OR  REGISTERED  MAIL  DIRECTED TO THE
PARTIES HERETO AT THEIR  ADDRESSES SET FORTH ON THE SIGNATURE  PAGE HEREOF.  THE
PARTIES  HERETO  SHALL  APPEAR  IN ANSWER TO SUCH  SUMMONS,  COMPLAINT  OR OTHER
PROCESS WITHIN THE TIME PRESCRIBED BY LAW, FAILING WHICH THE PARTY FAILING TO SO
APPEAR  SHALL BE DEEMED IN  DEFAULT  AND  JUDGMENT  MAY BE  ENTERED BY THE PARTY
PROSECUTING  THE CLAIM FOR THE  AMOUNT OF THE CLAIM AND OTHER  RELIEF  REQUESTED
THEREIN.

     ss. 5.12.  Execution in  Counterparts.  This  Agreement  may be executed in
counterparts,  each of which when so executed  shall be deemed to be an original
and all of  which  when  taken  together  shall  constitute  one  and  the  same
agreement.

     ss.  5.13.  No  Proceedings.  The Borrower  hereby  agrees that it will not
institute  against the Lender any  proceeding  of the type referred to in clause
(g) of Exhibit V so long as any senior  indebtedness  issued by the Lender shall
be outstanding or there shall not have elapsed one

                                       14

<PAGE>



year plus one day since the last day on which any such senior indebtedness shall
have been outstanding.


                  [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

                                       15

<PAGE>



                  IN WITNESS WHEREOF,  the parties have caused this Agreement to
be executed by their respective  officers  thereunto duly authorized,  as of the
date first above written.


      BORROWER:                CCA FUNDING LLC


                               By:
                               Name:
                               Title: Manager

                               Address: 3050 N. Horseshoe Drive, Suite 260
                                        Naples, FL 33942
                                        Attention: Mr. David H. Fater
                                        Facsimile Number: (941) 435-0408

      LENDER:                  DAIWA HEALTHCO-2 LLC


                               By:
                               Name:
                               Title:

                               c/o Lord Securities Corporation
                                   Two Wall Street
                                   New York, NY  10005
                                   Attention:  Andrew L. Stidd
                                   Facsimile Number:  (212) 346-9012


                                       16

<PAGE>



                                   EXHIBIT I.

                                   DEFINITIONS

     As used in the  Agreement  (including  its  Exhibits  and  Schedules),  the
following  terms shall have the following  meanings (such meanings to be equally
applicable to both the singular and plural forms of the terms defined):

     "Accounts" means any and all accounts (including,  without limitation,  all
Receivables),  general intangibles and other obligations owing or to be owing to
the  Borrower  for the  payment  of money  arising  out of any  sale of  medical
products or rendition of medical,  surgical,  diagnostic  or other  professional
medical services in the ordinary course of business by any Provider  (including,
without limitation, under any tradenames of such Provider), whether now existing
or hereafter arising, including all rights to reimbursement under any agreements
with and payments from  Obligors,  patients,  residents or other Persons and all
proceeds of any of the foregoing.

     "Affiliate"  means,  as to any Person,  any other Person that,  directly or
indirectly,  is in control of, is controlled by or is under common  control with
such Person or is a director or officer of such Person. For the purposes of this
definition, "control", when used with respect to any specified Person, means the
power to  direct  the  management  and  policies  of such  Person,  directly  or
indirectly,  whether through the ownership of voting securities,  by contract or
otherwise.

     "Agreement" has the meaning set forth in the preamble hereto.

     "A/R Fee"  means the  account  receivable  tracking  fee,  due on the first
Business Day of each Month, in an amount equal to:

                              AORA x TD / 360 x ARP

where:

         AORA            = The average  outstanding amount of the Revolving Loan
                         for  the  prior  Month,  calculated  as the  arithmetic
                         average of all daily balances

         TD              = The actual amount of days in such prior Month

         ARP             = The  applicable  A/R Fee  Percentage,  determined  by
                         reference to the AORA for the prior Month, as follows:


                                       I-1

<PAGE>




AORA for                                                          A/R Fee
the Prior Month                                                  Percentage
- ---------------                                                  ----------

less than or equal to $3,000,000  0.60% greater than $3,000,000 but less than or
equal to  $5,000,000  0.55%  greater than  $5,000,000  but less than or equal to
$7,000,000  0.50% greater than  $7,000,000 but less than or equal to $10,000,000
0.45%  greater  than  $10,000,000  but less than or equal to  $15,000,000  0.40%
greater than  $15,000,000  but less than or equal to  $20,000,000  0.35% greater
than $20,000,000 0.30%;

provided  that if this  Agreement  shall be  terminated  on a day other than the
first Business Day of a Month, such A/R Fee for such period from the last day of
the  prior  Month to the date of  termination  shall be  calculated  as above by
substituting such final period for the term "Month" hereinabove.

     "Authorized  Representative" shall mean each Person designated from time to
time, as appropriate,  in a Written Notice by the Borrower to the Lender for the
purposes of giving  notices of  borrowing,  conversion  or renewal of  Revolving
Advances,  which designation shall continue in force and effect until terminated
in a Written Notice to the Lender.

     "Basic Borrowing Amount" shall mean an amount equal to eighty-five  percent
(85%) of the Expected Net Value of Eligible Receivables as of such time.

     "Borrower" has the meaning set forth in the preamble hereto.

     "Borrower's Certificate" has the meaning set forth in Section 1.03.

     "Borrower  Account" means account  #2090001617808  of the Borrower at First
Union  National  Bank of  Florida,  ABA #063 0000 21,  125 North  Airport  Road,
Naples,  FL 34104,  or such other bank  account  designated  by the  Borrower by
Written Notice to the Master  Servicer,  the Lender and the Program Manager from
time to time.

     "Borrowing Base" shall mean, (a) during the Special Period,  the greater of
(i) the Basic  Borrowing  Amount or (ii) an  amount  equal to the  lesser of (x)
$14,500,000 and (y)  ninety-four  percent (94%) of the Expected Net Value of all
Accounts  (including  receivables of private payors) owned by the Borrower which
meet the criteria set forth in clauses (a) through (d), (f) through (m), and (p)
of the  Eligibility  Criteria  hereunder,  and solely for the  purposes  of this
clause (ii)(y),  "Obligor"  shall include  private payors;  and, (b) at any time
following  the  expiration of the Special  Period,  an amount equal to the Basic
Borrowing  Amount;  in each case and at all times as  determined by reference to
and as set forth in the most recent Borrowing Base Certificate  delivered to the
Lender by the Borrower as of such time pursuant to Exhibit IV, Clause (j)(i).


                                       I-2

<PAGE>



     "Borrowing Base Certificate" shall mean a certificate (which may be sent by
Transmission),  substantially  in the form set forth in  Exhibit  VII-A  hereto,
which shall provide the most recently available  information  (including updated
information)   with  respect  to  the  Eligible   Receivables  of  the  Borrower
(segregated  by the classes set forth in the  definition of "Net Value  Factor")
that is set forth in the general trial balance of each of the Providers, in form
and substance satisfactory to the Lender and the Master Servicer.

     "Borrowing  Base  Deficiency"  shall  mean,  as of any date,  the  positive
difference,  if  any,  between  (x)  the  outstanding  principal  amount  of the
Revolving  Loan,  minus (y) the  Borrowing  Base  indicated  on the most  recent
Borrowing Base Certificate.

     "Borrowing Limit" has the meaning set forth in Section 1.02.

     "Business  Day" means any day on which banks are not authorized or required
to close in New York City, New York or Naples, Florida.

     "CCA" means  Community Care of America,  Inc.,  together with its corporate
successors and permitted assigns.

     "CHAMPUS"  means the Civilian  Health and Medical  Program of the Uniformed
Service, a program of medical benefits covering former and active members of the
uniformed services and certain of their dependents, financed and administered by
the  United  States  Departments  of  Defense,  Health  and Human  Services  and
Transportation  and  established  pursuant to 10 USC ss.ss.  1071-1106,  and all
regulations  promulgated thereunder including without limitation (a) all federal
statutes (whether set forth in 10 USC ss.ss.  1071-1106 or elsewhere)  affecting
CHAMPUS; and (b) all rules,  regulations (including 32 CFR 199), manuals, orders
and  administrative,  reimbursement  and other  guidelines  of all  Governmental
Authorities (including,  without limitation,  the Department of Health and Human
Services,  the  Department of Defense,  the  Department of  Transportation,  the
Assistant  Secretary of Defense (Health Affairs),  and the Office of CHAMPUS, or
any  Person or  entity  succeeding  to the  functions  of any of the  foregoing)
promulgated  pursuant to or in connection with any of the foregoing  (whether or
not having  the force of law) in each case as may be  amended,  supplemented  or
otherwise modified from time to time.

     "Claims" has the meaning set forth in Section 1.09.

     "Collections" means all cash collections, wire transfers,  electronic funds
transfers and other cash proceeds of Accounts deposited in or transferred to the
Lender  Lockbox  Account,  including,  without  limitation,  all  cash  proceeds
thereof.

     "Credit  and  Collection   Policy"  means  those  receivables   credit  and
collection  policies and  practices of the Borrower in effect on the date of the
Agreement  and  described in Schedule II hereto,  as modified  from time to time
with the consent of the Lender.


                                       I-3

<PAGE>



     "Debt" of any Person means (without  duplication):  (i) all  obligations of
such party for borrowed  money,  (ii) all obligations of such party evidenced by
bonds, notes, debentures, or other similar instruments, (iii) all obligations of
such party to pay the  deferred  purchase  price of property or services  (other
than trade  payables in the  ordinary  course of  business),  (iv) all  "capital
leases" (as defined by GAAP) of such party,  (v) all Debt of others  directly or
indirectly guaranteed (which term shall not include endorsements in the ordinary
course of  business)  by such  party,  (vi) all  obligations  secured  by a Lien
existing on property owned by such party, whether or not the obligations secured
thereby  have been  assumed by such party or are  non-recourse  to the credit of
such party (but only to the extent of the value of such property), and (vii) all
reimbursement  obligations  of such party  (whether  contingent or otherwise) in
respect of letters of credit, bankers' acceptances and similar instruments.

     "Default"  shall mean an event,  act or condition  which with the giving of
notice or the lapse of time, or both, would constitute an Event of Default.

     "Defaulted  Receivable" shall mean a Receivable (i) as to which the Obligor
thereof or any other Person obligated  thereon has taken any action, or suffered
any event to occur, of the type described in paragraph (i) of Exhibit V, or (ii)
which,  consistent with the Credit and Collection  Policy,  would be written off
the appropriate Provider's books as uncollectible.

     "Delinquency Ratio" has the meaning set forth in the RPA.

     "Delinquent  Receivable" shall mean a Receivable (a) that has not been paid
in full on or following  the 180th day  following the Last Service Date thereof,
or (b) that is a Denied Receivable.

     "Denied  Receivable"  shall  mean  any  Receivable  to  which  any  related
representations  or  warranties  have been  discovered  at any time to have been
breached.

     "Depositary  Agreement" means that certain  Depositary  Account  Agreement,
dated the date hereof, among the Providers,  CCA, the Borrower,  the Lender, and
the Lockbox Bank, in substantially  the form attached hereto as Exhibit VIII, as
such  agreement may be amended,  modified or  supplemented  from time to time in
accordance with its terms.

     "Distribution"  shall mean any dividend  payment or other  distribution  of
assets,  properties,  cash, rights,  obligations or securities on account of any
capital interest in the Borrower,  or return any capital to its members as such,
or purchase,  retire, defease, redeem or otherwise acquire for value or make any
payment  in  respect  of any  shares of any class of  capital  interests  in the
Borrower or any warrants,  rights or options to acquire any such interests,  now
or hereafter outstanding.

     "Documents" shall mean this Agreement,  the RPA, the Depositary  Agreement,
each  Borrower's  Certificate,  each Borrowing Base  Certificate  and each other
document or instrument now

                                       I-4

<PAGE>



or  hereafter  executed  and  delivered  to the  Lender  by or on  behalf of the
Borrower pursuant to or in connection herewith or therewith.

     "Eligible  Receivables"  means  Receivables  that  satisfy the  Eligibility
Criteria, as determined by the Lender Group.

     "Eligibility Criteria" means the criteria and basis for determining whether
a  Receivable  shall be deemed by the Lender  Group to  qualify  as an  Eligible
Receivable,  all as set forth in Exhibit VI hereto, as such Eligibility Criteria
may be  modified  from time to time by the Lender in its good  faith  discretion
upon Written Notice to the Provider.

     "Employee  Benefit Plan" means any employee benefit plan within the meaning
of ss. 3(3) of ERISA  maintained  by any Provider,  the  Borrower,  any of their
respective  ERISA  Affiliate,  or with  respect  to which  any of them  have any
liability.

     "EOB" means the  explanation of benefit from an Obligor that identifies the
services rendered on account of the Receivable specified therein.

     "ERISA"  means the Employee  Retirement  Income  Security  Act of 1974,  as
amended.

     "ERISA  Affiliate"  means any entity which is under common control with the
Borrower  within the  meaning of ERISA or which is treated as a single  employer
with the Borrower under the Internal Revenue Code of 1986, as amended.

     "Event of Default" means any of the events specified in Exhibit V hereto.

     "Event of Termination" shall have the meaning set forth in the RPA.

     "Excluded Claims" has the meaning set forth in Section 1.09(b)

     "Excluded  Taxes" shall mean taxes upon or  determined  by reference to the
Lender's  net  income  imposed  by the  jurisdiction  that  any such  Lender  is
organized or has its principal or registered office.

     "Expected Net Value" means,  with respect to any Eligible  Receivable,  the
gross unpaid amount of such  Receivable on date of creation  thereof,  times the
Net Value Factor.

     "Fee and Interest Shortfall" as of any Funding Date, shall mean the amount,
if any,  of A/R Fee or interest  that is due and  payable and has not  otherwise
been paid in full by the Borrower.

     "Funding  Date" means Tuesday of each week after the Initial  Funding Date,
or if such day is not a Business Day, the next succeeding Business Day.


                                       I-5

<PAGE>



     "GAAP" means generally accepted accounting  principles in the United States
of  America,  applied  on a  consistent  basis as set forth in  Opinions  of the
Accounting  Principles  Board of the  American  Institute  of  Certified  Public
Accountants  and/or in statements of the Financial  Accounting  Standards  Board
and/or the rules and  regulations  of the  Securities  and  Exchange  Commission
and/or their respective successors and which are applicable in the circumstances
as of the date in question.

     "Governmental  Entity" means the United States of America,  any state,  any
political subdivision of a state and any agency or instrumentality of the United
States of America or any state or political  subdivision  thereof and any entity
exercising  executive,  legislative,   judicial,  regulatory  or  administrative
functions of or pertaining to government.  Payments from  Governmental  Entities
shall be deemed to include  payments  governed under the Social Security Act (42
U.S.C. 1395, et seq.), including payments under Medicare,  Medicaid and CHAMPUS,
and payments administered or regulated by HCFA.

     "HCFA" means the Health Care Financing  Administration of the United States
Department of Health and Human Services.

     "Indemnified Party" has the meaning set forth in Section 1.09.

     "Initial Funding Date" means the date of the initial  Revolving  Advance in
respect of Receivables hereunder.

     "Insurer"  means any Person which in the ordinary course of its business or
activities  agrees  to  pay  for  healthcare  goods  and  services  received  by
individuals,  including  commercial  insurance  companies,  nonprofit  insurance
companies (such as Blue Cross, Blue Shield entities),  employers or unions which
self-insure  for  employee  or member  health  insurance,  prepaid  health  care
organizations,   preferred   provider   organizations  and  health   maintenance
organizations.  "Insurer" includes insurance companies issuing health,  personal
injury,  workers'  compensation or other types of insurance but does not include
any individual guarantors.

     "Interest  Payment Date" shall mean the last day of the Interest Period for
the applicable Revolving Advance.

     "Interest  Period" shall mean the period commencing on, as the case may be,
the  borrowing or  conversion  date with respect to such  Revolving  Advance and
ending one month thereafter;  provided,  however, that no Interest Period may be
selected that expires later than the Maturity Date; and provided,  further, that
any Interest Period that begins on the last Business Day of a Month (or on a day
for which there is no numerically  corresponding  day in the Month at the end of
such Interest Period) shall,  subject to the foregoing proviso,  end on the last
Business Day of a Month.


                                       I-6

<PAGE>



     "Last Service  Date" means,  with respect to any Eligible  Receivable,  the
date set forth on the related  invoice or  statement  as the most recent date on
which  services  or  merchandise  were  provided  by a Provider  to the  related
patient.

     "Lender" has the meaning set forth in the preamble hereto.

     "Lender  Debt"  means and  includes  any and all amounts  due,  whether now
existing  or  hereafter  arising,  under  the  Agreement,   including,   without
limitation, any and all principal,  interest penalties, fees, charges, premiums,
indemnities  and costs owed or owing to the Lender,  the Program  Manager or the
Master  Servicer by the Provider,  any Affiliate of the Provider or any "Lender"
under the RPA,  arising under or in connection with this  Agreement,  the RPA or
the  Depositary  Agreement,  in each instance,  whether  absolute or contingent,
direct or indirect,  secured or unsecured,  due or not,  arising by operation of
law or otherwise, and all interest and other charges thereon, including, without
limitation,  post-petition interest whether or not such interest is an allowable
claim in a bankruptcy.

     "Lender  Group"  means (i) the Lender,  the Program  Manager and the Master
Servicer,  and (ii) the Lender's  agents and delegates  identified  from time to
time to effectuate this Agreement.

     "Lender  Lockbox"  means the  lockbox  located at the  address set forth on
Schedule IV to receive checks and EOB's with respect to  Receivables  payable by
Insurers.

     "Lender Lockbox Account" means the account at the Lockbox Bank as set forth
on Schedule IV as  associated  with the Lender  Lockbox and  established  by the
Borrower to deposit  Collections,  including  Collections received in the Lender
Lockbox and Collections received by wire transfer directly from Insurers, all as
more fully set forth in the Depositary Agreement.

     "Lender Position" has the meaning set forth in Section 5.03.

     "LIBO Rate" means an annualized  30-day  interest rate  (calculated  on the
basis of actual days elapsed over a 360-day year) equal to the offered rate that
appears  on page  3751 of the  Telerate  Service  for the Bank of Tokyo for U.S.
dollar  deposits of amounts and in funds  comparable to the principal  amount of
such  Revolving  Advance  requested  by the  Borrower for which the LIBO Rate is
being determined with maturities  comparable to the 30-day period for which such
LIBO Rate will apply as of approximately 10:00 a.m. (New York time) two Business
Days prior to the commencement of such Funding Date.

     "Lien"  means any lien,  mortgage,  security  interest,  tax lien,  pledge,
hypothecation, assignment, preference, priority, other charge or encumbrance, or
any other type of preferential  arrangement of any kind or nature  whatsoever by
or with any Person (including, without limitation, any conditional sale or title
retention  agreement),  whether  arising  by  contract,  operation  of  law,  or
otherwise.

     "Lockbox  Bank"  means  KeyBank,  as  lockbox  bank  under  the  Depositary
Agreement.

                                       I-7

<PAGE>



     "Loss-to-Liquidation  Ratio"  means,  as of the last  Business  Day of each
Month, a percentage equal to:

                                     DR / C


where:

                  DR                = The  Expected  Net  Value of all  Eligible
                                    Receivables     which    became    Defaulted
                                    Receivables   in  the   four   week   period
                                    immediately    prior    to   the   date   of
                                    calculation.

                  C                 = Collections  on such Eligible  Receivables
                                    in the four week period immediately prior to
                                    the date of calculation.

     "Master  Servicer"  means RJE Data  Processing,  Inc., and any other Person
then identified by the Lender to the Borrower as being  authorized to administer
and service Receivables.

     "Maturity  Date" means the earlier of (a) the Scheduled  Maturity Date, and
(b) the  occurrence  of an Event of Default  unless  such event is waived by the
Lender in writing.

     "Material Adverse Effect" means any event, condition, change or effect that
(a) has a materially  adverse  effect on the  business,  operations or financial
condition of (i) CCA on a consolidated  basis,  (ii) the Borrower,  or (iii) any
Provider,  (b)  materially  impairs the  ability of the  Borrower to perform its
obligations under this Agreement,  (c) materially  impairs the ability of CCA, a
Provider or the Borrower to perform their respective  obligations under the RPA,
or (d)  materially  impairs the  validity or  enforceability  of, or  materially
impairs the rights,  remedies or  benefits  available  to the Lender  under this
Agreement or (as assignee from the Lender) under the RPA.

     "Maximum Permissible Rate" has the meaning set forth inSection 1.11(a).

     "Month" means a calendar month.

     "Multiemployer  Plan"  means a plan,  within the  meaning  of ss.  3(37) of
ERISA,  as to which the  Borrower  or any  ERISA  Affiliate  contributed  or was
required to contribute within the preceding five (5) years.

                  "Net Value Factor" means,  initially, as follows:

                           Obligor                   Net Value Factor
                           Private                          98%
                           Medicare                         99%
                           Medicaid                         99%
                           Medicare Part B                  99%

                                       I-8

<PAGE>



                           Insurance                        98%
                           VA and Other                     98%

as such percentage may be adjusted,  upwards or downwards with Written Notice to
the Borrower,  in the good faith  discretion  of the Lender but in  consultation
with the Borrower and CCA, based on historical actual final collections received
on the Receivables within the past 180 days.

     "Non-Utilization Fee" has the meaning set forth in Section 1.05(d).

     "Obligor" means the Insurer or Governmental  Entity, as applicable,  who is
responsible for the payment of all or any portion of a Receivable.

     "Other  Corporations"  means  each  Provider  and  each of its  direct  and
indirect parents or subsidiaries other than the Borrower.

     "Other Taxes" has the meaning set forth in Section 1.08.

     "Overnight  Rate" means the interest rate for overnight funds as set by the
Lockbox Bank from time to time.

     "PBGC"  means  the  Pension  Benefit  Guaranty  Corporation  or any  entity
succeeding to all or any of its functions under ERISA.

     "Person"  means  an  individual,  partnership,   corporation  (including  a
business trust), joint stock company, trust, unincorporated  association,  joint
venture or other entity, or a government or any political  subdivision or agency
thereof.

     "Program Manager" means (i) Daiwa Securities America Inc. or (ii) any other
Person then  identified  by the Lender to the  Borrower as being  authorized  to
provide  administrative  services  with  respect to the Lender and the  Lender's
finance, funding and collection of healthcare receivables.

     "Property" means property of all kinds, real,  personal or mixed,  tangible
or intangible  (including,  without  limitation,  all rights relating  thereto),
whether owned or acquired on or after the date of this Agreement.

     "Provider"  means each party listed as a Provider  under the RPA,  together
with its corporate successors and permitted assigns.

     "Provider  Ancillary  Lockbox"  means the  lockbox set forth on Schedule IV
hereto to  receive  checks  and EOB's with  respect  to  Receivables  payable by
private payors.

     "Provider  Ancillary  Lockbox  Account"  means  the  account  set  forth on
Schedule IV hereto in the name of the Providers and associated with the Provider
Ancillary Lockbox established

                                       I-9

<PAGE>



and controlled by the Providers to deposit  Collections,  including  Collections
received in the  Provider  Ancillary  Lockbox and  Collections  received by wire
transfer, all as more fully set forth in the Depositary Agreement.

     "Provider  Government  Lockbox"  means the lockbox set forth on Schedule IV
hereto to  receive  checks  and EOB's with  respect  to  Receivables  payable by
Governmental Entities.

     "Provider  Government  Lockbox  Account"  means  the  account  set forth on
Schedule IV hereto in the name of the Providers and associated with the Provider
Government  Lockbox  established  and  controlled  by the  Providers  to deposit
Collections,  including  Collections received in the Provider Government Lockbox
and Collections  received by wire transfer directly from Governmental  Entities,
all as more fully set forth in the Depositary Agreement.

     "Provider  Lockboxes" means,  collectively,  the Provider Ancillary Lockbox
and the Provider  Government Lockbox,  or, as the context requires,  either such
lockbox.

     "Provider  Lockbox  Account" means,  collectively,  the Provider  Ancillary
Lockbox Account and the Provider Government Lockbox Account,  or, as the context
requires, either such lockbox account.

     "Receivable Information" has the meaning set forth in the RPA.

     "Receivables"  means  the  third-party   reimbursable  or  the  third-party
directly  payable portion of healthcare  accounts  receivable,  owing (or in the
case of Unbilled Receivables,  to be owing) to the Borrower,  arising out of the
rendition  of  medical,  surgical,  diagnostic  or  other  professional  medical
services or the sale of medical  products by the Provider,  including all rights
to reimbursement under any agreements with and payments from Obligors,  together
with,  to the  maximum  extent  permitted  by  law,  all  accounts  and  general
intangibles  related  thereto,  all  rights,  remedies,   guaranties,   security
interests and Liens in respect of the  foregoing,  all books,  records and other
Property  evidencing  or related to the foregoing and all proceeds of any of the
foregoing.

     "Related Person" means any incorporator, stockholder, Affiliate (other than
the Program Manager),  agent,  attorney,  officer,  director,  member,  manager,
employee or partner of the Lender or its stockholders.

     "RPA" means that certain Receivables Purchase and Transfer Agreement, dated
as of the date of this Agreement,  among CCA, the Providers  named therein,  and
the Borrower,  as such agreement may be amended,  modified or supplemented  from
time to time in accordance with the terms hereof and thereof.

     "Revolving Advance" has the meaning set forth in Section 1.01.

     "Revolving Commitment" has the meaning set forth in Section 1.02.

                                      I-10

<PAGE>



     "Revolving Loan" has the meaning set forth in Section 1.01.

     "Scheduled  Maturity  Date"  means  the date 36 months  after  the  Initial
Funding Date.

     "Servicer Termination Event" shall have the meaning set forth in the RPA.

     "Special  Period" shall mean the period  commencing on the Initial  Funding
Date and ending on the earliest to occur of (i) the three month  anniversary  of
the  Initial  Funding  Date,  and (ii) the  occurrence  of any Event of Default,
unless such event is waived by the Lender in writing.

     "Tangible Net Worth" with respect to the Borrower,  means, at any time, the
excess of (i) the Expected Net Value of all  Receivables  owned and not financed
by the Lender,  plus cash, plus  investments,  plus amounts which are owing from
the Lender minus (ii) the sum of all accrued  unpaid  monetary  obligations  and
accrued unpaid fees and expenses payable hereunder or otherwise.

     "Transmission"  means, upon establishment of computer interface between the
Borrower  and  the  Master  Servicer  in  accordance  with  the   specifications
established by the Master Servicer,  the transmission of Receivable  Information
through computer  interface to the Master Servicer,  and prior to such time (not
to exceed 60 days from the Initial  Funding  Date),  by  facsimile  or overnight
courier, all in a manner satisfactory to the Master Servicer.

     "UCC" means the Uniform  Commercial  Code as from time to time in effect in
the specified jurisdiction.

     "Unbilled Receivable" means a Receivable in respect of which the goods have
been shipped,  or the services rendered,  to the customer or patient,  rights to
payment  thereon  have  accrued,  but the invoice  has not been  rendered to the
applicable Obligor.

     "Written   Notice"  and  "in  writing"  shall  mean  any  form  of  written
communication or a communication by means of telex, telecopier device, telegraph
or cable.


     Other Terms. All accounting terms not specifically  defined herein shall be
construed in accordance with GAAP. All terms used in Article 9 of the UCC in the
State of New York,  and not  specifically  defined  herein,  are used  herein as
defined in such Article 9.



                                      I-11

<PAGE>



                                   EXHIBIT II.

                        CONDITIONS OF REVOLVING ADVANCES

                  1. Conditions Precedent on Initial Funding Date. The making of
the Revolving  Advance on the Initial  Funding Date is subject to the conditions
precedent  that the Lender shall have received on or before the Initial  Funding
Date the following,  each (unless otherwise  indicated) dated such date, in form
and substance satisfactory to the Lender:

                  (a) A  certificate  issued  by the  Secretary  of State of the
State of Delaware, dated as of a recent date, as to the legal existence and good
standing of the Borrower  (which  certificate may be dated not more than 20 days
prior to the Initial  Funding Date) or an opinion of counsel for the Borrower to
that effect.

                  (b)  Certified  copies of the  Articles  of  Organization  and
Operating  Agreement of the Borrower,  certified  copies of  resolutions  of the
Managers of the Borrower  approving this  Agreement and certified  copies of all
documents   evidencing   other  necessary   corporate  action  and  governmental
approvals, if any, with respect to this Agreement.

                  (c) A certificate  of the Secretary or Assistant  Secretary of
the Borrower  certifying  the names and true  signatures  of the officers of the
Borrower  authorized  to sign  this  Agreement  and the  other  documents  to be
delivered by it hereunder.

                  (d) A copy of the opening  balance sheet of the Borrower as at
the  Initial  Funding  Date,  certified  by the chief  financial  officer of the
Borrower.

                  (e)  Acknowledgment  or time-stamped  receipt copies of proper
financing  statements  (showing the Borrower as debtor and the Lender as secured
party)  duly filed on or before the  Initial  Funding  Date under the UCC of all
jurisdictions  that the Lender may deem  necessary  or  reasonably  desirable in
order to perfect the ownership interests contemplated by the Agreement.

                  (f)   Releases  of,  and   acknowledgment   copies  of  proper
termination  statements (Form UCC-3), if any,  necessary to evidence the release
of all security  interests,  ownership and other rights of any Person previously
granted by Borrower in its Receivables.

                  (g) A copy of all of the Providers'  existing forms of patient
consents  which were  signed by each  patient for which the  currently  existing
Receivables were created,  as well as a copy of each new patient consent form to
be signed by each  patient  for which a  Receivable  will be  created  after the
Initial Funding Date, which consents  authorize certain  demographic and medical
information with respect to such patient to be disclosed by each Provider to its
servicing  agents  and by such  servicing  agents  to any third  party  obligors
thereon,  certified  by a Secretary  or  Assistant  Secretary of the Borrower as
being true, complete and correct.


                                      II-1

<PAGE>



                  (h)      A favorable opinion of Blass & Driggs, substantially
in the form attached hereto as Exhibit IX-A.

                  (i) A  favorable  opinion of Blass & Driggs,  counsel  for the
Borrower,  CCA and the Providers,  substantially  in the form attached hereto as
Exhibit IX-B.

                  (j) The  Assignment  of Contract  with  respect to the RPA and
assignments of all other documents,  lockboxes and lockbox accounts with respect
to the RPA,  duly  executed  by the  Borrower  and  acknowledged  by CCA and the
Providers.

                  (k)  Originally   executed   copies  of  the  RPA,  all  other
documentation  required to be delivered  with respect to this  Agreement and the
RPA, all in form and  substance  satisfactory  to the Lender,  which  agreements
shall be in full force and  effect  and  enforceable  in  accordance  with their
respective terms.

                  (l) Evidence that all of the conditions precedent with respect
to each Provider to the initial  purchase from such Provider  under the RPA have
been satisfied or waived.

                  (m)  A  duly  executed  Depositary  Agreement,  together  with
evidence satisfactory to the Lender that the Provider Lockboxes and the Provider
Lockbox Accounts have been established.

                  (n)      Payment of a facility fee of $150,000 to Daiwa
Securities America Inc.

                  (o)      Payment of all reasonable attorneys' fees incurred by
the Lender Group plus reasonable disbursements.

                  (p)      Affirmation by Duff & Phelps Credit Rating Co. or an
equivalent rating agency acceptable to the Lender of the transactions
contemplated hereunder with a minimum rating of AA/BBB-.

                  (q)      Evidence that the capitalization of the Borrower is
satisfactory to the Lender.

                  2. Conditions  Precedent on All Funding Dates.  Each Revolving
Advance on a Funding Date  (including the Initial Funding Date) shall be subject
to the further conditions  precedent that the Borrower and the Lender shall have
agreed upon the terms of such Revolving Advance and also that:

                  (a) the Borrower shall have delivered to the Lender,  at least
two Business Days prior to such Funding Date, in form and substance satisfactory
to  the  Lender  a  completed  Borrower's   Certificate  and  a  Borrowing  Base
Certificate,  together with such  additional  information  as may  reasonably be
requested by the Lender or the Master Servicer;


                                      II-2

<PAGE>



                  (b) on such Funding  Date the  following  statements  shall be
true (and acceptance of the proceeds of such Revolving Advance shall be deemed a
representation and warranty by the Borrower that such statements are then true):

                           (i)      the representations and warranties contained
in Exhibits III and VII are correct on and as of the date of such Revolving
Advance as though made on and as of    such date, and

                           (ii) no event  has  occurred  and is  continuing,  or
         would  result  from such  Revolving  Advance or any  actions  connected
         therewith, that constitutes a Default or an Event of Default;

                  (c)      the Lender shall have received such other approvals,
 opinions or documents as it may reasonably request.

                                      II-3

<PAGE>



                                  EXHIBIT III.

                         REPRESENTATIONS AND WARRANTIES

                  The Borrower represents and warrants as follows:

                  (a)  The  Borrower  is  a  limited   liability   company  duly
organized,  validly existing and in good standing under the laws of the State of
Delaware,  and is duly  qualified to do business,  and is in good  standing,  in
every  jurisdiction  where  the  nature  of its  business  requires  it to be so
qualified.

                  (b) The execution, delivery and performance by the Borrower of
the Agreement and the other documents to be delivered by it thereunder,  (i) are
within the Borrower's  powers,  (ii) have been duly  authorized by all necessary
organizational  action,  (iii) do not contravene (1) the Borrower's  Articles of
Organization or Operating Agreement,  (2) any law, rule or regulation applicable
to the Borrower,  (3) any  contractual  restriction  binding on or affecting the
Borrower or its Property, or (4) any order, writ, judgment, award, injunction or
decree  binding on or affecting  the Borrower or its  Property,  and (iv) do not
result in or require the creation of any Lien upon or with respect to any of its
Properties,  other than the  security  interest  created by the  Agreement.  The
Agreement has been duly executed and delivered by the Borrower. The Borrower has
previously furnished to the Lender a correct and complete copy of the Borrower's
Articles of  Organization  and  Operating  Agreement  including  all  amendments
thereto.

                  (c) No  authorization  or approval or other  action by, and no
notice to or filing  with,  any  Governmental  Entity  is  required  for the due
execution,  delivery and  performance  by the  Borrower of the  Agreement or any
other document to be delivered thereunder.

                  (d) The  Agreement  constitutes  the legal,  valid and binding
obligation of the Borrower,  enforceable against the Borrower in accordance with
its terms, except as limited by bankruptcy,  insolvency,  moratorium, fraudulent
conveyance  or other laws  relating  to the  enforcement  of  creditors'  rights
generally and general principles of equity (regardless of whether enforcement is
sought at equity or law).

                  (e) The  Borrower  has all  power and  authority,  and has all
permits, licenses, accreditations,  certifications,  authorizations,  approvals,
consents and agreements of all Insurers,  Governmental  Entities,  accreditation
agencies and any other Person  necessary or required for the Borrower (i) to own
the  assets  (including  Receivables)  that it now  owns,  (ii) to  carry on its
business as now conducted,  (iii) to execute, deliver and perform the Agreement,
and (iv) to receive  payments  from the Obligors in the manner  contemplated  in
this Agreement.

                  (f) Except as disclosed in Schedule  III, the  Providers  have
not been  notified  by any  Insurer,  Governmental  Entity  or  instrumentality,
accreditation  agency or any other person,  during the immediately  preceding 12
month  period,  that such party has  rescinded or not renewed,  or is reasonably
likely  to  rescind  or not  renew,  any such  permit,  license,  accreditation,
certification,

                                      III-1

<PAGE>



authorization,  approval, consent or agreement granted by it to such Provider or
to which it and such Provider are parties.

                  (g) As of the Initial  Funding Date, all conditions  precedent
set forth in Exhibit II have been  fulfilled or waived in writing by the Lender,
and as of each Funding Date, the  conditions  precedent set forth in paragraph 2
of such Exhibit II shall have been fulfilled or waived in writing by the Lender.

                  (h) The opening balance sheet of the Borrower, copies of which
have been furnished to the Lender, fairly present the financial condition of the
Borrower as at such date all in accordance with GAAP.

                  (i)  The RPA is in full  force  and  effect  and no  Event  of
Termination or Servicer  Termination Event (without regard to waivers granted or
sought) is continuing thereunder.

                  (j)  There is no  pending  or,  to the  Borrower's  knowledge,
threatened  action  or  proceeding  or  injunction,  writ or  restraining  order
affecting the Borrower or any Provider before any court,  Governmental Entity or
arbitrator  which could  reasonably be expected to result in a Material  Adverse
Effect, or which purports to affect the legality,  validity or enforceability of
the Agreement,  the RPA or any other document executed in connection herewith or
therewith,  and neither the Borrower  nor any Provider is currently  the subject
of, or has any present  intention of  commencing,  an  insolvency  proceeding or
petition in bankruptcy.

                  (k) The  Borrower  is the  legal and  beneficial  owner of the
Receivables  free and  clear of any  Lien;  the  Lender  shall  acquire  a valid
security interest in the Receivables and in the Collections with respect thereto
subject to no third-party  claims of interest  thereon.  No effective  financing
statement or other instrument  similar in effect covering any Receivables or the
Collections  with respect  thereto is on file in any  recording  office,  except
those being  terminated on or before the Initial Funding Date and those filed in
favor of the Borrower  relating to the purchase of the Receivables under the RPA
and those in favor of the Lender  relating to the  Agreement,  and no  competing
notice  or  notice  inconsistent  with  the  transactions  contemplated  in  the
Agreement has been sent to any Obligor.

                  (l) All Receivable  Information,  information  provided in the
application  for the  program  effectuated  by the  Agreement,  and  each  other
document,  report and Transmission  provided by the Borrower to the Lender Group
is or shall be  accurate in all  material  respects as of its date and as of the
date so  furnished,  and no such  document  contains or will  contain any untrue
statement  of a  material  fact or omits or will omit to state a  material  fact
necessary in order to make the statements contained therein, in the light of the
circumstances under which they were made, not misleading.

                  (m) The principal place of business and chief executive office
of the Borrower and the office where the Borrower  keeps its records  concerning
the Receivables are located at the address  referred to on the signature page of
the  Agreement  and  there  have  been no  other  such  locations  for the  four
immediately prior months.

                                      III-2

<PAGE>



                  (n) The  provisions  of the Agreement  create,  on the Initial
Funding Date, legal and valid Liens in all of the Borrower's  Receivables in the
Lender's  favor and when all  proper  filings  and other  actions  necessary  to
perfect  such  Liens  have been  completed,  will  constitute  a  perfected  and
continuing Lien on all of the Borrower's  Receivables,  having priority over all
other  Liens  on such  Receivables  of the  Borrower,  enforceable  against  the
Borrower and all third parties.

                  (o)      The Borrower has not changed its principal place of
business or chief executive office in the last five years.

                  (p) The  exact  name of the  Borrower  is as set  forth on the
signature  page of the  Agreement,  and  except as  notified  in  writing to the
Lender, the Borrower has not changed its name in the last 12 months, and, except
as notified in writing to the Lender,  the  Borrower  did not use,  nor does the
Borrower now use, any fictitious or trade name.

                  (q) With  respect to the Borrower or the  Provider,  since the
Funding Date prior to the making of this  representation,  there has occurred no
event which has or is reasonably likely to have a Material Adverse Effect.

                  (r)  Neither the  Borrower  nor any  Provider is in  violation
under any applicable  statute,  rule, order,  decree or regulation of any court,
arbitrator or governmental body or agency having  jurisdiction over the Borrower
or any Provider  which has or is  reasonably  likely to have a Material  Adverse
Effect.

                  (s) The  Borrower  has filed on a timely basis all tax returns
(federal,  state and local)  required to be filed and has paid, or made adequate
provision for payment of, all taxes,  assessments and other governmental charges
due from the Borrower.  No tax Lien has been filed and is now effective  against
the  Borrower or any of its  Properties  except any Lien in respect of taxes and
other charges not yet due or contested in good faith by appropriate proceedings.
To the Borrower's knowledge,  there is no pending investigations of the Borrower
by any taxing  authority  or any pending but  unassessed  tax  liability  of the
Borrower.

                  (t) The  Borrower  is solvent  and will not  become  insolvent
after giving effect to the  transactions  contemplated  by this  Agreement;  the
Borrower has not incurred  debts or  liabilities  beyond its ability to pay; the
Borrower  will,  after giving  effect to the  transaction  contemplated  by this
Agreement,  have an adequate  amount of capital to conduct  its  business in the
foreseeable  future;  the sales of Receivables  hereunder are made in good faith
and without intent to hinder,  delay or defraud  present or future  creditors of
the Borrower.

                  (u) Each Provider  maintains only the one Provider  Government
Lockbox and only the one Provider Government Lockbox Account,  each as described
on  Schedule IV to this  Agreement,  for  Receivables  of which the Obligor is a
Governmental  Entity (except those lockboxes and lockbox accounts  terminated or
being  terminated  prior to or on the Initial Funding Date); and no direction is
in effect directing Obligors to remit payments on Receivables other than to the

                                      III-3

<PAGE>



applicable Lender Lockbox, Lender Lockbox Account, Provider Lockbox, or Provider
Lockbox Account, each as described on Schedule IV.

                  (v)      The Borrower has no pension plans or profit sharing
plans.

                  (w) There are no pending civil or criminal  investigations  by
any  Governmental  Entity  involving the Borrower,  any Provider or any of their
respective  officers or directors and neither the Borrower,  any Provider or any
of their  respective  officers or directors has been involved in, or the subject
of, any civil or criminal investigation by any Governmental Entity.

                  (x)      The sole business of the Borrower is as provided in
its Operating Agreement.

                  (y) The assets of the Borrower are free and clear of any Liens
in favor of the  Internal  Revenue  Service,  any  Employee  Benefit  Plan,  any
Multiemployer  Plan or the PBGC other than inchoate tax Liens  resulting from an
assessment of any Provider, CCA or the Borrower.

                  (z)      None of the Eligible Receivables constitutes or has
constituted an obligation of any Person which is an Affiliate of the Borrower.

                  (aa) The Obligor of each Proposed Eligible  Receivable has not
been the Obligor of any Defaulted Receivables in the past 12 months (other than,
for the purpose of this clause, as a result of good faith disputes).

                  (bb) No transaction contemplated under this Agreement requires
compliance with any bulk sales act or similar law.

                  (cc)     The Borrower has no Debt except hereunder and under
the RPA.

                  (dd) Each Receivable  that is an Unbilled  Receivable will be,
or has been, billed to the Obligor of such Receivable within 45 days of the Last
Service Date.



                                      III-4

<PAGE>



                                   EXHIBIT IV.

                                    COVENANTS

                  Until  the  payment  in  full  of  all  Lender  Debt  and  the
termination of the Revolving Commitment hereunder:

                  (a) Compliance with Laws, etc. The Borrower will comply in all
material  respects with all applicable laws,  rules,  regulations and orders and
preserve   and   maintain   its   corporate   existence,   rights,   franchises,
qualifications,  and  privileges  except to the  extent  that the  failure so to
comply with such laws,  rules and  regulations or the failure so to preserve and
maintain such  existence,  rights,  franchises,  qualifications,  and privileges
would not result in Material Adverse Effect.

                  (b) Offices,  Records and Books of Account.  The Borrower will
keep its principal place of business and chief  executive  office and the office
where it keeps its  records  concerning  the  Receivables  at the address of the
Borrower set forth under its name on the  signature  page to the  Agreement  or,
upon 30 days' prior  Written  Notice to the Lender,  at any other  locations  in
jurisdictions where all actions reasonably  requested by the Lender or otherwise
necessary to protect and perfect the Lender's  interest in the Receivables  have
been taken and  completed.  The  Borrower  shall keep its books and  accounts in
accordance  with  generally  accepted  accounting  principles  and shall  make a
notation on its books and records,  including  any computer  files,  to indicate
which  Receivables have been assigned as security to the Lender and the security
interest of the Lender in the  Borrower's  Accounts  not assigned to the Lender.
The  Borrower  shall  maintain  and  implement   administrative   and  operating
procedures  (including,  without  limitation,  an  ability to  recreate  records
evidencing  Receivables and related contracts in the event of the destruction of
the originals thereof), and keep and maintain all documents,  books, records and
other  information   reasonably   necessary  or  advisable  for  collecting  all
Receivables (including, without limitation, records adequate to permit the daily
identification of each Receivable and all Collections of and adjustments to each
existing Receivable) and for providing the Receivable Information.

                  (c)  Performance  and Compliance with Contracts and Credit and
Collection Policy.  The Borrower will, at its expense,  timely and fully perform
and comply  (and will cause the  applicable  Provider  or its  designee to fully
perform and comply) with all material  provisions,  covenants and other promises
required to be observed by it under the  contracts  related to the  Receivables,
and  timely  and fully  comply in all  material  respects  with the  Credit  and
Collection Policy in regard to each Receivable and the related contract, and the
Borrower  shall  maintain,  at its expense,  in full  operation each of the bank
accounts  and  lockboxes  required to be  maintained  under the  Agreement.  The
Borrower shall do nothing,  nor suffer or permit any other Person,  to impede or
interfere with the collection by the Lender or the Master Servicer, on behalf of
the Lender, of the Receivables.

                  (d)      Notice of Breach of Representations and Warranties.
The Borrower shall promptly (and in no event later than five Business Days
following actual knowledge thereof) inform

                                      IV-1

<PAGE>



the Lender and the Master Servicer of any breach of covenants or representations
and warranties hereunder and under the RPA, including,  without limitation, upon
discovery  of a breach of the  criteria  set  forth in  Exhibit  VI  hereof  and
thereof.

                  (e) Debt,  Sales,  Liens,  etc. The Borrower will not incur or
assume any Debt or issue any securities  except under or as contemplated by this
Agreement. The Borrower will not sell, assign (by operation of law or otherwise)
or  otherwise  dispose  of, or create or suffer to exist any Liens  upon or with
respect to, the Borrower's  Accounts,  or upon or with respect to any account to
which any Collections are sent, or assign any right to receive income in respect
thereof  except (i) the Borrower may grant a Lien on Accounts  that is expressly
subordinated in writing to the Lien created  hereunder in a manner acceptable to
the Lender, in its sole discretion,  and (ii) those Liens in favor of the Lender
or any assignee of the Lender relating to the Agreement.

                  (f) Extension or Amendment of Receivables.  The Borrower shall
not amend,  waive or  otherwise  suffer or permit a Provider to, or agree to any
deviation from the terms or conditions of any  Receivable  owned by the Borrower
in a manner inconsistent with the Credit and Collection Policy.

                  (g) Change in Business or Credit and  Collection  Policy.  The
Borrower  will not make any change in the Credit and  Collection  Policy or make
any change in the character of its business that, in either event, is reasonably
likely to result in a Material  Adverse  Effect.  The Borrower will not make any
other  material  changes in the Credit and  Collection  Policy without the prior
written consent of the Lender.

                  (h) Audits and Visits.  The Borrower  will,  from time to time
during regular business hours as requested by the Lender, permit the Lender upon
reasonable  notice,  without  interfering  with the  Borrower's  or a Provider's
business or operations and subject to compliance with applicable law in the case
of review of patient  information,  or its agents or representatives  (including
the Master  Servicer),  (i) to examine and make copies of and abstracts from all
books, records and documents (including, without limitation,  computer tapes and
disks) in the  possession  or under the  control  of the  Borrower  relating  to
Receivables including,  without limitation,  the related contracts,  and (ii) to
visit the offices and  properties  of the  Borrower for the purpose of examining
such materials described in clause (i) above, and to discuss matters relating to
Receivables or the Borrower's  performance hereunder or under the contracts with
any of the  officers or  employees  of the  Borrower  having  knowledge  of such
matters.  The Borrower shall permit the Master  Servicer to have at least one of
its   agents  or   representatives   physically   present   in  the   Borrower's
administrative office during normal business hours to assist the Borrower in the
collection of Receivables.

                  (i)  Change in Payment  Instructions.  The  Borrower  will not
terminate the Provider  Lockboxes,  the Provider  Lockbox  Accounts,  the Lender
Lockbox, or the Lender Lockbox Account, or make any change or replacement in the
instructions  contained in any Notice or otherwise,  or regarding payments to be
made to the Borrower,  the Lender or the Master Servicer,  except upon the prior
and express direction of the Program Manager or the Lender.


                                      IV-2

<PAGE>



                  (j)      Reporting Requirements.  The Borrower will provide to
the Lender (in multiple copies, if requested by the Lender) the following:

                           (i)      on Monday of each week (or, if such day is
not a Business Day, the immediately following Business Day), a Borrowing Base
Certificate;

                           (ii) as soon as available  and in any event within 45
         days after the end of each of the first  three  quarters of each fiscal
         year of the Borrower,  balance  sheets of the Borrower as of the end of
         such quarter and statements of income, cash flows and retained earnings
         of the  Borrower  for the period  commencing  at the  beginning  of the
         current fiscal year and ending with the end of such quarter,  certified
         by the chief  financial  officer of the Borrower,  and accompanied by a
         certificate  of an  authorized  officer of the Borrower  detailing  its
         compliance  for  such  fiscal  period  with  the  financial   covenants
         contained in this Agreement;

                           (iii) as soon as available and in any event within 90
         days after the end of each fiscal year of the Borrower,  balance sheets
         as of, and statements of income for, such fiscal year, and  accompanied
         by a certificate of an authorized officer of the Borrower detailing its
         compliance  for  such  fiscal  period  with  the  financial   covenants
         contained in this Agreement;

                           (iv)  promptly and in any event within five  Business
         Days after the occurrence of each Event of Default or event which, with
         the giving of notice or lapse of time,  or both,  would  constitute  an
         Event of Default,  a statement  of the chief  financial  officer of the
         Borrower  setting forth details of such Event of Default or event,  and
         the  action  that the  Borrower  has  taken and  proposes  to take with
         respect thereto;

                         (v) at least ten  Business  Days prior to any change in
                    the Borrower's name, a notice setting forth the new name and
                    the proposed effective date thereof;

                           (vi)  promptly  (and  in no  event  later  than  five
         Business Days following actual knowledge or receipt  thereof),  Written
         Notice in  reasonable  detail,  of (x) any Lien  asserted or claim made
         against  a  Receivable,  (y)  the  occurrence  of a Event  of  Default,
         including the occurrence of any other event which could have a Material
         Adverse Effect, or (z) the results of any cost report or similar audits
         of  a  Provider  being  conducted  by  any  federal,  state  or  county
         Governmental Entity or its agents or designees;

                           (vii) no later than five (5) Business  Days after the
         commencement  thereof,  Written  Notice  of  all  actions,  suits,  and
         proceedings before any Governmental  Authority or arbitrator  affecting
         the Borrower which, if determined adversely to the Borrower, could have
         a Material Adverse Effect;


                                      IV-3

<PAGE>



                           (viii) as soon as  possible  and in any event  within
         five (5) Business Days after becoming aware of the occurrence  thereof,
         Written Notice of any matter that could have a Material Adverse Effect;

                           (ix) within 90 days after the end of each fiscal year
         of  the  Borrower,  a  certificate  of  independent   certified  public
         accountants  stating that to their  knowledge  no Servicer  Termination
         Event has occurred and exists as of the end of such fiscal year,  or if
         in their opinion such a Servicer  Termination Event has occurred and is
         continuing, a statement as to the nature thereof; and

                           (x) such other information respecting the Receivables
         or the condition or operations, financial or otherwise, of the Borrower
         as the Lender may from time to time reasonably request.

                  (k) Notice of  Proceedings;  Overpayments.  The Borrower shall
promptly  notify  the  Master  Servicer  (and  modify  the next  Borrowing  Base
Certificate  to be  delivered  hereunder)  in the  event  of any  action,  suit,
proceeding,  dispute, set-off, deduction, defense or counterclaim that is or may
be asserted by an Obligor with  respect to any  Receivable.  The Borrower  shall
make all  payments  to the  Obligors  necessary  to prevent  the  Obligors  from
offsetting  any  earlier  overpayment  to the  Borrower  against any amounts the
Obligors owe on any Receivables.

                  (l)   Officer's   Certificate.   On  the  date  the  financial
statements referred to in clause (ii) above are to be delivered each fiscal year
after the Initial  Funding  Date,  the chief  financial  officer of the Borrower
shall deliver a certificate  to the Lender,  stating that, as of such date,  (i)
all  representations  and warranties  are true and correct,  (ii) the conditions
precedent  set forth in paragraph 2 of Exhibit II have been  fulfilled or waived
in  writing  by the  Lender,  and  (iii)  no  Event  of  Default  exists  and is
continuing.

                  (m) Further Instruments, Continuation Statements. The Borrower
shall, at its expense,  promptly execute and deliver all further instruments and
documents,  and take all further  action that the Program  Manager or the Lender
may reasonably request, from time to time, in order to perfect,  protect or more
fully evidence the assignment as security of the  Receivables,  or to enable the
Lender or the  Program  Manager to  exercise or enforce the rights of the Lender
hereunder  or under the  Receivables.  Without  limiting the  generality  of the
foregoing, the Borrower will upon the request of the Program Manager execute and
file such UCC financing or  continuation  statements,  or amendments  thereto or
assignments  thereof,  and such other instruments or notices,  as may be, in the
opinion of the Program  Manager,  necessary or appropriate.  The Borrower hereby
authorizes the Program Manager,  upon two Business Days' notice,  to file one or
more financing or continuation statements and amendments thereto and assignments
thereof,  relative to all or any of the  Receivables  now  existing or hereafter
arising  without the  signature of the Borrower  where  permitted by law. If the
Borrower  fails to  perform  any of its  agreements  or  obligations  under  the
Agreement,  the  Program  Manager  may (but  shall not be  required  to)  itself
perform, or cause performance of, such agreement or obligation, and the expenses
of the Program Manager incurred in connection  therewith shall be payable by the
Borrower.

                                      IV-4

<PAGE>



                  (n) Merger,  Consolidation.  The Borrower shall not merge with
or into or consolidate with or into, another Person, or convey,  transfer, lease
or  otherwise  dispose of all or  substantially  all of its assets  (whether now
owned or hereafter acquired).

                  (o) No  "Instruments".  The Borrower shall not take any action
which would allow, result in or cause any Eligible Receivable to be evidenced by
an "instrument" within the meaning of the UCC of the applicable jurisdiction.

                  (p)  Preservation of Corporate  Existence.  The Borrower shall
preserve and maintain its corporate existence, rights, franchises and privileges
in the  jurisdiction of its  organization,  and qualify and remain  qualified in
good standing as a foreign corporation in each jurisdiction where the failure to
preserve  and  maintain  such  existence,  rights,  franchises,  privileges  and
qualification  would materially  adversely affect the interests of the Lender or
the Program Manager or their ability of to perform their respective  obligations
hereunder or under the RPA.

                  (q) RPA. The Borrower  will, at its sole  expense,  timely and
fully  perform  and comply with all  provisions,  covenants  and other  promises
required to be observed to be observed by it under the RPA,  maintain the RPA in
full force and effect,  enforce the RPA in accordance  with its terms,  take all
such action to such end as may be from time to time reasonably  requested by the
Lender,  and  make to any  party  to the  RPA  such  demands  and  requests  for
information  and  reports  or for action as the  Borrower  is  entitled  to make
thereunder and as may be from time to time  reasonably  requested by the Lender.
The Borrower shall not permit any waiver,  modification or amendment of the RPA.
The Borrower shall not permit any other Person to become a "Provider"  under the
RPA or permit the removal of any "Provider"  thereunder pursuant to Section 5.19
of the RPA without the written consent of the Lender (which  consent,  unless an
Event of Default is continuing  hereunder,  shall be governed by the  conditions
set forth in Section 5.19 of the RPA).

                  (r) Master  Servicer  Certificate.  On or before the thirtieth
calendar day after the Initial  Funding  Date,  the  Purchaser  shall  receive a
certificate  from the Master  Servicer  stating  that all  computer  linkups and
interfaces  necessary or desirable,  in the judgment of the Master Servicer,  to
effectuate the transactions and information  transfers  contemplated  hereunder,
are fully operational to the satisfaction of the Master Servicer.


                                      IV-5

<PAGE>



                                SPECIAL COVENANTS
                               ENTITY SEPARATENESS

               Until the payment in full of all Lender Debt and the  termination
          of the Revolving Commitment hereunder:

               (i)  The  Borrower  will  at all  times  maintain  at  least  one
          independent  manager  who is (x)  not a  current  or  former  officer,
          director  or  employee of an  Affiliate  of the  Borrower or any Other
          Corporation  and who is not a current or former officer or employee of
          the Borrower and (y) not a stockholder of any Other Corporation or any
          of their respective Affiliates.

               (ii)  The  Borrower  will  not  direct  or   participate  in  the
          management of any of the Other Corporations' operations.

               (iii) The Borrower will at all times be adequately capitalized in
          light of its contemplated business.

               (iv) The Borrower will at all times provide for its own operating
          expenses and liabilities from its own funds.

               (v)  Subject to  consolidation  with CCA for  accounting  and tax
          purposes,  the  Borrower  will  maintain  its assets and  transactions
          separately  from  those of the Other  Corporations  and  reflect  such
          assets and transactions in financial  statements separate and distinct
          from those of the Other  Corporations  and  evidence  such  assets and
          transactions by appropriate  entries in books and records separate and
          distinct from those of the Other  Corporations.  The Borrower will not
          hold itself out as being  liable,  primarily or  secondarily,  for any
          obligations of the Other Corporations.

               (vi) The Borrower  will not  maintain any joint  account with any
          Provider  or  any  Other  Corporation,  or be a  party,  whether  as a
          co-obligor  or  otherwise,   to  any  agreement  to  which  any  Other
          Corporation  is a party  (other  than the RPA) or  become  liable as a
          guarantor or otherwise with respect to any indebtedness or contractual
          obligation of any Other Corporation.

               (vii) Other than as  contemplated  under this  Agreement or under
          the RPA and the payment of dividends or  distributions to its members,
          the Borrower will not make any payment or  distribution of assets with
          respect to any obligation of any Other  Corporation or grant a Lien on
          any of its assets to secure any obligation of any Other Corporation.

               (viii) The Borrower  will not make loans,  Revolving  Advances or
          otherwise  extend  credit to any of the Other  Corporations,  provided
          that, the Borrower may issue dividends or distributions to each of its
          members to the extent  otherwise  permitted  under this  Agreement and
          under applicable law.

               (ix) The Borrower will hold regular duly noticed  meetings of its
          members and make and retain minutes of such meetings.

                                      IV-6

<PAGE>



                  (x) The Borrower will comply in full with the  procedures  set
forth in the RPA with  respect to the  assignment  of all assets from any of the
Other Corporations.

                  (xi) The Borrower will not engage in any transaction  with any
of the Other  Corporations or any of their  respective  subsidiaries,  except as
permitted or contemplated by the Agreement and as contemplated by the RPA.

                  (xii) The Borrower  will not enter into any  transaction  with
any Affiliate or third party except (a)(x) as permitted or  contemplated by this
Agreement or the RPA, or (y) investments of cash and cash equivalents with third
parties and (b) on terms and conditions  which  reasonably  approximate an arm's
length transaction between unaffiliated parties.

                  (xiii) The Borrower will not amend,  modify or supplement  its
Articles of Organization or Operating Agreement.

                  (xiv)    The Borrower will not have any Subsidiaries.

                                      IV-7

<PAGE>



                                   EXHIBIT V.

                                EVENTS OF DEFAULT

                  Each of the following shall be an "Event of Default":

                  (a) The Borrower shall default in the due and punctual payment
of the  principal of the Revolving  Loan,  when and as the same shall become due
and  payable  (except  that the  Borrower  shall  have up 15 days to cure such a
default with respect to a Borrowing Base Deficiency) whether pursuant to Article
II of this Agreement, at maturity, by acceleration or otherwise.

                  (b) The Borrower shall default in the due and punctual payment
of any installment of interest on any of the Revolving Loans or any other Lender
Debt  or of any  fee or  expense  owing  to the  Lender  pursuant  to any of the
Documents,  when and as such amount of interest, fee or expense shall become due
and payable and such default shall  continue  unremedied  for three (3) Business
Days.

                  (c)  The  Borrower   shall  default  in  the   performance  or
observance of any covenant,  agreement or provision  (other than as described in
clause (a) or (b) above) contained in this Agreement or any other Document or in
any instrument or document  evidencing or creating any  obligation,  guaranty or
Lien in favor of the Lender in connection  with or pursuant to this Agreement or
any  Lender  Debt,  and,  except  in the case of the  agreements  and  covenants
contained  in any  Document as to each of which no notice or grace  period shall
apply, such default continues for a period of thirty days (or, in the case where
agreements  and covenants  contained in any Document  provide for a grace period
that is less than thirty days, continuance of a default for such shorter period)
after the earlier of (i) there has been given Written  Notice of such default to
any of CCA,  the  Borrower  or the  Providers  by the  Lender or (ii)  discovery
thereof by the Borrower;  or if this Agreement or any other Document or any such
other  instrument or document shall  terminate,  be terminated or become void or
unenforceable  for any reason  whatsoever  without  the  written  consent of the
Agent.

                  (d) An Event of Termination  shall have occurred under the RPA
(without regard to waivers granted or sought).

                  (e) The Borrower shall send a Revocation  Order (as defined in
the  Depositary  Agreement)  or make any change or  replacement  in the Standing
Revocable Instruction (as defined in the Depositary Agreement).

                  (f) Any  representation or warranty made or deemed made by the
Borrower  (other than with respect to the eligibility of Receivables as Eligible
Receivables  hereunder)  under  or in  connection  with  the  Agreement  or  any
information  or report  delivered by the Borrower  (other than with respect to a
Provider) pursuant to the Agreement shall prove to have been incorrect or untrue
in any material respect when made or deemed made or delivered.


                                       V-1

<PAGE>



                  (g) The Borrower shall fail to pay any principal of or premium
or interest on any of its Debt when the same becomes due and payable (whether by
scheduled maturity, required prepayment, acceleration, demand or otherwise), and
such failure shall continue after the applicable grace period, if any, specified
in the agreement or  instrument  relating to such Debt; or any other event shall
occur or condition shall exist under any agreement or instrument relating to any
such  Debt and  shall  continue  after  the  applicable  grace  period,  if any,
specified  in such  agreement  or  instrument,  if the  effect of such  event or
condition is to accelerate,  or to permit the  acceleration  of, the maturity of
such Debt; or any such Debt shall be declared to be due and payable, or required
to be  prepaid  (other  than  by a  regularly  scheduled  required  prepayment),
redeemed,  purchased  or  defeased,  or an offer to repay,  redeem,  purchase or
defease such Debt shall be required to be made, in each case prior to the stated
maturity thereof.

                  (h) This  Agreement  shall for any reason (other than pursuant
to the terms  hereof) fail or cease to create or fail or cease to be a valid and
perfected  security interest in the Receivables and the Collections with respect
thereto free and clear of all Liens (other than Liens referred to in clauses (i)
and (ii) of paragraph (e) of Exhibit IV).

                  (i) The Borrower or any Provider  shall  generally not pay its
debts as such debts  become due, or shall admit in writing its  inability to pay
its debts  generally,  or shall  make a general  assignment  for the  benefit of
creditors;  or any proceeding  shall be instituted by or against the Borrower or
any  Provider  seeking to  adjudicate  it a bankrupt  or  insolvent,  or seeking
liquidation, winding up, reorganization,  arrangement,  adjustment,  protection,
relief,  or composition of it or its debts under any law relating to bankruptcy,
insolvency or  reorganization  or relief of debtors,  or seeking the entry of an
order for relief or the appointment of a receiver,  trustee,  custodian or other
similar  official for it or for any substantial part of its Property and, in the
case of any such  proceeding  instituted  against it (but not instituted by it),
either such proceeding  shall remain  undismissed or unstayed for a period of 30
days,  or any of the  actions  sought  in such  proceeding  (including,  without
limitation,  the entry of an order for relief  against,  or the appointment of a
receiver,  trustee,  custodian  or other  similar  official  for,  it or for any
substantial  part of its Property)  shall occur; or the Borrower or any Provider
shall take any action to  authorize  any of the  actions set forth above in this
paragraph (i).

                  (j) As of any date of  determination,  a Provider  is found to
have been  overpaid  by  Governmental  Entities  by 8% or more during any period
covered by an audit  conducted  by the HCFA and such  overpayment  is not repaid
within 30 days of the  earlier of receipt of a notice by, or the  knowledge  of,
such Provider of a notice of such overpayment.

                  (k) There  shall have  occurred  any  change in the  financial
condition  or  operations  of the  Borrower  since  September  30, 1996 that has
resulted in a Material Adverse Effect.

                  (l) The Borrower  (x) shall have entered into any  transaction
and not provided prompt Written Notice thereof to the Lender,  or (y) shall have
consummated,  any transaction  which shall result in the consummation of (i) the
merger  or  consolidation  of the  Borrower,  (ii) the  acquisition  of all or a
substantial portion of the assets of any Person, (iii) the transfer, sale,

                                       V-2

<PAGE>



assignment,  lease or other  disposition of all or a substantial  portion of the
Borrower's  assets or  Properties,  (iv) a change in the  general  nature of the
Borrower's  business,  or (v) the sale of a  controlling  interest,  directly or
indirectly, in the Borrower.

     (m) The Loss-to-Liquidation Ratio in any four week period exceeds 5%.

     (n) The arithmetic average of the  Loss-to-Liquidation  Ratios in any three
consecutive four week periods exceeds 3%.

     (o) The Delinquency Ratio in any four week period exceeds 10%.

     (p)  Judgments  or orders for  payment of money  (other than  judgments  or
orders in respect of which  adequate  insurance  is  maintained  for the payment
thereof) in excess of  $500,000 in the  aggregate  against the  Borrower  remain
unpaid, unstayed on appeal,  undischarged,  unbonded or undismissed for a period
of 90 days or more.

     (q) Any governmental authority (including, without limitation, the Internal
Revenue  Service or the PBGC)  files a notice of a Lien  against  (i) any of the
Receivables  or (ii) assets  other than the  Receivables  involving an aggregate
amount in excess of $500,000  which remains unpaid or discharged for a period of
60 days or more.

     (r) The  Borrower  shall fail to  discharge  within a period of thirty (30)
days after the commencement thereof any attachment,  sequestration,  forfeiture,
or similar proceeding or proceedings  involving an aggregate amount in excess of
$500,000 against any of its Properties.

     (s) The Borrower does not pay or discharge at or before  maturity or before
becoming delinquent all taxes,  levies,  assessments,  and governmental  charges
imposed on it or its income or profits or any of its Property, except any taxes,
levies,   assessments  or  charges   contested  in  good  faith  by  appropriate
proceedings.

     (t) The Borrower sells, leases,  assigns,  transfers, or otherwise disposes
of any of its  Receivables,  except as  permitted  or  contemplated  under  this
Agreement.

     (u) The Borrower declares or makes any Distribution,  unless both prior and
subsequent to the effectiveness of such proposed  Distribution,  (i) no Event of
Default is  continuing,  including an Event of Default  under clause (w) of this
Exhibit V hereof,  (ii) such  Distribution is in full compliance with applicable
law,  including the law of the State of Delaware as in effect at such time,  and
(iii)  the  Borrower  and the  recipient  of such  Distribution  have  taken all
necessary and appropriate corporate action to effectuate such Distribution.

     (v) The Borrower  engages in any business  other than solely the businesses
of directly or indirectly purchasing Receivables from the Provider and financing
in such Receivables to the Lender hereunder and the other transactions permitted
or contemplated hereby.


                                       V-3

<PAGE>



                  (w) The Borrower shall at any time fail to maintain a Tangible
Net Worth of at least 3.0% of the higher of (i) the Revolving Advance Limit, and
(ii) the then outstanding amount of the Revolving Loan.

                  (x) Any  representation or warranty made or deemed made by the
Provider  under or in  connection  with  the RPA or any  information  or  report
delivered by the Provider pursuant to the RPA shall prove to have been incorrect
or untrue in any material respect when made or deemed made or delivered and such
misstatement causes a Event of Default under the RPA.

                  (y) The  Borrower  shall fail to perform or observe  any other
term, covenant or agreement contained in the Collateral Account Agreement on its
part to be performed or observed.

                  (z) If, at any date,  the aggregate  Expected Net Value of all
Delinquent  Receivables that became  Delinquent  during the prior 3 months is in
excess of 20% of the aggregate Expected Net Value of all Receivables sold by the
Borrower  to the Lender  during the prior 3 months  (regardless  of whether  the
Denied  Receivables are reassigned by the Borrower pursuant to Article IV of the
Agreement).

                  (aa) As of any date after the Initial  Funding  Date,  (i) the
dollar-weighted  average  days  outstanding  with  respect  to  all  outstanding
Eligible  Receivables  on  such  date  and on the  same  day of  each of the two
preceding  Months  (or if there is no  corresponding  day in any such  preceding
month,  the last day of such month) is greater than 65 days, or (ii) the average
over  the  preceding  90-  day  period  of  the  dollar-weighted   average  days
outstanding  with respect to all  outstanding  Eligible  Receivables on each day
during such period is greater than 60 days.

                  (bb) As of any date after the Initial  Funding Date, more than
25% of all outstanding Eligible Receivables are aged more than 120 days but less
than  180  days  from  the  respective  Last  Service  Dates  of  such  Eligible
Receivables.

                  (cc) As of any date,  Collections on all Eligible  Receivables
that have been  liquidated  or written  off during the then most  recent 13 week
period,  are less than 50% of the aggregate  gross value (billed amount) of such
Eligible Receivables.

                                       V-4

<PAGE>



                                   EXHIBIT VI.

                              ELIGIBILITY CRITERIA

                  The following shall  constitute the  eligibility  criteria for
acceptance of  Receivables  for  financing  and inclusion in the Borrowing  Base
under the Agreement (the "Eligibility Criteria"):

                  (a) The  information  provided by the Borrower with respect to
each such Receivable is complete and correct and all documents, attestations and
agreements  relating thereto that have been delivered to the Lender are true and
correct. Other than in respect of Unbilled Receivables,  the applicable Provider
has  billed  the  applicable  Obligor  and has  delivered  to such  Obligor  all
requested  supporting  claim  documents  with respect to such  Receivable and no
amounts with respect to such  Receivable  have been paid as of the date and time
of the sale of such Receivable to the Lender. Each such Provider has, or has the
right to use,  valid  provider  identification  numbers and licenses to generate
valid  Receivables.  All information set forth in the bill and supporting  claim
documents  with respect to such  Receivable  is true,  complete and correct;  if
additional  information  is  requested  by the  Obligor,  the  Borrower  (or the
applicable Provider) has or will promptly provide the same, and if any error has
been made with respect to such  information,  the Borrower will promptly correct
the same and, if necessary, rebill such Receivable.

                  (b) Each  Provider's  Medicare and Medicaid  cost reports with
respect to such  Receivable for all cost  reporting  periods ending on or before
the date of the last audited cost report have been  examined and audited by (i),
as to Medicaid,  the applicable state agency or other HCFA- designated agents or
agents of such state  agency,  charged with such  responsibility  or (ii), as to
Medicare, the Medicare intermediary or other HCFA-designated agents charged with
such responsibility; and there is no basis for any Governmental Entity to assert
an offset against each such Provider.

                  (c) Each such Receivable (i) is payable, in an amount not less
than its  Expected  Net  Value,  by the  Obligor  identified  by the  applicable
Provider as being  obligated  to do so, (ii) is based on an actual and bona fide
rendition of services or sale of goods to the patient by the applicable Provider
in the ordinary  course of business,  (iii) is  denominated  and payable only in
U.S.  dollars  in the  United  States,  (iv) is  (or,  in the  case of  Unbilled
Receivables,  will be upon billing) an account  receivable or general intangible
within the meaning of the UCC of the state in which the applicable  Provider has
its  principal  place of  business,  or is a right to payment  under a policy of
insurance or proceeds thereof, and is not evidenced by any instrument or chattel
paper, and (v) shall be subject to a patient consent form approved by the Lender
and executed by the applicable patient. There is no payor other than the Obligor
identified  by the Borrower as the payor  primarily  liable on such  Receivable;
provided,  however,  notwithstanding the foregoing,  Receivables billed or to be
billed to Medicaid or Medicare  for services or goods which were  initially  the
obligation of the patient or customer on a "Medicaid/Medicare pending" basis are
eligible to be Eligible Receivables hereunder.


                                      VI-1

<PAGE>



     (d) Each  such  Receivable  (i) is not the  subject  of any  action,  suit,
proceeding or dispute (pending or threatened),  setoff,  counterclaim,  defense,
abatement,  suspension,  deferment,  deductible, reduction or termination by the
Obligor  (except for  statutory  rights of  Governmental  Entities  that are not
pending or  threatened),  (ii) is not past,  or within 60 days of, the statutory
limit for collection applicable to the Obligor or is not aged more than 180 days
from its Last  Service  Date,  and (iii) was not billed to the Obligor on a date
more than 45 days after the Last Service Date.

     (e) Each such Receivable is not due from any  Governmental  Entity based on
any cost report settlement or expected settlement.

     (f) Neither the Borrower  nor any  Provider has any guaranty of,  letter of
credit  providing   credit  support  for,  or  collateral   security  for,  such
Receivable,  other  than any such  guaranty,  letter  of  credit  or  collateral
security as has been assigned to the Lender,  and any such  guaranty,  letter of
credit or  collateral  security is not subject to any Lien in favor of any other
Person.

     (g) The goods or services  provided and reflected by such  Receivable  were
medically necessary for the patient,  and the patient has received such goods or
services.

     (h) The fees charged for the goods or services  constituting  the basis for
such  Receivable are consistent  with the usual,  customary and reasonable  fees
charged by other  similar  medical  goods or service  providers  for the same or
similar  goods or services in the  applicable  Provider's  community  and in the
community in which the patient resides.

     (i) The Obligor with respect to each such  Receivable  is (i) not currently
the subject of any bankruptcy,  insolvency or receivership proceeding, nor is it
unable to make payments on its obligations  when due, (ii) located in the United
States of America,  and (iii) one of the  following:  (x) a Person  which in the
ordinary  course of its  business  or  activities  agrees to pay for  healthcare
services  received by individuals,  including,  without  limitation,  commercial
insurance  companies and non-profit  insurance companies (such as Blue Cross and
Blue Shield) issuing health,  personal  injury,  worker's  compensation or other
types of insurance, employers or unions which self-insure for employee or member
health  insurance,   prepaid   healthcare   organizations,   preferred  provider
organizations,   health   maintenance   organizations,   commercial   hospitals,
physician's  groups  or any other  similar  person  and which has a debt  rating
equivalent  to "A" or higher,  (y) a state,  an agency or  instrumentality  of a
state or a political subdivision of a state, or (z) the United States of America
or an agency or instrumentality of the United States of America.

     (j) The financing of such  Receivables  hereunder is made in good faith and
without actual intent to hinder, delay or defraud present or future creditors of
the Borrower.

     (k) The  insurance  policy,  contract  or other  instrument  obligating  an
Insurer to make payment with respect to such Receivable (i) does not contain any
provision  prohibiting  the  grant  of  a  security  interest  in  such  payment
obligation  from the patient to the applicable  Provider,  from such Provider to
the Borrower,  or from the Borrower to the Lender, (ii) has been duly authorized
and,  together with such  Receivable,  constitutes the legal,  valid and binding
obligation of

                                      VI-2

<PAGE>



the Insurer in accordance with its terms,  (iii) together with such  Receivable,
does not  contravene in any material  respect any  requirement of law applicable
thereto,  and (iv) was in full force and effect and applicable to the patient at
the time the goods or services  constituting  the basis for such Receivable were
sold or performed.

                  (l)  The  insurance  policy,   contract  or  other  instrument
obligating a Governmental Entity to make payment with respect to such Receivable
(i) has been duly  authorized  and,  together  with the  applicable  Receivable,
constitutes the legal, valid and binding  obligation of the Governmental  Entity
in accordance with its terms, (ii) together with the applicable Receivable, does
not  contravene  in any  material  respect  any  requirement  of law  applicable
thereto, and (iii) was in full force and effect and applicable to the patient at
the time the goods or services  constituting  the basis for such Receivable were
sold or performed.

                  (m) No  consents  by any  third  party  to the  sale  of  such
Receivable  are required other than consents  previously  obtained in writing by
the Borrower, a copy of each such consent having been provided to the Lender.

                  (n) The inclusion of such  Receivable  in the  Borrowing  Base
would  not  increase  the  fraction  expressed  as a  percentage  where  (i) the
numerator  is the sum of the  then  outstanding  principal  amount  of  Eligible
Receivables for any obligor (or group of obligors)  listed below included in the
Borrowing  Base, and (ii) the denominator is the Borrowing Base for all Eligible
Receivables, above the corresponding maximum percentage listed below:


                                                                Maximum
Obligor                                                        Percentage
- -------                                                        ----------

Medicare                                                           50%
Medicaid                                                           85%
Blue Cross/Blue Shield                                             25%
All Commercial Insurance Obligors, HMOs and PPOs                   75%
CHAMPUS/Champva                                                    20%
any single AAA rated (non-governmental) Obligor                    10%
any single AA rated (non-governmental) Obligor                     10%
any single A rated (non-governmental) Obligor                       5%
any single BBB rated (non-governmental) Obligor                     2%
any single unrated (non-governmental) Obligor                       1%

                  (o) Unless  specifically  verified  and accepted by the Master
Servicer or Program Manager,  no single Eligible  Receivable has an Expected Net
Value  greater  than  $25,000 for  inpatient  services or $5,000 for  outpatient
services.


                                      VI-3

<PAGE>



                  (p) No prior sale or assignment of security  interest which is
still in effect on the applicable  Funding Date has been made with respect to or
granted in any such Receivable.

                                      VI-4

<PAGE>



                                  EXHIBIT VII-A


                       FORM OF BORROWING BASE CERTIFICATE
                       [FOR USE DURING THE SPECIAL PERIOD]
                              DAIWA HEALTHCO-2 LLC
                              Borrowing Base Report

Report Submission Date:_____________
Schedule #:______________
As of Date:______________

                                                   A. Eligible     B. A/R's less
                                                     Receivables   than 180 days
                                                     -----------   -------------

VII.     Beginning A/R Balance (from Previous Report)

VIII.    Additions:
         8.01.    New billings
         8.02.    Late Charges/Adjustments
Total Additions

IX.      Deductions:
         9.01.    Collections
         9.02.    Contractual/Discounts
         9.03.    Transfers Bad Debt
         9.04.    Other Discounts/Adjustments
Total Deductions

X.       Accounts Receivable Balance

XI.      Less:  Ineligible Collateral

XII.     Total Eligible Collateral (Gross)
XIII.    Estimated Net Value %
XIV.     Total Eligible Collateral (Net)
XV.      Less:  Unposted Cash


                                      VII-1

<PAGE>




XVI.     Adjusted Net Eligible Collateral
XVII.    Advance Rate Percentage                       85%            94%
XVIII.   Maximum Loan Availability on Collateral
XIX.     Maximum Loan Availability per Agreement    $15,000,000  $14,500,000
                                                    -----------  -----------

XX.      TOTAL LOAN AVAILABILITY (LESSOR OF 12 OR 13)

XXI.     Outstanding Loan Balance Prior Report
XXII.    Less Collections (Net Cash)
XXIII.   Plus Draws Since Prior Report
XXIV.    Interest Due/Fees
XXV.     Additional Advance Requested

XXVI.    LOAN BALANCE THIS REPORT

XXVII.   NET AVAILABILITY (14. minus 20.)

The undersigned  represents and warrants that the foregoing information is true,
complete  and  correct  and  that  the  collateral  reflected  herein  with  the
conditions,  terms,  warrantees,  representations and covenants set forth in the
Loan and Security Agreement between the undersigned and Daiwa Healthco-2 LCC and
any  supplements  and  amendments,  if  any,  thereto  (the  "Agreement").   The
undersigned  promises  to pay to  Daiwa  Healthco-2  LCC the new  loan  balances
reflected above, plus interest, as set forth in the Agreement.


CCA FUNDING LLC


By:_____________________________                              Date:____________
      Name:
      Title:


                                      VII-2

<PAGE>



                       [FOR USE AFTER THE SPECIAL PERIOD]

                              DAIWA HEALTHCO-2 LLC
                              Borrowing Base Report

Report Submission Date:_____________
Schedule #:______________
As of Date:______________


XXVIII.           Beginning A/R Balance (from Previous Report)

XXIX.    Additions:
         29.01.   New billings
         29.02.   Late Charges/Adjustments
Total Additions

XXX.     Deductions:
         30.01.   Collections
         30.02.   Contractual/Discounts
         30.03.   Transfers Bad Debt
         30.04.   Other Discounts/Adjustments
Total Deductions

XXXI.    Accounts Receivable Balance

XXXII.   Less:  Ineligible Collateral

XXXIII.           Total Eligible Collateral (Gross)
XXXIV.            Estimated Net Value %
XXXV.             Total Eligible Collateral (Net)
XXXVI.            Less:  Unposted Cash
XXXVII.           Adjusted Net Eligible Collateral
XXXVIII.          Advance Rate Percentage                           85%
XXXIX.            Maximum Loan Availability on Collateral


                                      VII-1

<PAGE>




XL.      Maximum Loan Availability per Agreement

XLI.     TOTAL LOAN AVAILABILITY (LESSOR OF 12 OR 13)

XLII.    Outstanding Loan Balance Prior Report
XLIII.   Less Collections (Net Cash)
XLIV.    Plus Draws Since Prior Report
XLV.     Interest Due/Fees
XLVI.    Additional Advance Requested

XLVII.   LOAN BALANCE THIS REPORT

XLVIII.           NET AVAILABILITY (14. minus 20.)

The undersigned  represents and warrants that the foregoing information is true,
complete  and  correct  and  that  the  collateral  reflected  herein  with  the
conditions,  terms,  warrantees,  representations and covenants set forth in the
Loan and Security Agreement between the undersigned and Daiwa Healthco-2 LCC and
any  supplements  and  amendments,  if  any,  thereto  (the  "Agreement").   The
undersigned  promises  to pay to  Daiwa  Healthco-2  LCC the new  loan  balances
reflected above, plus interest, as set forth in the Agreement.


CCA FUNDING LLC


By:_____________________________                              Date:____________
      Name:
      Title:


                                      VII-2

<PAGE>



                                  EXHIBIT VII-B


                         FORM OF BORROWER'S CERTIFICATE



Daiwa Healthco-2 LLC
Two Wall Street
New York, New York 10005


Ladies and Gentlemen:

                  The  undersigned  refers to the Loan and  Security  Agreement,
dated  as of  December  __,  1996 (as the  same  may be  amended,  supplemented,
restated,  or  modified  from time to time,  the "Loan  Agreement")  between CCA
Funding  LLC  (the   "Borrower")  and  Daiwa   Healthco-2  LLC  (the  "Lender").
Capitalized  terms used herein and not otherwise defined shall have the meanings
ascribed to them in the Loan Agreement.

                  In accordance  with Section 1.03 of the Loan  Agreement and in
fulfillment  of the condition  precedent set forth in Section 2(a) of Exhibit II
thereto,  the Borrower hereby gives you irrevocable  notice that the undersigned
requests  a  Revolving  Advance  under  the Loan  Agreement,  and in  connection
therewith sets forth below the information  relating to such Advance as required
by Section 1.03 of the Loan Agreement:

                  Proposed Revolving Advance:

                    (i) The Funding Date of such Revolving  Advance is requested
                     to be _______ __, 199_;

                    (ii) The amount of the Revolving  Advance is requested to be
                     $_______________; and

                    (iii)Attached is the Borrowing Base Certificate delivered to
                     you on the immediately prior Monday.

                  The Borrower  hereby  certifies that the following  statements
are true and  correct on the date  hereof,  and will be true and  correct on the
date of the proposed Revolving Advance:

                           (A) the representations  and warranties  contained in
                  Exhibits III and IV of the Loan Agreement are and will be true
                  and  correct,  both  before  and  after  giving  effect to the
                  Revolving  Advance  requested herein and to the application of
                  the  proceeds  thereof,  as though made on and as of such date
                  (it being understood and agreed that


                                      VII-3

<PAGE>



                  any representation or warranty which by its terms is made on a
                  specified  date shall be required to be true and correct  only
                  as of such specified date); and

                           (B) no event has occurred and is continuing, or would
                  result from the Revolving Advance requested herein or from the
                  application  of the proceeds  thereof that  constitutes  or an
                  Event of Default; and

                           (C) the aggregate outstanding principal amount of the
                  Revolving  Advances  after  giving  effect  to  the  Revolving
                  Advance requested herein is not in excess of the lesser of the
                  Revolving Commitment and the Borrowing Limit.



                                                Very truly yours,
                                                CCA FUNDING LLC


                          By:__________________________
                                      Name:
                                     Title:

                                      VII-4

<PAGE>



                                  EXHIBIT VIII


                          FORM OF DEPOSITARY AGREEMENT


                                [TO BE ATTACHED]



                                     VIII-1

<PAGE>



                                  EXHIBIT IX-A


                           FORM OF OPINION OF COUNSEL



                                      IX-1

                                     <PAGE>



                                  EXHIBIT IX-B


                           FORM OF OPINION OF COUNSEL



                                      IX-2

<PAGE>



                                   SCHEDULE I


                              ADDRESSES FOR NOTICE



If to the Program Manager:

                                    Daiwa Securities America Inc.
                                    Financial Square
                                    32 Old Slip
                                    New York, New York 10005-3538
                                    Attention: Chief Financial Officer
                                    Tel:    (212) 612-6290
                                    Fax:    (212) 612-7122


If to the Master Servicer:

                                    RJE Data Processing, Inc.
                                    2513 West Peterson
                                    Chicago, Illinois 60659
                                    Attention: Jack Callahan, President
                                    Tel:     (312) 561-6966
                                    Fax:     (312) 878-6355


                                      IX-3

<PAGE>



                                   SCHEDULE II


                          CREDIT AND COLLECTION POLICY



                                [TO BE ATTACHED]



                                      IX-4

<PAGE>



                                  SCHEDULE III


                               LICENSE REVOCATIONS




The following  facilities have been  decertified  from the Medicaid and Medicare
Programs during the past 24 months:

(1)      Community Care of America at Toledo (Toledo, Iowa)
                  Community  Care  of  America   voluntarily   decertified  this
                  facility  from  both  the  Medicare  and Iowa  state  Medicaid
                  programs on March 8, 1996. The company has been recertified to
                  participate in both programs effective  September 20, 1996 and
                  November 20, 1996 respectively.

(2)               Community  Care of America at Council  Bluffs  North  (Council
                  Bluffs,  Iowa) This  facility  was  decertified  from both the
                  Medicare and Iowa state  Medicaid  programs on April 17, 1996.
                  The  company  has  been  recertified  to  participate  in both
                  programs effective July 1, 1996.


                                      IX-5

<PAGE>



                                   SCHEDULE IV


                               LOCKBOX INFORMATION




Provider Ancillary Lockbox:
                                    CCA - Self-pay
                                    Post Office Box 710278
                                    Cincinnati, Ohio 45271-0278

Provider Ancillary Lockbox Account:
                                    CCA - Self-pay
                                    Account #00109-98906
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039

Provider Government Lockbox:
                                    CCA - Governmental
                                    Post Office Box 710275
                                    Cincinnati, Ohio 45271-0275

Provider Government Lockbox Account:
                                    CCA - Governmental
                                    Account #00109-98891
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039

Lender Lockbox:
                                    Post Office Box 710276
                                    Cincinnati, Ohio 45271-0276

Lender Lockbox Account:
                                    Account # 50020-61106
                                    KeyBank
                                    127 Public Square, seventh floor
                                    Cleveland, Ohio 44114-1306
                                    ABA #041 001 039


                                      IX-6


                      ASSIGNMENT OF HEALTHCARE RECEIVABLES
                         PURCHASE AND TRANSFER AGREEMENT
                             AS COLLATERAL SECURITY


                  FOR VALUE  RECEIVED,  CCA  FUNDING  LLC,  a  Delaware  limited
liability  company (the  "Assignor"),  hereby grants a security  interest in and
assigns and transfers to DAIWA HEALTHCO-2 LLC, as Lender (the  "Assignee"),  all
right,  title and  interest  of the  Assignor  in and to,  all  benefits  of the
Assignor under,  and all monies due or to become due to the Assignor under or in
connection with, the contract more particularly described as follows:

                  That  certain  Healthcare  Receivables  Purchase  and Transfer
         Agreement,  dated as of December  __,  1996,  among  Community  Care of
         America,  Inc.,  the other parties named therein as Providers,  and the
         Assignor  as  Purchaser  (as  may be  amended,  restated,  modified  or
         supplemented from time to time in accordance with the terms thereof and
         hereof, the "Transfer Agreement")

as  collateral  security  for  any and all of the  obligations  of the  Assignor
pursuant to that certain Loan and  Security  Agreement  dated as of December __,
1996 between the Assignor and the Assignee (as such may be amended,  modified or
supplemented from time to time, the "Loan Agreement",  the terms defined therein
and not otherwise defined herein being used herein as therein defined),  whether
at stated maturity, by acceleration or otherwise (including, without limitation,
all interest  thereon,  whether accruing prior or subsequent to the commencement
of a bankruptcy or similar proceeding  involving the Assignor as a debtor),  and
all  present  and future  obligations  of the  Assignor  under this  Assignment,
whether at stated  maturity,  by acceleration or otherwise (all of the foregoing
being herein referred to as the "Obligations").

                  The Assignor agrees, covenants, represents and warrants that:

                  1. The  Assignor's  right,  title and interest in the Transfer
         Agreement  is  owned by the  Assignor  free  and  clear of all  claims,
         mortgages, pledges, liens, encumbrances and security interests of every
         nature  whatsoever,  except  in  favor  of the  Assignee.  Without  the
         Assignee's prior written consent, the Assignor will not sell, transfer,
         assign,  pledge or grant a security interest in the Transfer  Agreement
         to any other person.  Any such sale,  transfer,  assignment,  mortgage,
         pledge or encumbrance  without the Assignee's  written consent shall be
         void and of no force and effect.

                  2. Without the Assignee's prior written consent,  the Assignor
         will not amend  (directly or  indirectly),  modify,  supplement,  waive
         compliance   with,   seek  or  grant  a  waiver   under  or  assent  to
         non-compliance with the Transfer Agreement.

                  3. The Assignor specifically  acknowledges and agrees that the
         Assignee  does not assume,  and shall have no  responsibility  for, the
         payment of any sums due or to become due under the  Transfer  Agreement
         by the Assignor or the  performance of any  obligations to be performed
         under or with respect to the Transfer  Agreement by the  Assignor,  and
         the

                                        1
<PAGE>



         Assignor hereby agrees to indemnify and hold the Assignee harmless with
         respect  to any and all  claims by any  person  relating  thereto.  The
         Assignee, in its discretion, may file or record this Assignment.

                  4. If an Event of  Termination  shall occur and be continuing,
         in addition to all other rights and  remedies of the Assignee  pursuant
         to any  agreements  of the Assignor in favor of or assigned to and held
         by the  Assignee  or  pursuant  to  applicable  law or  otherwise,  the
         Assignee or its successor  shall have all rights and benefits under the
         Transfer Agreement,  including,  without limitation, any and all rights
         to  indemnification  claims  of  the  Assignor,  without  modifying  or
         discharging  any of the  Obligations,  except to the extent  payment in
         respect thereof is received.  Upon the occurrence and continuance of an
         Event of  Termination,  the  Assignor  agrees  to  execute  any and all
         documents  requested by the Assignee in its sole  discretion  to enable
         the Assignee to exercise  all of the rights of the  Assignor  under the
         Transfer  Agreement.  The specified  remedies to which the Assignee may
         resort under the terms of this  Assignment  are  cumulative and are not
         intended to be exclusive  of any other  remedies or means of redress to
         which the  Assignee  may be lawfully  entitled in case of any breach or
         threatened  breach by the Assignor of any provision hereof or of any of
         the  Obligations.  Nothing  contained in this  Assignment and no act or
         action taken or done by the Assignee  pursuant to the powers and rights
         granted to it hereunder or under any instrument collateral hereto shall
         be deemed  to be a waiver  by the  Assignee  of any of its  rights  and
         remedies against the Assignor in connection with, or in respect of, any
         of the  Obligations.  The right of the  Assignee to collect and enforce
         collection  of  the   Obligations  and  to  enforce  any  security  and
         collateral  held  by it may be  exercised  by the  Assignee  prior  to,
         simultaneously  with, or subsequent to any action taken by the Assignee
         hereunder.

                  5. Upon the  payment  and  satisfaction  in full of all of the
         Obligations  and the  termination  of any commitment by the Assignee to
         make loans or other financial  accommodations  to or for the benefit of
         the  Assignor  under  the  Loan  Agreement,  this  Assignment  shall be
         terminated  by the Assignee and shall be of no further force or effect,
         but the  affidavit,  certificate,  letter or  statement of any officer,
         agent  or  attorney  of the  Assignee  showing  that  any  part  of the
         Obligations remains unpaid or unsatisfied shall be and constitute prima
         facie evidence of the validity,  effectiveness  and continuing force of
         this  Assignment and any person may, and is hereby  authorized to, rely
         thereon.

                  6. The  Assignee  may take,  or release,  in whole or in part,
         other  security  which it may hold for the payment of the  Obligations,
         may release any party primarily or secondarily liable therefor, and may
         apply any other  security  held by it to the  satisfaction,  or partial
         satisfaction,  of such  Obligations,  without  prejudice  to any of its
         rights under this Assignment.

                  7. This Assignment  shall inure to the benefit of the Assignee
         and its  permitted  successors,  assigns  and  designees,  and shall be
         binding upon any subsequent owner of the Assignor's  interest in and to
         the Transfer Agreement.

                                        2

<PAGE>



                  8. The  Assignor  covenants  to  execute  and  deliver  to the
         Assignee,  upon demand, such additional  assurances,  writings or other
         instruments as may be reasonably required by the Assignee to effectuate
         the purpose hereof. This Assignment may not be changed orally and is to
         be governed by the internal laws of the State of New York applicable to
         contracts executed and to be performed in such State.

                  9. The Assignor hereby irrevocably designates and appoints the
         Assignee   as   attorney-in-fact   of  the   Assignor   with  power  of
         substitution,  and  with  authority  from  and  after  and  during  the
         continuance of an Event of Termination:  to execute and deliver for and
         on  behalf  of  the  Assignor  any  and  all  instruments,   documents,
         agreements and other  writings  necessary or advisable for the exercise
         on behalf of the Assignor  pursuant  hereto of any rights,  benefits or
         options created or existing under or pursuant to the Transfer Agreement
         and in this  regard;  to endorse the name of the Assignor on its behalf
         on any  and all  notes,  acceptances,  checks,  drafts,  money  orders,
         instruments or other  evidences of  collateral,  that may come into the
         Assignee's possession;  to execute proofs of claim and loss; to execute
         endorsements,  assignments  or  other  instruments  of  conveyance  and
         transfer;  to execute  releases;  and,  to do all other acts and things
         necessary and advisable in the  discretion of the Assignee to carry out
         and enforce this  Assignment or the  Obligations.  All acts done by the
         Assignee  under the  foregoing  authorization  are hereby  ratified and
         approved,  and neither the Assignee or its  successors nor any designee
         or agent thereof shall be liable for any acts of commission or omission
         (other  than  acts  committed  or  omitted  through  bad  faith,  gross
         negligence  or willful  misconduct),  for any error of  judgment or for
         mistake of facts or law.  This power of attorney  being coupled with an
         interest  is  irrevocable  while any of the  Obligations  shall  remain
         unpaid and unperformed.

                  10. If an Event of Termination  shall occur and be continuing,
         the Assignee  may, in its  discretion,  in its name or the  Assignor's,
         notify any obligor under the Transfer  Agreement to make payment to the
         Assignee  of all  amounts  due or to  become  due  under  the  Transfer
         Agreement.

                  11. If an Event of Termination  shall occur and be continuing,
         the  Assignee  may,  in its  discretion,  demand,  sue for,  collect or
         receive  any money or  property at any time  payable or  receivable  on
         account of or in exchange for the Transfer Agreement,  or, with respect
         to  payments  which have  become  due and  payable  under the  Transfer
         Agreement,  make any compromise or settlement  deemed  desirable by the
         Assignee.

                  12.  The  Assignor  agrees  that any  copy of this  Assignment
         signed by the Assignor and  transmitted  by telefax for delivery to the
         Assignee shall be admissible in evidence as the original  itself in any
         judicial or administrative  proceeding,  whether or not the original is
         in existence.


                                        3

<PAGE>



     IN WITNESS  WHEREOF,  the  undersigned  has caused  this  Assignment  to be
executed this __th day of December, 1996.


                                    CCA FUNDING LLC

                                    By: CCA Funding Manager, Inc., its Manager


                                    By:
                                    Name:
                                    Title:


Acknowledged By:

COMMUNITY CARE OF AMERICA,
INC.


By:
Name:
Title:


ECA HOLDINGS, INC.



By:
Name:
Title:


COMMUNITY CARE OF NEBRASKA,
INC.


By:
Name:
Title:




COMMUNITY CARE OF GEORGIA, INC.



By:
Name:
Title:


COMMUNITY CARE OF AMERICA OF
 ALABAMA, INC.


By:
Name:
Title:


CCA OF MIDWEST, INC.



By:
Name:
Title:




                                        4

<PAGE>


ECA PROPERTIES, INC.


By:
Name:
Title:


LULING/SCC, INC.


By:
Name:
Title:


DUBLIN/SCC, INC.


By:
Name:
Title:


MARIETTA/SCC, INC.


By:
Name:
Title:


MACON/SCC, INC.


By:
Name:
Title:


COLLEGE PARK/SCC, INC.


By:
Name:
Title:


GLENWOOD/SCC, INC.


By:
Name:
Title:


QUALITY CARE OF COLUMBUS, INC.


By:
Name:
Title:


QUALITY CARE OF LYONS, INC.


By:
Name:
Title:









                 AMENDED AND RESTATED REVOLVING CREDIT AGREEMENT

                  AGREEMENT made as of the 27th day of December,  1996,  between
COMMUNITY CARE OF AMERICA,  INC., a Delaware corporation  ("Borrower"),  and IHS
FINANCIAL HOLDINGS, INC., a Delaware corporation ("Lender" or "Manager").

                  WHEREAS,   Borrower  and  Lender  are  concurrently   herewith
entering into a Management  Agreement (the "Management  Agreement")  pursuant to
which Borrower has engaged the services of Lender to manage various functions of
the Borrower's business; and

                  WHEREAS, Lender is willing to make available to the Borrower a
revolving  line of credit in the maximum  aggregate  amount of  $5,000,000,  and
Borrower wishes to obtain such revolving line of credit,  all upon the terms and
conditions of this Agreement;

NOW,  THEREFORE,   in  consideration  of  the  premises,   the  mutual  promises
hereinafter  set  forth,  and for other  good and  valuable  consideration,  the
receipt and  sufficiency  of which are hereby  acknowledged,  the parties hereby
agree that:




<PAGE>






1.       IHS Revolving Line of Credit.

     (a)  Subject  to the terms  and  conditions  hereof  and  relying  upon the
representations  and warranties of the Borrower herein set forth,  Lender hereby
makes  available  to  Borrower  a  revolving  line of  credit  (the "IHS Line of
Credit") in the aggregate  maximum  principal amount  outstanding at any time of
FIVE MILLION DOLLARS ($5,000,000). It is contemplated that, subject to the terms
and conditions  hereof, the Borrower will be permitted to effect draws under the
IHS Line of Credit  at any time and from time to time  during  the  period  that
commences  on the date  hereof  and ends on the second  anniversary  of the date
hereof.

     (b) Lender shall not be required to make any advances under the IHS Line of
Credit to the Borrower  unless all of the following  conditions  shall have been
satisfied at the time the advance is  requested  and at the time such advance is
to be made: (i) all of the  representations  and warranties made by the Borrower
in this Agreement and the Management  Agreement shall be true and correct in all
respects at and as of the date on which such advance is to be made with the same
force and effect as if each such  representation or warranty were made at and as
of such time, and in furtherance  thereof,  the Borrower shall  automatically be
deemed to have remade each of such  representations  and warranties on each such
date;  (ii) the Borrower  shall have  performed and complied with all covenants,
agreements and  obligations  required to be performed or complied with by it, on
or  prior to the date on which  such  advance  is to be made;  (iii) no Event of
Default (as defined in Section 5) shall have  occurred and be  continuing;  (iv)
the Borrower  shall have complied with the procedure set forth in subsection (c)
below with respect to such advance;  and (v) Lender shall have  consented to the
making of such advance, such consent not to, be unreasonably withheld; provided,
however, that Lender's consent to the making of an advance shall not be required
if the  proceeds  of such  advance  are  applied  to  payment  of fees under the
Management Agreement.

     (c) (i) If the Borrower  shall desire that Lender make an advance to it, it
shall provide Lender with a written request,  certified to be true, complete and
correct by its President or Chief Financial  Officer,  at least forty-eight (48)
hours prior to the date on which the borrowing is to be made. Such request shall
set forth: (A) the amount of the requested advance, (B) the proposed use thereof
in reasonable  detail,  and (C) shall contain a statement  that:  (I) all of the
representations  and  warranties  made in this Agreement are true and correct in
all  respects  as if made on the date of the  request,  (II) the  Borrower is in
compliance  with all of its covenants and  obligations  under this Agreement and
the  Management  Agreement,  and (III) no Event of Default  has  occurred.  Such
request shall also contain an undertaking  by the  individual  executing same to
immediately  notify  Lender if any of the  statements  made therein shall become
untrue,  incomplete  or incorrect  after the date of delivery and on or prior to
the date of the requested borrowing.

     (ii) If the Manager  shall desire that an advance be made to the  Borrower,
it shall  provide the Borrower with notice (which notice may be oral) thereof at
least  forty-eight  (48) hours prior to the date on which the borrowing is to be
made. Such request shall set forth: (A) the amount of the requested advance, and
(B) the proposed use thereof in reasonable detail. No such advance shall be made
at  Manager's  request  (unless  pursuant  to  Section  5.3  of  the  Management
Agreement)  without  the consent of the  Borrower,  which  consent  shall not be
unreasonably  withheld and shall be deemed given unless Borrower shall otherwise
notify  Manager  (which  notice may be oral)  within  forty-eight  hours of said
request.  (d) The  proceeds  of each  advance  shall be used as  directed by the
Manager in accordance with the terms of the Management Agreement.

     (e) Lender  shall have no  obligation  to make any further  advances if the
payment of the Note (as defined below) shall have been accelerated.

         2.   Loan Note.

     The obligation of the Borrower to repay the unpaid  principal amount of the
IHS Line of Credit,  together with interest thereon, and Lender's fees and costs
in connection  therewith  shall be evidenced by that certain  Subordinated  Note
dated December 27, 1996 (the "Note") of Borrower of even date herewith,  payable
to the order of Lender in a face  amount  equal to the  maximum  loan amount set
forth in Section  1,  above,  and having a maturity  date which is on the second
anniversary of the date hereof (the "Maturity Date").

         3.   Repayment of IHS Line of Credit.

     Interest  on the IHS Line of Credit  shall be  payable  monthly  during the
period  commencing  on the date  hereof and ending on the  Maturity  Date.  Such
interest  shall be  payable  at a rate per  annum  equal to the  annual  rate of
interest set forth in the Revolving Credit  Agreement by and between  Integrated
Health Services, Inc., as Borrower, and Citibank, N.A., as Lender, dated May 16,
1996 plus two (2%) percent.

         4.   Additional Covenants of Borrowers.

     Until all of the Borrower's  obligations  under this Agreement and the Note
(the  "Obligations") are satisfied in full, subject to the provisions of Section
5, below,  the Borrower  agrees that it will do or perform each of the following
(except to the extent that any of the following are the responsibility of Lender
in its capacity as Manager pursuant to the Management Agreement):

     (a) furnish or cause to be furnished  to the Lender any  financial or other
information that the Lender may reasonably deem necessary or desirable;

     (b) duly pay and discharge all taxes,  assessments and governmental charges
owed by or  against  the  Borrower  or any of its  subsidiaries  or any of their
respective  properties,  prior to the date on which penalty will attach thereto,
unless and only to the extent that any such taxes are contested in good faith by
appropriate proceedings by the Borrower;

     (c) take  whatever  actions are  necessary  to comply with all statutes and
regulations governing the operation of the Borrower's business;

     (d)  promptly  cure any  defects  in the  execution  and  delivery  of this
Agreement  and  all  other   instruments   executed  in  connection   with  this
transaction;

     (e) execute and deliver or cause to be  executed  and  delivered  any other
instruments or documents which the Lender may reasonably request;

     (g) promptly  notify the Lender of any Event of Default  discovered  by the
Borrower; and

     (h) permit the Lender to designate  one  additional  member of the Board of
Directors of Borrower.

         5.   Events of Default.

     At the  option  of  Lender,  all  or any  part  of  the  Obligations  shall
immediately become due and payable  irrespective of any agreed maturity upon the
happening of any of the following events of default  ("Events of Default"):  (a)
any Acceleration  Event occurs under the Note; (b) any breach by the Borrower of
any of its  representations or warranties under this Agreement or the Management
Agreement;  (c) any other breach of this Agreement which breach  continues for a
period of sixty (60) days following  notice from Lender to the Borrower;  or (d)
the termination of the Management Agreement.

         6.   Waivers.

     The Lender  shall not be deemed to have  waived  any of its rights  upon or
under any of the Obligations  unless such waiver be in writing,  shall expressly
refer to this Section 6 and shall be signed by the Lender.  No delay or omission
on the part of the Lender on  Obligations,  whether  evidenced  hereby or by any
other instrument or papers,  shall be cumulative and may be exercised separately
or concurrently.

         7.   Transfers by Lender.

     Subject to the same  limitations  as are set forth in  Section  11.1 of the
Management Agreement, Lender may transfer any or all of the Obligations.

         8.   Definition of Borrowers.

     The term "Borrower" as used throughout this Agreement shall include (a) its
successors and assigns;  (b) any individual,  association,  trust,  partnership,
corporation,  or other entity to which all or substantially  all of the business
or assets of the Borrower shall have been  transferred or with or into which any
of them shall have been merged,  consolidated,  reorganized or absorbed; and (c)
in  the  case  of a  partnership  or  joint  venture,  any  general  or  limited
partnership  or joint  venture  which  shall have been  created by reason of, or
continued  in existence  after,  the  admission of any new partner,  partners or
joint venturers therein or the dissolution of the existing  partnership or joint
venture by the death,  resignation  or other  withdrawal of any partner or joint
venturer.

         9.   Maximum Interest.

     All agreements between the Borrower and Lender are hereby expressly limited
so that in no contingency or event whatsoever, whether by reason of deferment in
accordance with this Agreement or advancement of the loan proceeds, acceleration
of maturity of the Obligations, or otherwise, shall the amount paid or agreed to
be paid to  Lender  for the use,  forbearance  or  detention  of the money to be
loaned hereunder exceed the maximum  permissible  under applicable law. If, from
any circumstance  whatsoever,  fulfillment of any provision  hereof, at the time
performance of such provision shall be due, shall involve transcending the limit
of validity  prescribed by law, then, ipso facto, the obligation to be fulfilled
shall be reduced  to the limit of such  validity,  and if from any  circumstance
Lender  should ever receive as interest an amount which would exceed the highest
lawful rate,  such amount which would be excessive  interest shall be applied to
the  reduction  of the  principal of the  Obligations  and not to the payment of
interest.  This provision  shall control every other provision of all agreements
between the Borrower and Lender.

         10.          Borrower's Representations and Warranties.

        To induce the Lender to lend monies  pursuant to the Note,  the Borrower
represents and warrants to Lender that:

     (a) The Borrower is duly  authorized to execute and deliver this Agreement,
the Note and the Management  Agreement and to perform its obligations  hereunder
and thereunder;

     (b) the execution and delivery by the Borrower of this Agreement,  the Note
and  the  Management  Agreement,  and the  performance  by the  Borrower  of its
obligations  hereunder  and  thereunder  do not and will not  conflict  with any
provision of the charter or by-laws of the Borrower;

     (c) this  Agreement,  the  Note  and the  Management  Agreement  when  duly
executed  and  delivered,  will be the legal,  valid and binding  obligation  of
Borrower enforceable against it in accordance with its terms;

     (d) Neither the execution and delivery of this  Agreement,  the Note or the
Management  Agreement  nor  the  performance  by  Borrower  of  its  obligations
hereunder and thereunder  will result in the creation or imposition of any lien,
charge or  encumbrance  of any nature  whatsoever  upon any of the  property  or
assets of the Borrower,  except as  contemplated  or provided herein or therein,
and such execution, delivery and performance will not conflict with or result in
the breach or violation  of or a default  (with due notice or passing of time or
both) under the terms,  conditions or provisions of (a) any indenture,  evidence
of indebtedness,  loan or financing agreement,  or other agreement or instrument
of whatever  nature to which the Borrower is a party or by which the Borrower is
bound; or (b) any provision of any existing law, rule, regulation,  order, writ,
injunction  or decree  of any  court or  federal,  state,  county  or  municipal
governmental authority to which the Borrower is subject;

     (e) Each  representation  and warranty  contained in Sections 6.4, 6.5, 6.6
and 6.7 of the Management Agreement is true and correct.

     (f) No person is  entitled  to  receive  from the  Borrower  any  brokerage
commission,  finder's  fee or  similar  fee or payment  in  connection  with the
consummation of the transactions contemplated by this Agreement, the Note or the
Management Agreement.

         11. Notices.

         Any notice or other communication by either party to the other shall be
in writing (except as otherwise  expressly provided in this Agreement) and shall
be given  and be deemed to have been  duly  given,  upon the date  delivered  if
delivered  personally  or upon the date  received  if mailed  postage  pre-paid,
registered,  or  certified  mail,  or upon  confirmation  of  receipt if sent by
telefacsimile transmission, or one business day after sent if sent by nationally
recognized overnight courier service, in each case, addressed as follows:


         To the Borrower:               Community Care of America, Inc.
                                        3050 N. Horseshoe Drive
                                        Naples, FL  33942
                                        Attention:  Gary Singleton, President
                                        Fax:  941-435-0087

         With a copy to:                J. Allen Miller
                                        Chadbourne & Parke, LLP
                                        30 Rockefeller Plaza
                                        New York, NY  10022
                                        Fax:  212-541-5369

         To the Lender:                 IHS Financial Holdings, Inc.
                                        10065 Red Run Boulevard
                                        Owings Mills, MD  21117
                                        Attention:  Eleanor Harding
                                        Fax:  410-998-8716

         With a copy to:                Integrated Health Services, Inc.
                                        10065 Red Run Boulevard
                                        Owings Mills, MD  21117
                                        Attention:  Marshall A. Elkins, Esq.
                                        Fax:  410-998-8747

                                                     - and -

                                        Frank Agostino
                                        Calo Agostino
                                        27 Warren Street
                                        Hackensack, NJ 07601
                                        Fax:  201-488-5855

or to such other  address,  and to the attention of such other person or officer
as either party may designate in writing by notice.

         12.          Applicable Law.

     The  substantive  laws of the State of Maryland  shall govern the validity,
construction,  enforcement  and  interpretation  of this Agreement and all other
documents  and  instruments  referred  to  herein,  unless  otherwise  specified
therein.

         13.          Counterparts.

     This Agreement may be executed in two or more  counterparts,  each of which
shall be deemed an original,  but all of which together shall constitute one and
the same instrument.

         14.          Construction.

     The parties have  participated  jointly in the  negotiation and drafting of
this   Agreement.   In  the  event  an   ambiguity  or  question  of  intent  or
interpretation  arises,  this Agreement shall be construed as if drafted jointly
by the parties  and no  presumption  or burden of proof shall arise  favoring or
disfavoring  any Party by virtue of the  authorship of any of the  provisions of
this  Agreement.  If any party has breached  any  representation,  warranty,  or
covenant  contained  herein in any respect,  the fact that there exists  another
representation,  warranty,  or  covenant  relating  to the same  subject  matter
(regardless  of the  relative  levels  of  specificity)  which the party has not
breached shall not detract from or mitigate the fact that the party is in breach
of the first representation, warranty, or covenant.

         15.          Press Releases and Public Announcements.

     Neither   party  shall  issue  any  press   release  nor  make  any  public
announcement  relating to the subject matter of this Agreement,  the Note or the
Management  Agreement  without the prior  written  approval of an officer of the
Borrower and the Lender;  provided,  however, that any party may make any public
disclosure  it  believes  in good faith is  required  by  applicable  law or any
listing or trading agreement concerning its publicly-traded securities (in which
case the  disclosing  party will use its best efforts to advise and consult with
the other party before making the disclosure.

         16.          Arbitration.

     If any  controversy  should  arise  between  the  parties  in  performance,
interpretation,  or application of this Agreement or the Note which involves any
matter, either party may serve upon the other a written notice stating that such
party desires to have the controversy reviewed by an arbitrator.  If the parties
cannot agree  within  fifteen (15) days from the service of such notice upon the
selection of such  arbitrator,  an arbitrator shall be selected or designated by
the  American  Arbitration  Association  upon  written  request of either  party
hereto.  Arbitration  of such  controversy,  disagreement,  or dispute  shall be
conducted in accordance with the Commercial  Arbitration  Rules then in force of
the  American  Arbitration  Association  and  the  decision  and  award  of  the
arbitrator  so  selected  shall be  binding  upon the  Owner  and  Manager.  The
arbitration will be held in New York, New York.

     As a condition  precedent to the appointment of any arbitrator both parties
shall be required to make a good faith effort to resolve the  controversy  which
effort  shall  continue for a period of thirty (30) days prior to any demand for
arbitration.  The cost of any such  arbitration  shall be shared  equally by the
parties.  Each  party  shall  pay its own  costs  incurred  as a  result  of its
participation in any such arbitration.

     The  Arbitrator  shall have no authority to award  punitive  damages or any
other damages in excess of the prevailing  party's actual  damages,  and may not
make any  ruling,  finding  or award  that  does not  conform  to the  terms and
conditions of this Agreement.

                                        [SIGNATURES ON THE FOLLOWING PAGE]









<PAGE>


IN WITNESS  WHEREOF,  the  undersigned  have executed this Agreement on the date
first above written.

Borrower:                                               LENDER:

COMMUNITY CARE OF AMERICA,                              IHS FINANCIAL HOLDINGS,
  INC.                                                    INC.

By:                                                     By:

Title:                                                  Title:



Attest:                                                 Attest:








                                SUBORDINATED NOTE

December 27, 1996                                                    $5,000,000

     FOR VALUE RECEIVED,  Community Care of America, a Delaware corporation (the
"Maker"), having an address at 3050 N. Horseshoe Drive, Naples, FL 33942, hereby
promises  to pay to the  order  of IHS  Financial  Holdings,  Inc.,  a  Delaware
corporation  ("Payee"),  or assigns, in lawful money of the United States at its
address at 10065 Red Run  Boulevard,  Owings Mills,  MD 21244,  or at such other
address as the holder of this Note shall specify from time to time to the Maker,
on the second  anniversary  of the date hereof,  such amounts as are advanced to
the Maker by the  holder of this Note from time to time in  accordance  with the
Credit Agreement (as hereinafter  defined),  such principal amount not to exceed
in the aggregate at any one time Five Million  Dollars  ($5,000,000),  and which
shall be then  outstanding.  All amounts due under this Note shall bear interest
at the Applicable Rate (as hereinafter  defined) as in effect from time to time,
payable on each date when a payment of principal is made or due and,  commencing
with and  continuing  after  January 1, 1997,  on the first day of each calendar
month of each year.

     The  "Applicable  Rate"  shall  mean two  percent  (2%)  above  the rate of
interest charged to Integrated  Health Services in that certain Revolving Credit
Agreement by and between  Integrated  Health  Services,  Inc., as Borrower,  and
Citibank,  N.A., as Lender,  dated May 16, 1996 (hereinafter  referred to as the
"Citibank Rate"), or any replacement of such senior secured debt.





<PAGE>






     Upon and  during  the  continuance  of an  Acceleration  Event (as  defined
below),  all amounts payable under this Note shall accrue interest at a rate per
annum equal to three percent (3%) in excess of the Applicable Rate (the "Default
Rate"). Any such default interest shall be due on demand.

In the event  that any  payment,  including,  without  limitation,  interest  or
principal,  required  to be made by the  Borrower  under  this Note shall not be
received  by the  Lender  within  ten (10) days  after the same shall be due and
payable,  the Lender may charge, and if so charged,  the Borrower shall pay upon
demand,  a late charge of five cents  ($0.05)  for each  dollar  ($1.00) of such
delinquent  payment.  This Note may be  prepaid  in whole at any time or in part
from time to time without  penalty.  Each such prepayment shall be applied first
to unpaid fees and charges under this note, accrued and unpaid interest and then
to principal.


At the time of making of each  advance  by the holder of this Note to the Maker,
and upon each payment of principal of any such  advances the holder of this Note
shall, and is hereby  authorized to, make a notation on the Grid attached hereto
and made a part  hereof,  of the date and the amount of such advance or payment,
as the case may be. The  notations  on the Grid  shall  constitute  prima  facie
evidence  of the amount of  principal  outstanding  under this Note from time to
time. Notwithstanding the foregoing, the failure to make a notation with respect
to any advance or payment shall not limit or otherwise  affect the obligation of
the Maker  hereunder with respect to any advance or payment.  Although this Note
is dated the date of issue, interest in respect hereof shall be payable only for
the periods  during  which the advances  evidenced  hereby are  outstanding  and
although the stated  principal amount of this Note shall be Five Million Dollars
($5,000,000),  this Note  shall be  enforceable,  with  respect  to the  Maker's
obligation to pay this principal amount hereof, only to the extent of the unpaid
principal amount of the advances at the time evidenced hereby.



This is the Grid Note  referred to in, and is  entitled  to the  benefits of the
Revolving  Credit  Agreement of even date  herewith  between Payee and the Maker
(the "Credit  Agreement").  Without  limiting the  generality of the  foregoing,
Payee's  obligation  to make  advances  to the Maker  under  this Note  shall be
governed  by the Credit  Agreement.  The  remedies of the holder of this Note as
provided  herein,  in the Credit  Agreement,  or in any other  loan or  security
instrument,  agreement or document,  or any of them relating to this Note, or at
law or in equity, shall be cumulative and concurrent, and may be pursued singly,
successively,  or together at the sole discretion of the holder of this Note and
may be exercised as often as occasion therefor shall occur.


If an Acceleration  Event shall occur,  then, at the option of the holder hereof
upon written notice  thereof to the Maker,  all amounts then  outstanding  under
this Note shall become  immediately due and payable;  provided,  however,  if an
Acceleration Event as defined in Paragraph (e) of the next succeeding  paragraph
shall occur with respect to the Maker, then this Note automatically shall become
immediately due and payable in its entirety.


An "Acceleration Event" shall be deemed to have occurred hereunder if:

     a) the Maker shall fail to pay any amount due under this Note for more than
ten (10) days after the holder of this Note shall have given the Maker notice of
such failure;

     (b) the Maker shall  breach any of its  obligations  under this Note or the
Credit  Agreement (other than for the payment of any amount due under this Note)
and such  breach  shall  continue  for thirty (30) days after the holder of this
Note shall have given the Maker notice of said default;

     (c) any statement,  representation,  or warranty of the Maker  contained in
this Note or the Credit  Agreement shall be untrue in any material  respect when
made;

<PAGE>


     (d) any creditor of the Maker or of any  principal  subsidiary of the Maker
(other  than any  creditor  identified  in  writing  by Maker to Payer  prior to
execution  and delivery of this Note,  with respect to the amount so  specified)
shall  give  notice  or  demand  that any  obligations  of the  Maker or of such
subsidiary  for the payment of money due to such  creditor in an amount not less
than $100,000 be  immediately  paid or otherwise  declares such  obligations  to
become immediately due and payable; or

     (e) the  Maker or any  principal  subsidiary  of the  Maker,  shall  become
insolvent  or bankrupt or make an  assignment  for the benefit of  creditors  or
consent to the appointment of a trustee or receiver;  or a trustee or a receiver
shall  be  appointed  for any of them  or for a  substantial  part of its or his
respective  property;  or  bankruptcy,  liquidation,  termination  of existence,
reorganization  or insolvency or similar  proceedings  shall be instituted by or
against any of them; or

     (f) there  shall be a  Fundamental  Event (as  hereinafter  defined) of the
Maker.

     A  "Fundamental  Event"  shall be  deemed  to occur if (i)  there  shall be
consummated  (x) any  consolidation  or  merger  of the  Maker or any  principal
subsidiary of the Maker in which the Maker or such  subsidiary,  as the case may
be, is not the  continuing or surviving  corporation or pursuant to which shares
of the capital  stock of the Maker or such  subsidiary  would be converted  into
cash,  securities  or other  property,  other than a merger of the Maker or such
subsidiary,  as the case may be,  in which  the  holders  of the  capital  stock
thereof immediately prior to the merger have the same proportionate ownership of
capital stock of the surviving corporation  immediately after the merger, or (y)
any sale,  lease,  exchange or other transfer (in one transaction or a series of
related  transactions) of all or substantially all of the assets of the Maker or
any of its principal subsidiaries (including by way of management agreement), or
(ii)  stockholders  of  the  Maker  shall  approve  any  plan  or  proposal  for
liquidation  or  dissolution  of the Maker or any  principal  subsidiary  of the
Maker,  or (iii) any new person or group (as such term is used in Sections 13(d)
and 14(d)(2) of the  Securities  Exchange Act of 1934, as amended)  shall become
the  beneficial  owner (within the meaning of Rule 13d-3 under the Exchange Act)
of 30% or more of the capital  stock of the Maker,  or (iv) during any period of
two  consecutive  years,  individuals  who  at  the  beginning  of  such  period
constitute  the  entire  Board  of  Directors  shall  cease  for any  reason  to
constitute  a  majority  thereof  unless the  election,  or the  nomination  for
election by the Maker stockholders,  of each new director was approved by a vote
of at least  two-thirds of the directors then still in office who were directors
at the beginning of the period, or (v) the Maker or any principal  subsidiary of
the Maker shall issue any equity  securities or any securities  convertible into
or exchangeable  for equity  securities in an aggregate  amount in excess of 30%
percent (thirty percent) of the equity of the Maker or such principal subsidiary
on a fully diluted basis on the date hereof.

     The indebtedness  represented by this Note (including the interest thereon)
shall be subordinate and junior in right of payment to the prior payment in full
of all Senior Indebtedness (as defined below). By accepting this Note, the Payee
agrees   from  time  to  time  to  enter  into  such   commercially   reasonable
subordination   agreements  with  or  for  the  benefit  of  holders  of  Senior
Indebtedness  as such  holders  shall  reasonably  require  from time to time to
evidence the  subordination of the Payee's rights hereunder to the rights of the
holders of Senior  Indebtedness;  provided  such  agreements  shall contain only
subordination  provisions  ordinarily  obtained by such  holders  under  similar
circumstances, provided, further, that Payee shall not be required to return any
payment  made prior to the  receipt  of a written  notice of an Event of Default
from the holder of the Senior Indebtedness. Each such subordination agreement is
sometimes  referred  to  in  this  Note  as  a  "Subordination   Agreement"  and
collectively as the "Subordination Agreements".  "Senior Indebtedness" means (a)
the principal of, premium, if any, and interest on, and all other obligations to
pay money or expend  funds under,  all  Indebtedness  to Daiwa Bank,  Health and
Retirement  Properties  Trust  ("HRPT")  or any other  lender  or  lessor  which
replaces, refinances, or succeeds to the position, in whole or in part, of Daiwa
Bank, or HRPT, in an amount not to exceed thirty million dollars  ($30,000,000);
and (b) any amendments, modifications,  deferrals, renewals or extensions of any
such  Senior   Indebtedness,   or  debentures,   notes  or  other  evidences  of
indebtedness  issued in  exchange  for any such  Senior  Indebtedness.  The term
"Indebtedness"  as used in the  foregoing  sentence  means any  liability of the
Maker (i) for money  borrowed  from,  or the  issuance  of letters of credit and
other  financial  accommodations  by, any bank,  financial  institution or other
lender,  or (ii) arising  under a lease of  property,  equipment or other assets
whether or not classified  upon the balance sheet of the Maker as a liability of
the Maker,  or (iii)  arising  under a guaranty by the Maker of the liability of
another (including any subsidiary of the Maker) where the liability of the Maker
arising thereunder is, under the express  provisions of such guaranty,  superior
in right of payment to this Note.

     Subject to the  payment in full of all Senior  Indebtedness,  the holder of
this  Note  shall  be  subrogated  to  the  rights  of  the  holders  of  Senior
Indebtedness  to  receive  payments  or  distributions  of  cash,   property  or
securities of the Maker applicable to the Senior  Indebtedness until all amounts
owing on this  Note  shall be paid in full,  and,  as  between  the  Maker,  its
creditors  other  than  holders of Senior  Indebtedness,  and the holder of this
Note, no payment or  distribution  of cash,  property or securities  made to the
holders of Senior Indebtedness by virtue of the subordination  provisions hereof
which  otherwise would have been made to the holder of this Note shall be deemed
to be a payment  by the Maker on  account  of the  Senior  Indebtedness,  and no
payment or  distribution  of cash,  property or securities made to the holder of
this Note by virtue of the subrogation provided for herein which otherwise would
have been made to the  holders  of Senior  Indebtedness  shall be deemed to be a
payment on account of this Note; it being understood that the provisions  hereof
are, and are intended solely, for the purpose of defining the relative rights of
the  holder  of this  Note,  on the one  hand,  and the  holders  of the  Senior
Indebtedness, on the other hand.

<PAGE>


     The obligation of the Maker to pay to the holder of this Note the principal
of and  interest on this Note and all other sums due in  connection  herewith as
and when the same shall  become due and  payable  in  accordance  with the terms
hereof is absolute and unconditional.  The holder of this Note shall be entitled
to exercise  singularly or cumulatively and in any order, all remedies permitted
by applicable law, equity, this Note, or otherwise upon default hereunder.

     The Maker  agrees to pay all costs of  collection  arising  out of or under
this  Note,  including,  without  limitation,  reasonable  attorneys'  fees  and
expenses. Such costs shall be due on demand.

     Anything to the contrary contained in this Note notwithstanding, at no time
shall the Maker be  obligated  or  required  to pay  interest  on the  principal
balance due  hereunder at a rate which could subject the holder hereof to either
civil or  criminal  liability  as a result  of being in  excess  of the  maximum
interest  rate which the Maker is  permitted  by  applicable  law to contract or
agree to pay. If, by the terms of this Note or any security agreement, the Maker
is at any time  required or obligated to pay interest on the  principal  balance
due hereunder at a rate in excess of such maximum rate, the applicable  interest
rate  shall be deemed to be  immediately  reduced to such  maximum  rate and all
previous  payments  in excess of the  maximum  rate shall be deemed to have been
payments  in  reduction  of  principal  and not on account of the  interest  due
hereunder.

     The obligations  hereunder shall be binding upon the successors and assigns
of the Maker.  The Maker,  for itself and its successors  and assigns,  and each
endorser, co-obligor, surety and guarantor hereof, hereby waives presentment for
payment,  notice of nonpayment or dishonor,  protest,  notice of protest and all
other  notices  in  connection   with  delivery,   acceptance,   performance  or
enforcement of this Note. [SIGNATURE ON NEXT PAGE]







<PAGE>






                                            This  Note  shall  be  construed  in
                                            accordance  with and governed by the
                                            laws  of  the   State  of   Maryland
                                            applicable  to  contracts  executed,
                                            delivered and to be fully  performed
                                            in  Florida  without  regard  to its
                                            choice of law provisions.  COMMUNITY
                                            CARE OF AMERICA, INC.


                                            By:      __________________________
                                                      Gary Singleton, President








<PAGE>


                                      GRID

                          ADVANCE AND PAYMENT SCHEDULE


                              Amount of         Unpaid         Name of
  Date of     Amount of     Principal Paid     Principal    Person Making
  Advance      Advance        or Prepaid        Balance        Notation
  -------      -------        ----------        -------        --------










                          Warrant ACQUISITION agreement



This Warrant  Acquisition  Agreement  (this  "Agreement")  is entered into as of
January  13,  1997 (the  "Effective  Date")  by and  between  Community  Care of
America, Inc., a Delaware corporation ("CCA"), on the one hand, and on the other
hand, Integrated Health Services, Inc., a Delaware corporation ("IHS").


WHEREAS, CCA and IHS are parties to that certain Management Agreement,  dated as
of December  27, 1996 (the  "Management  Agreement"),  pursuant to which IHS has
agreed to provide certain services to CCA, on the terms and conditions contained
therein; and


WHEREAS, in connection with the Management  Agreement,  CCA and IHS entered into
that  certain  Revolving  Credit  Agreement,  dated as of December 27, 1996 (the
"Revolving Credit Agreement"), pursuant to which IHS agreed to make available to
CCA a line of  credit  (the  "Line of  Credit")  for up to Two  Million  Dollars
($2,000,000) to be evidenced by a Subordinated Note (the  "Subordinated  Note");
and


WHEREAS,  CCA and IHS have continued to negotiate the terms upon which IHS would
be willing to provide CCA with a Line of Credit for up to Five  Million  Dollars
($5,000,000); and


WHEREAS, in order to induce IHS to provide an aggregate Line of Credit to CCA of
Five Million Dollars ($5,000,000),  CCA has agreed to issue to IHS warrants (the
"Warrants") to purchase up to 9.9% of the  outstanding  common stock of CCA (the
"Common Stock"), on the terms and conditions set forth herein.


NOW, THEREFORE, the parties hereby agree as follows:


1.  DEFINITIONS.1.DEFINITIONS  As used in this  Agreement,  the following  terms
shall have the following respective meanings:


"Affiliate"  of any  particular  Person means any  executive  officer,  director
(regardless  of whether an  officer),  general  partner,  trustee  and any other
Person that  controls,  is  controlled  by or is under common  control with such
particular Person, where "control" means the possession, directly or indirectly,
of the power to direct the management and policies of the particular Person

                                       


<PAGE>



whether through the ownership of voting securities, contract or otherwise.

         "Common Stock" shall mean CCA's common stock, $.0025 par value.

         "day" shall mean any calendar  day;  "business  day" shall mean any day
other than  Saturdays,  Sundays and days that are a banking  holiday in New York
City;  and "trading  day" shall mean any day other than  Saturdays,  Sundays and
days that are a scheduled  holiday for the principal  securities market in which
the Common Stock is quoted or traded.

         "Additional Transaction Documents" shall mean the Series A and Series B
Warrants  described in Section 2.1 and the Registration  Rights Agreement in the
form attached hereto as Exhibit 3.

         "Person"   shall  mean  any   natural   person  and  any   corporation,
partnership,  limited liability company,  limited liability  partnership,  joint
venture,   association,    joint-stock   partnership,    trust,   unincorporated
organization or government or other agency or political subdivision thereof.

         "Subsidiary"  shall mean, with respect to any Person,  any corporation,
limited  liability   company,   limited  liability   partnership,   partnership,
association or other business  entity of which (i) if a corporation,  a majority
of the total voting  power of shares of stock  entitled  (without  regard to the
occurrence of any contingency) to vote in the election of directors, managers or
trustees thereof is at the time owned or controlled,  directly or indirectly, by
that  Person  or one or more of the  other  Subsidiaries  of  that  Person  or a
combination  thereof, or (ii) if a limited liability company,  limited liability
partnership,  partnership,  association or other business  entity, a majority of
the partnership or other similar ownership interest thereof is at the time owned
or controlled,  directly or indirectly,  by a Person or one or more Subsidiaries
of that  Person or a  combination  thereof.  For  purposes  hereof,  a Person or
Persons  shall be  deemed to have a  majority  ownership  interest  in a limited
liability company,  limited liability partnership,  partnership,  association or
other business entity if such Person or Persons shall be allocated a majority of
limited  liability   company,   limited  liability   partnership,   partnership,
association or other business  entity gains or losses or shall be or control any
managing director or general partner of such limited liability company,  limited
liability partnership, partnership, association or other business entity.

         "Underlying  Common  Stock"  shall mean (i) the shares of Common  Stock
issued or issuable upon exercise of the Warrant and (ii) any Common Stock issued
or issuable  with respect to the  securities  referred to in clause (i) above by
way of stock  dividend or stock split or in  connection  with a  combination  of
shares, recapitalization, merger, consolidation or other reorganization.

2. PURCHASE AND SALE OF THE WARRANTS.2.PURCHASE AND SALE OF THE WARRANTS

         2.1. The Effective Date Transaction.  Simultaneously with the execution
and delivery of this Agreement:  (a) CCA is issuing to IHS the Series A Warrant,
in the form attached hereto as Exhibit 1 (the  "A-Warrant");  (b) CCA is issuing
to IHS the  Series B  Warrant,  in the form  attached  hereto as  Exhibit 2 (the
"B-Warrant");  and (c) the  Revolving  Credit  Agreement  is deemed to have been
amended by CCA and IHS to provide an  aggregate  Line of Credit of Five  Million
Dollars ($5,000,000) in consideration for the issuance and sale of the Warrants.

3. ADDITIONAL TRANSACTION DOCUMENTS.7.ADDITIONAL TRANSACTION DOCUMENTS.

     3.1.  Registration Rights Agreement.  Simultaneously with the execution and
delivery of this Agreement,  CCA and IHS shall enter into a Registration  Rights
Agreement in the form attached hereto as Exhibit 3.

4. REPRESENTATIONS AND WARRANTIES OF CCA; COVENANTS OF CCA.8.REPRESENTATIONS AND
WARRANTIES OF CCA. CCA hereby represents and warrants to IHS that the statements
in the  following  subsections  of this Section 4 are all true and correct as of
the Effective Date and covenants to CCA as follows:

     4.1. Organization, Standing, and Qualification of CCA. CCA is a corporation
duly  organized,  validly  existing and in good  standing  under the laws of the
State of Delaware. Copies of the Certificate of Incorporation and Bylaws of CCA,
and all the amendments  thereof to date,  have been, if requested,  delivered to
IHS and are complete and correct. CCA has the power and the authority to own the
property and assets now owned by it and to conduct the business  presently being
conducted by it.

     4.2.  Absence of  Conflicting  Agreements.  Neither  (a) the  execution  or
delivery of this Agreement,  the Additional Transaction Documents, the amendment
to the  Revolving  Credit  Agreement  or the  other  instruments  and  documents
required or contemplated  hereby and thereby,  nor (b) the performance by CCA of
the transactions contemplated hereby or thereby,  conflicts with, or constitutes
a breach of or a default or requires the consent of any third party under (i) to
the best of its knowledge after due inquiry, any applicable law, rule, judgment,
order, writ, injunction, or decree of any court, currently in effect; or (ii) to
the best of its knowledge  after due inquiry,  any applicable rule or regulation
of any  administrative  agency  or other  governmental  authority  currently  in
effect; or (iii) any agreement,  indenture,  contract or instrument to which CCA
(or any of its  Subsidiaries)  is now a party or by which the  assets of CCA (or
any of its Subsidiaries) are bound.

<PAGE>


     4.3. Authority.  CCA has been and is duly authorized to execute and deliver
this Agreement,  the Additional Transaction Documents, the Management Agreement,
the Revolving Credit Agreement (as amended hereby) and the other instruments and
transactions  required or  contemplated  hereby and thereby,  and to perform its
obligations hereunder and thereunder.  The execution and delivery by CCA of this
Agreement,  the Additional Transaction Documents,  the Management Agreement, the
Revolving  Credit  Agreement (as amended  hereby) and the other  instruments and
transactions required or contemplated hereby and thereby, and the performance by
CCA of its  obligations  hereunder  and  thereunder do not and will not conflict
with any provision of the Certificate of  Incorporation or Bylaws of CCA (or any
of its  Subsidiaries)  as  amended  to  date.  This  Agreement,  the  Additional
Transaction Documents,  the Management Agreement, the Revolving Credit Agreement
(as  amended  hereby) and the other  instruments  and  transactions  required or
contemplated hereby and thereby,  when duly executed and delivered,  will be the
legal, valid and binding obligation of CCA enforceable  against it in accordance
with its and their terms,  subject, as to enforcement of remedies, to applicable
bankruptcy,  insolvency,  moratorium,  reorganization and similar laws affecting
creditors  rights  generally.  Upon execution of this  Agreement,  CCA will have
received the full purchase price or other  consideration  to be paid or given by
IHS for the Warrants, as evidenced by the execution and delivery of the Warrants
by CCA.

     4.4 Legal Proceedings.  There are no claims,  actions, suits or proceedings
or  arbitrations,  either  administrative  or  judicial,  pending,  or,  to  the
knowledge of CCA, overtly  threatened against or affecting CCA, its subsidiaries
or  affiliates,   affecting   CCA's  ability  to  consummate  the   transactions
contemplated  herein or, except as may be set forth in reports filed by CCA with
the  Securities  and Exchange  Commission  ("SEC"),  of a nature  required to be
disclosed in reports filed with the SEC.

     4.5. Consents. No authorization,  consent, approval, license, exemption by,
filing or registration  with any court or governmental  department,  commission,
board,  bureau,  agency or  instrumentality,  domestic or foreign, is or will be
necessary in connection  with the  execution,  delivery and  performance of this
Agreement by CCA other than any notice filing that is permitted to be made after
the event that  causes  such  filing to be made.  CCA will  timely make all such
notice filings.

     4.6.  Capitalization.  The authorized  capital stock of CCA consists of the
following:

     (a) Common Stock. A total of 15,000,000  authorized shares of Common Stock,
$.0025 par value, of which [7,597,801] shares are issued and outstanding.

     (b) Preferred Stock. A total of authorized  shares of Preferred Stock, none
of which is issued and outstanding.

     (c) Options,  Warrants,  Reserved Shares.  CCA will provide IHS within five
business  days  of the  Effective  Date a list of each  stock  option,  warrant,
convertible  security or other rights to acquire its Common Stock outstanding as
of the Effective  Date.  Except as disclosed in its filings under the Securities
Exchange Act of 1934, as amended (the  "Exchange  Act"),  CCA has no obligation,
contingent or otherwise,  to repurchase  any shares of Common Stock,  whether or
not currently outstanding.

     4.7. Disclosure.  No representation or warranty by CCA in this Agreement or
in any statement or certificate  signed by any officer of CCA furnished or to be
furnished to IHS pursuant to this Agreement  contains or will contain any untrue
statement of a material  fact or omits or will omit to state any  material  fact
required  to be stated  therein  or  necessary  in order to make the  statements
therein,  in light of the  circumstances in which they are made, not misleading.
CCA's Form 10-K for the period ending December 31, 1995, filed on April 1, 1996;
Forms 10-Q for the periods  ending March 30, 1996,  June 31, 1996, and September
30, 1996; Forms 8-K filed on October 11, 1996, July 12, 1996, June 11, 1996, May
29, 1996 (as  amended on July 30,  1996) and May 2, 1996 (as amended on July 12,
1996),  and Proxy  Statement  dated May 10, 1996,  each  contained  all material
information  required to be stated  therein under the Exchange Act and the rules
and regulations thereunder, as applicable,  and as of their respective dates did
not contain any untrue statement of a material fact.

<PAGE>


     4.8. Registration Rights. CCA has not granted or agreed to grant any Person
any rights  inconsistent  with the rights granted under the Registration  Rights
Agreement.

     4.9 Reservation of Shares.  CCA hereby represents and covenants that it has
reserved and at all times there shall be reserved  for issuance  such number and
type of  securities  as the holders of the Warrants are entitled to receive upon
exercise  thereof.  Prior  to the  issuance  of any  equity  securities  (or any
instrument  exercisable for or convertible into equity  securities) and whenever
otherwise  required to satisfy this Section 4.9, CCA will amend its  Certificate
of  Incorporation  to the extent  necessary to ensure that there is reserved for
issuance  a  sufficient  number  and type of  securities  as the  holders of the
Warrants are entitled to receive upon exercise thereof.

     4.10 Press  Release.  CCA shall issue a press release on the Effective Date
in the form attached hereto as Exhibit 4.

5.  REPRESENTATIONS  AND WARRANTIES OF  IHS.9.REPRESENTATIONS  AND WARRANTIES OF
IHS. IHS represents and warrants to CCA as follows:

     5.1. Purchase for Own Account;  Investment  Intent.  The Warrants are being
acquired for IHS's own account,  not as a nominee or agent,  and not with a view
to or in connection  with the sale or  distribution  of any part thereof,  other
than pursuant to a transaction, or series of transactions,  registered or exempt
from registration under the Securities Act.

6. INFORMATION & INSPECTION RIGHTS.14.INFORMATION & INSPECTION RIGHTS.

     6.1.  Information  Rights.  Prior to the expiration or full exercise of the
Warrants, CCA shall deliver to IHS and any other Registered Holder (as such term
is defined in the Warrants) of the Warrants copies of CCA's Forms 10-K, 10-Q and
8-K and CCA's Annual  Reports to  Stockholders  and definitive  proxy  statement
promptly after such documents are filed with the SEC.

     6.2  Inspection  Rights.  Prior to the  expiration  or full exercise of the
Warrants,  IHS and any person  IHS may  designate  as agent  shall have the same
right as a stockholder  to review all books and records,  reports,  accounts and
other  financial  documents  of CCA and to copy the  same  and to make  excerpts
therefrom,  all at such  reasonable  times  and as often  as IHS may  reasonably
request,  upon prior  written  notice to CCA, so long as such review and copying
does not  unreasonably  interfere with the business of CCA and IHS and its agent
agree to keep confidential,  and not disclose,  except as may be required by law
or court order, any information obtained during such review of a confidential or
proprietary  nature (and not  otherwise  known to IHS through  other  sources or
publicly known).

7. MISCELLANEOUS.17.MISCELLANEOUS.

     7.1. Governing Law. This Agreement shall be governed in all respects by and
construed in accordance with the laws of the State of Delaware without regard to
provisions regarding choice of laws.

     7.2. Survival.  The representations,  warranties,  covenants and agreements
made herein  shall  survive any  investigation  made by any party hereto and the
closing of the transactions contemplated hereby.

     7.3. Successors and Assigns. Except as otherwise expressly provided herein,
the  provisions  hereof shall inure to the benefit of, and be binding upon,  the
successors,  assigns,  heirs, executors and administrators of the parties hereto
whose  rights or  obligations  hereunder  are affected by such  amendments.  Any
assignment  or  transfer  of the  Warrants  shall be  governed  by the terms and
conditions  set forth  therein.  This  Agreement and the rights and  obligations
therein may not be assigned by CCA without the advance written consent of IHS.

<PAGE>

     7.4. Notices.  Except as may be otherwise  provided herein, all notices and
other  communications  required or permitted  hereunder  shall be in writing and
shall be conclusively  deemed to have been duly given (a) when hand delivered to
the other party;  (b) when  received  when sent by facsimile to number set forth
below (provided, however, that notices given by facsimile shall not be effective
unless either (i) a duplicate copy of such facsimile notice is promptly given by
one of the other methods described in this Section,  or (ii) the receiving party
delivers a written  confirmation  of receipt for such notice either by facsimile
or any other method  described in this  Section;  and (c) the next  business day
after  deposit with a national  overnight  delivery  service,  postage  prepaid,
addressed  to the  parties as set forth  below with  next-business-day  delivery
guaranteed,  provided that the sending party receives a confirmation of delivery
from the delivery service provider.

        To: IHS                                     To: CCA

     Integrated Health Services, Inc.          Community Care of America, Inc.
     10065 Red Run Boulevard                   3050 N. Horseshoe Drive
     Owings Mills, MD  21117                   Naples, FL  33942
     Fax:  410-998-8747                        Fax:  941-435-0087
     Attn.  Marshall A. Elkins, Esq.           Attn:  Gary Singleton, President

A party may  change or  supplement  the  addresses  given  above,  or  designate
additional  addresses,  for  purposes of this  Section by giving the other party
written notice of the new address in the manner set forth above.

     7.5.  Amendments.  Any term of this  Agreement may be amended only with the
written consent of CCA and IHS.

     7.6. Delays or Omissions. No delay or omission to exercise any right, power
or remedy  accruing  to CCA or to IHS,  upon any  breach or default of any party
hereto under this Agreement, shall impair any such right, power or remedy of CCA
or IHS,  nor shall it be construed to be a waiver of any such breach or default,
or an  acquiescence  therein,  or of any  similar  breach or default  thereafter
occurring;  nor shall any waiver of any other breach or default  theretofore  or
thereafter  occurring.  Any waiver,  permit,  consent or approval of any kind or
character  on the  part  of CCA or IHS of  any  breach  or  default  under  this
Agreement  and  any  waiver  on the  part  of CCA  or IHS of any  provisions  or
conditions of this Agreement,  must be in writing and shall be effective only to
the extent  specifically set forth in such writing.  All remedies,  either under
this  Agreement,  or by law or  otherwise,  afforded  to  CCA  or IHS  shall  be
cumulative and not alternative.

     7.7.  Finder's  Fees.  Each party hereby  agrees to  indemnify  and to hold
harmless  the  other  party  hereto  from  and  against  any  liability  for any
commission or compensation in the nature of a finder's fee claimed by any broker
or other person or firm (and the costs and  expenses of  defending  against such
liability or asserted  liability) for which the indemnifying party or any of its
employees or representatives are responsible.

     7.8.  Titles and Subtitles.  The titles of the Sections and  subsections of
this  Agreement  are  for  convenience  of  reference  only  and  are  not to be
considered in construing this Agreement.

<PAGE>

     7.9.  Counterparts.  This  Agreement  may  be  executed  in any  number  of
counterparts,  each of which  shall be an  original,  but all of which  together
shall constitute one instrument.

     7.10. Severability. Should any provision of this Agreement be determined to
be illegal or unenforceable,  such determination  shall not affect the remaining
provisions of this Agreement.

     7.11. Public  Disclosure.  Each party hereto agrees that neither it nor its
Affiliates  shall make any public  statement or issue any press release relating
to this  Agreement,  the Additional  Transaction  Documents or the  transactions
contemplated  hereby or thereby,  without the prior  consent and approval of the
other party,  unless such party  determines  that such disclosure is required by
law, in which case a copy of the  disclosure  shall  provided to the other party
for review and comment a reasonable time prior to public disclosure.

     IN WITNESS  WHEREOF,  the parties have  executed  this Warrant  Acquisition
Agreement to be effective as of the date first above written.



INTEGRATED HEALTH SERVICES, INC.            COMMUNITY CARE OF AMERICA, INC

By:                                         By:    

Name:                                       Name:
                 
Title:                                      Title:



                                     







<PAGE>



                                              


Warrant No. A-1                                            ___________ Shares

            No sale, offer or transfer of this warrant shall be made
            unless a registration statement under the Securities Act
                    of 1933, as amended, with respect to such
                      transaction is then in effect or such
                             transfer is exempt from
                          registration under such Act.

                                     Warrant
                     To Subscribe for and Purchase Shares of
                                 Common Stock of

                         COMMUNITY CARE OF AMERICA, INC.

         This certifies that, for value received,  Integrated  Health  Services,
Inc., a Delaware  corporation  (the  "Holder")  or its  registered  assigns,  is
entitled,  subject to the terms and  conditions of this Warrant,  at any time or
from time to time at or after the time the  Purchase  Price (as defined  herein)
has been established (the  "Commencement  Date") and at or before 5:00 P.M., New
York time,  on January 13, 1999 (the  "Expiration  Date"),  to subscribe for and
purchase an aggregate of _____________ (_________) fully paid and non-assessable
shares of the common stock, $.0025 par value ("Common Stock"), of Community Care
of America,  Inc. (the  "Company"),  at the Purchase Price (as defined  herein),
upon  surrender of this Warrant and payment of the Purchase Price to the Company
at the  address  set forth  herein for  notices to the  Company or at such other
place as the Company may designate by written notice to the  Registered  Holder.
The number of shares of Common Stock  issuable upon exercise of this Warrant and
the Purchase Price are subject to adjustment and change as provided  herein (any
reference  hereinafter  to  Purchase  Price  shall  mean the  Purchase  Price as
adjusted pursuant the terms of this Warrant). This Warrant is issued pursuant to
that certain Warrant Acquisition Agreement, dated of even date herewith, between
the Company and the Holder (the "Purchase Agreement").


     1.Certain Definitions.

     As used in this  Warrant  the  following  terms  shall  have the  following
respective meanings:






<PAGE>




     "Common Stock Deemed  Outstanding"  means, at any given time, the number of
shares of Common Stock  actually  outstanding  at such time,  plus the number of
shares of Common Stock deemed to be outstanding  pursuant to Sections 4.1(i) and
4.1(ii) hereof  regardless of whether the Options or Convertible  Securities are
actually  exercisable  at such time,  but  excluding  any shares of Common Stock
issuable upon exercise of the IHS Warrants.  "Convertible Securities" shall mean
any stock or securities directly or indirectly convertible into Common Stock.

     "IHS Warrants"  shall mean this Warrant and Warrant No. W-2,  issued to the
Holder on even date  herewith,  and any warrants  delivered in  substitution  or
exchange therefor as provided herein and therein.

     "Market  Price" as to any  security on any day shall mean the closing  sale
price of such  security as reported  for such day  pursuant to the  consolidated
quotation  system or any other  transaction  reporting plan under Section 11A of
the  Securities  Exchange Act of 1934, as amended (the "Exchange  Act"),  or, if
there have been no sales so reported  for such day,  the average of the best bid
and best offer prices  quoted  under the  consolidated  quotation  system or any
other such  transaction  reporting  plan as of 4:00 P.M., New York time, on such
day, or, if on any day such  security is not so quoted,  the average of the best
bid and best offered prices on such day in the domestic  over-the-counter market
as reported by any electronic  communications  network,  as such term is used in
Rule  11Ac1-1(a)(8)  under the Exchange Act or by the National Quotation Bureau,
Incorporated,  or any similar  successor or comparable  organization.  If at any
time such security is not listed on any domestic  securities  exchange or quoted
under a transaction reporting plan or in the domestic  over-the-counter  market,
the "Market  Price" shall be the fair value  thereof  determined  jointly by the
Company and the Registered Holders;  provided that if such parties are unable to
reach agreement as to the Market Price,  the Market Price shall be determined by
appraisal  as set forth in Section  12 of this  Warrant.

     "Note"  shall mean the  Subordinated  Note,  dated as of December 27, 1996,
executed by the Company  pursuant to that certain  Revolving  Credit  Agreement,
dated as of December 27, 1996, between the Company and the Holder.

     "Options"  means any  rights,  warrants  or  options  to  subscribe  for or
purchase Common Stock or Convertible Securities.


     "Person"  shall mean any natural person and any  corporation,  partnership,
limited  liability  company,  limited  liability  partnership,   joint  venture,
association,  joint-stock  partnership,  trust,  unincorporated  organization or
government or other agency or political subdivision thereof.

     "Purchase Price" shall mean the price per share equal to the average of the
high and low  trading  price of the Common  Stock  reported  in The Wall  Street
Journal, Eastern edition, for the first two full trading days following the Date
of Issuance (as such term is defined in Section 7.2 hereof) of this Warrant,  as
such price may be adjusted from time to time pursuant to Section 4 hereof.

     "Registered  Holder"  shall mean any  Person in whose name this  Warrant is
registered upon the books and records maintained by the Company.

     "Subsidiary"  shall  mean,  with  respect to any Person,  any  corporation,
limited liability company, partnership,  association or other business entity of
which (i) if a  corporation,  a majority of the total  voting power of shares of
stock entitled  (without regard to the occurrence of any contingency) to vote in
the election of directors,  managers or trustees thereof is at the time owned or
controlled,  directly or indirectly,  by that Person or one or more of the other
Subsidiaries  of that  Person  or a  combination  thereof,  or (ii) if a limited
liability company, partnership, association or other business entity, a majority
of the partnership or other similar  ownership  interest  thereof is at the time
owned or  controlled,  directly  or  indirectly,  by that  Person or one or more
Subsidiaries of that Person or a combination  thereof.  For purposes  hereof,  a
Person or Persons  shall be deemed to have a majority  ownership  interest  in a
limited liability company, partnership,  association or other business entity if
such  Person or  Persons  shall be  allocated  a majority  of limited  liability
company,  partnership,  association or other business  entity gains or losses or
shall be or control any  managing  director or general  partner of such  limited
liability   company,   partnership,   association  or  other  business   entity.

     "Underlying  Common Stock" shall mean (i) the shares of Common Stock issued
or issuable  upon  exercise of the Warrant and (ii) any Common  Stock  issued or
issuable with respect to the  securities  referred to in clause (i) above by way
of stock dividend or stock split or in connection  with a combination of shares,
recapitalization,  merger,  consolidation or other reorganization.

     "Warrant"  as used  herein,  shall  include  this  Warrant  and any warrant
delivered in substitution or exchange therefor as provided herein.

     2. Exercise.

     2.1 Exercise  Period.  The Warrant shall be exercisable in whole or in part
from and after 9:00 A.M., New York time, on the Commencement Date.

     2.2 Exercise Procedure.

     (i) This Warrant  shall be deemed to have been  exercised  when the Company
has received all of the following items:

     (a) an  Election  to  Purchase  in the form  attached  hereto as Exhibit A,
properly  completed and executed by the Person (the "Purchaser")  exercising all
or part of the purchase rights represented by this Warrant;

     (b) this Warrant;

     (c) if this  Warrant is not  registered  in the name of the  Purchaser,  an
Assignment or Assignments  in the form set forth in Exhibit B hereto  evidencing
the  assignment of this Warrant to the  Purchaser,  in which case the Registered
Holder shall have complied with the  provisions set forth in Section 7.1 hereof;
and

     (d) either (1) a check or wire transfer payable to the Company in an amount
equal to the product of the Purchase Price multiplied by the number of shares of
Common  Stock  being  purchased  upon such  exercise  (the  "Aggregate  Exercise
Price"),  (2) a written  notice to the Company that the  Purchaser is exercising
the Warrant (or a portion  thereof) by authorizing  the Company to withhold from
issuance a number of shares of Common Stock  issuable  upon such exercise of the
Warrant  which when  multiplied  by the Market Price of Common Stock is equal to
the Aggregate  Exercise Price (and such withheld shares of Common Stock shall no
longer be issuable under this  Warrant),  or (3) if the Holder holds the Note, a
written  notice to the Company that the Holder is  exercising  the Warrant (or a
portion thereof) by authorizing the Company to withhold and apply such amount of
principal  or accrued but unpaid  interest  under the Note  (whether or not then
due) as is equal to the Aggregate  Purchase  Price (and such amount of principal
or accrued and unpaid  interest under the Note shall no longer be payable to the
Holder).

         (ii) Certificates for shares of Common Stock purchased upon exercise of
this Warrant shall be delivered by the Company to the Purchaser within three (3)
business days after the date of the exercise,  together with cash in lieu of any
fraction of a share of Common Stock that would be issuable upon such exercise in
an amount equal to the Market Price of such  fractional  share as of the date of
exercise. No fractional shares of Common Stock or scrip representing  fractional
shares of Common Stock shall be issued upon an exercise of this Warrant.  Unless
this Warrant has expired or all of the purchase rights  represented  hereby have
been exercised, the Company shall prepare a new Warrant, substantially identical
hereto,  representing the rights formerly represented by this Warrant which have
not  expired or been  exercised  and shall  within such three (3)  business  day
period deliver such new Warrant to the Purchaser.

     (iii) The shares of Common Stock issuable upon the exercise of this Warrant
shall be deemed to have been issued to the  Purchaser  at the time of  exercise,
and the  Purchaser  shall be deemed for all  purposes  to have become the record
holder of such Common Stock at such time.

     (iv) The Company  shall not close its books  against  the  transfer of this
Warrant or of any share of Common Stock issued or issuable  upon the exercise of
this Warrant in any manner  which  interferes  with the timely  exercise of this
Warrant.  The  Company  shall  from time to time take all such  action as may be
necessary  to assure that the par value per share of the  unissued  Common Stock
acquirable  upon  exercise of this Warrant is at all times equal to or less than
the Purchase Price then in effect.

     (v) The Company shall assist and cooperate  with any  Registered  Holder or
Purchaser to make any governmental filings or obtain any governmental  approvals
required prior to or in connection with any exercise of this Warrant (including,
without limitation,  making at the Company's own expense any filings required to
be made by the Company).

     3. Expiration Date.

     The Warrant  evidenced hereby may not be exercise after 5:00 P.M., New York
time, on the  Expiration  Date with respect to the shares of the Common Stock as
to which the Warrant may be  exercised  and, to the extent not  exercised by the
Expiration Date, the Warrant evidenced hereby shall become void.

     4. Adjustments.

     Subject to the  provisions  of this Section 4, the  Purchase  Price and the
number of shares of the Common  Stock as to which the Warrant  may be  exercised
shall be subject to adjustment from time to time as hereinafter set forth:

     4.1 Effect on Purchase Price and Number of Shares of Certain Events. If and
whenever on or after the  Commencement  Date, the Company issues or sells, or in
accordance  with this Section 4.1 is deemed to have issued or sold, any share of
Common  Stock for a  consideration  per share  less than the  Purchase  Price in
effect  immediately  prior to such time, then  immediately upon such issuance or
sale the Purchase  Price shall be reduced  pursuant to this Section 4.1 to a new
Purchase Price  determined by dividing (A) the sum of (x) the product derived by
multiplying the Purchase Price in effect immediately prior to such issue or sale
times the number of shares of Common Stock Deemed Outstanding  immediately prior
to such  issue or sale,  plus (y) the  consideration,  if any,  received  by the
Company  upon such issue or sale,  by (B) the  number of shares of Common  Stock
Deemed  Outstanding  immediately  after  such  issue or  sale.  Upon  each  such
adjustment of the Purchase Price,  the number of shares of Common Stock issuable
upon the  exercise  of this  Warrant (to the extent not  theretofore  exercised)
shall be  increased to a number  determined  by  multiplying  the number of such
shares so purchasable  immediately  prior to such adjustment by a fraction,  the
numerator of which shall be the Purchase  Price in effect  immediately  prior to
such  adjustment  and the  denominator  of which shall be the Purchase  Price in
effect  immediately  after such  adjustment.  For  purposes of  determining  the
Purchase  Price as adjusted  under this  Section  4.1,  the  following  shall be
applicable:

     (i) Issuance of Rights or Options. If on or after the Commencement Date the
Company  in any manner  issues,  grants or sells any  Options  and the price per
share for which a share of Common  Stock is  issuable  upon the  exercise of any
such Option, or upon conversion or exchange of any Convertible Security issuable
upon  exercise  of such  Option,  is less  than the  Purchase  Price  in  effect
immediately  prior to the time of the granting or sale of such Option,  then the
total  maximum  number of shares of Common Stock  issuable  upon the exercise of
such Options,  or upon  conversion  or exchange of the total maximum  amounts of
such Convertible Securities issuable upon the exercise of such Options, shall be
deemed to be  outstanding  for purposes of  determining  the Common Stock Deemed
Outstanding  and to have been  issued  and sold by the  Company at such time for
such price per share. For purposes of this Section 4.1(i),  the "price per share
for which a share of Common Stock is issuable"  shall be equal to the sum of the
amount of  consideration  (if any)  received or  receivable  by the Company with
respect  to the  issuance,  grant  or sale of the  Option,  plus the  amount  of
consideration  (if any) that would be received by the  Company  with  respect to
exercise  of the Option in full plus the amount of  consideration  (if any) that
would be received by the Company with respect to  conversion or exchange in full
of any Convertible  Security issuable upon exercise of such Option,  all divided
by the total  number of shares of Common  Stock  issuable  upon  exercise of the
Option and  conversion  or  exchange  of the  Convertible  Security.  No further
adjustment  of the  Purchase  Price shall be made upon the actual  issue of such
Common Stock or of such  Convertible  Security upon the exercise of such Options
or upon the actual  issue of such Common  Stock upon  conversion  or exchange of
such Convertible Security.

     (ii) Issuance of Convertible  Securities.  If on or after the  Commencement
Date the Company in any manner issues,  grants or sells any Convertible Security
and the price per share  for  which a share of  Common  Stock is  issuable  upon
conversion  or  exchange  thereof  is less  than the  Purchase  Price in  effect
immediately  prior to the time of such issue or sale, then the maximum number of
shares of Common Stock issuable upon conversion or exchange of such  Convertible
Securities  shall be deemed to be outstanding  for purposes of  determining  the
Common Stock Deemed  Outstanding and to have been issued and sold by the Company
at such time for such price per share. For the purposes of this Section 4.1(ii),
the "price  per share for which a share of Common  Stock is  issuable"  shall be
equal to the sum of the amount of consideration  (if any) received or receivable
by the Company with respect to the  issuance,  grant or sale of the  Convertible
Security plus the amount of consideration (if any) that would be received by the
Company with respect to the conversion or exchange of such Convertible  Security
in full, all divided by the total number of shares of Common Stock issuable upon
conversion or exchange of the Convertible Security. No further adjustment of the
Purchase  Price shall be made upon the actual  issue of such  Common  Stock upon
conversion  or exchange of any  Convertible  Security,  and if any such issue or
sale of such Convertible Security is made upon exercise of any Options for which
adjustments  of the Purchase  Price has been or is to be made  pursuant to other
provisions of this Section 4, no further  adjustment of the Purchase Price shall
be made under this Section 4.1(ii) by reason of such issue or sale.

     (iii)  Change in  Option  Price or  Conversion  Rate.  If the  amount to be
received by the Company upon the exercise of any Options  outstanding  as of the
Commencement  Date,  the  additional  consideration,  if any,  payable  upon the
issuance, conversion or exchange of any Convertible Securities outstanding as of
the  Commencement  Date,  or  the  rate  at  which  any  Convertible  Securities
outstanding as of the Commencement Date are convertible into or exchangeable for
Common Stock changes at any time after the  Commencement  Date, then such Option
or  Convertible  Security and the Common Stock deemed  issuable  upon  exercise,
conversion or exchange  thereof shall be deemed for purposes of this Section 4.1
to have been  issued,  granted  or sold as of the date of such  changes  and the
Purchase  Price  shall be adjusted as  provided  herein;  provided  that no such
change shall at any time cause the Purchase Price hereunder to be increased.

     (iv) Treatment of Expired Options and Unexercised  Convertible  Securities.
Upon the expiration of any Option described in Section 4.1(i) or the termination
of any right to convert or exchange  any  Convertible  Securities  described  in
Section  4.1(ii)  without the exercise or conversion in whole or in part of such
Option or Convertible Security, the Purchase Price then in effect and the number
of shares of Common Stock issuable  hereunder  shall be adjusted  immediately to
the  Purchase  Price and the number of shares of Common  Stock  which would have
been in effect at the time of such  expiration or termination had such Option or
Convertible  Securities,  never been issued,  granted or sold;  provided that if
such expiration or termination would result in an increase in the Purchase Price
then in effect,  such  increase  shall not be  effective  until thirty (30) days
after  written  notice  thereof  has been given to the  Registered  Holder.  For
purposes of this Section 4.1, the  expiration  or  termination  of any Option or
Convertible Security which was outstanding as of the Commencement Date shall not
cause the Purchase Price hereunder to be adjusted unless, and only to the extent
that, a change in the term of such Option or Convertible  Security  caused it to
be deemed to have been issued after the  Commencement  Date  pursuant to Section
4.1(iii).

     (v) Calculation of Consideration  Received. If any Common Stock, Options or
Convertible  Securities are issued or sold or deemed to have been issued or sold
for cash,  the  consideration  received  therefor  shall be deemed to be the net
amount received by the Company  therefor.  In case any Common Stock,  Options or
Convertible  Securities are issued or sold for a consideration  other than cash,
the amount of the consideration other than cash received by the Company shall be
the fair value of such consideration,  except where such consideration  consists
of securities, in which case the amount of consideration received by the Company
shall be the Market Price thereof as of the date of receipt.  In case any Common
Stock,  Options  or  Convertible  Securities  are  issued  to the  owners of the
non-surviving  entity in connection  with any merger in which the Company is the
surviving  corporation,  the amount of consideration therefor shall be deemed to
be the  fair  value  of such  portion  of the net  assets  and  business  of the
non-surviving  entity  as is  attributable  to such  Common  Stock,  Options  or
Convertible Securities,  as the case may be. The fair value of any consideration
other than cash or securities shall be determined jointly by the Company and the
Registered  Holder.  If such  parties are unable to reach  agreement,  such fair
value shall be determined by appraisal pursuant to Section 12.

     (vi)  Integrated  Transactions.  In case any Option is issued in connection
with the issue or sale of other securities of the Company,  together  comprising
one integrated  transaction in which no specific  consideration  is allocated to
such Options by the parties  thereto,  the Options  shall be deemed to have been
issued without consideration.

     (vii) Each Series a Separate  Security.  In case an  agreement  relating to
Options or Convertible  Securities  provides that more than one Purchase  Price,
conversion or exchange  provisions  are  applicable to the  securities  issuable
thereunder,  then the  securities  subject  to each  different  exercise  price,
conversion  or  exchange  provisions  shall be deemed to be subject to  separate
Options or Convertible Securities for purposes of applying this Section 4.1.

     (viii) Treasury Shares. The Common Stock outstanding at any given time does
not  include  shares  owned or held by or for the  account of the Company or any
Subsidiary,  and the  disposition  of any  shares  so  owned  or held  shall  be
considered an issue or sale of Common Stock.

     (ix) Record  Date.  If the Company  takes a record of the holders of Common
Stock for the  purpose of  entitling  them (A) to  receive a  dividend  or other
distribution  payable in Common Stock,  Options or in Convertible  Securities or
(B)  to  subscribe  for  or  purchase  Common  Stock,   Options  or  Convertible
Securities, then such record date shall be deemed to be the date of the issue or
sale of the shares of Common  Stock  deemed to have been issued or sold upon the
declaration  of such  dividend or the making of such other  distribution  or the
date of the granting of such right of subscription or purchase,  as the case may
be.

     4.2  Subdivision or Combination of Common Stock. If the Company at any time
subdivides (by any stock split, stock dividend,  recapitalization  or otherwise)
one or more  classes of its  outstanding  shares of Common  Stock into a greater
number  of  shares,  the  Purchase  Price in  effect  immediately  prior to such
subdivision shall be proportionately  reduced and the number of shares of Common
Stock  obtainable  upon exercise of this Warrant (to the extent not  theretofore
exercised)  shall  be  proportionally  increased.  If the  Company  at any  time
combines  (by  reverse  stock  split or  otherwise)  one or more  classes of its
outstanding shares of Common Stock into a smaller number of shares, the Purchase
Price  shall be  proportionately  increased  and the  number of shares of Common
Stock  issuable  upon  exercise of this  Warrant (to the extent not  theretofore
exercised) shall be proportionally decreased.

     4.3 Reorganization,  Reclassification,  Consolidation,  Merger or Sale. Any
recapitalization,  reorganization,  reclassification,  spin-off,  consolidation,
merger,  sale or distribution of the Company's assets or other  transaction,  in
each case which is effected  in such a way that the holders of Common  Stock are
entitled to receive  (either  directly or upon  subsequent  liquidation)  stock,
securities or assets with respect to or in exchange for Common Stock is referred
to herein as "Organic  Change." Prior to the consummation of any Organic Change,
the Company shall make appropriate provision (in form and substance satisfactory
to the Registered  Holders) to insure that each of the Registered  Holders shall
thereafter  have the right to acquire and receive,  in lieu of or in addition to
(as  the  case  may be) the  shares  of  Common  Stock  immediately  theretofore
acquirable  and  receivable  upon the exercise of such  Warrant,  such shares of
stock,  securities  or assets as may be issued or payable  with respect to or in
exchange  for the  number  of shares of  Common  Stock  immediately  theretofore
issuable upon  exercise of the Warrant had such Organic  Change not taken place.
In any such case,  the Company  shall make  appropriate  provision  (in form and
substance  satisfactory to the Registered Holders) with respect to such Holders'
rights and interests to insure that the  provisions of this Section 4, Section 5
and Section 6 hereof shall  thereafter be applicable to the Warrant  (including,
in the case of any such  consolidation,  merger or sale in which  the  successor
entity or purchasing entity is other than the Company, an immediate reduction in
the Purchase  Price to the value of the Common  Stock  reflected by the terms of
such consolidation,  merger or sale, and a corresponding immediate adjustment in
the number of shares of Common Stock  issuable upon exercise of this Warrant (to
the extent not  theretofore  exercised),  if the value so reflected is less than
the Purchase Price in effect immediately prior to such consolidation,  merger or
sale). The Company shall not effect any such spin-off, consolidation,  merger or
sale, unless prior to the consummation  thereof,  the successor entity (if other
than the Company) resulting from spin-off, consolidation or merger or the entity
purchasing  such assets  assumes by written  instrument  (in form and  substance
satisfactory to the Registered Holders),  the obligation to deliver to each such
holder such shares of stock,  securities  or assets as, in  accordance  with the
foregoing provisions, such holder may be entitled to acquire.

     4.4 Certain  Events.  If any event occurs of the type  contemplated  by the
provisions of this Section 4 but not expressly  provided for by such  provisions
(including,  without  limitation,  the  granting of stock  appreciation  rights,
phantom  stock  rights or other  rights  with equity  features  or  equity-based
valuation or any  dividend or  distribution  of the capital  stock issued by any
Person other than the Company), then the Company's Board of Directors shall make
an  appropriate  adjustment  in the  Purchase  Price  and the  number  of shares
issuable upon exercise of this Warrant (to the extent not theretofore exercised)
so as to protect the rights of the  Registered  Holders;  provided  that no such
adjustment shall increase the Purchase Price as otherwise determined pursuant to
this Section 4.

     4.5 Calculation of Purchase Price; Notices.

     (i) All  calculations  of the Purchase  Price under this Section 4 shall be
computed to the nearest One-Thousandth (1/1000th) of a cent.

     (ii)  Immediately  upon any adjustment of the Purchase  Price,  the Company
shall give written  notice thereof to the  Registered  Holder,  setting forth in
reasonable  detail and certifying the calculation of such  adjustment,  provided
however,  that  such  notice  shall not be  deemed  to be  conclusive  as to the
Purchase Price calculation. At the request of the Registered Holder, the Company
shall certify the Purchase Price of and the number of shares for which a Warrant
at the time may be exercised.

     (iii) The Company  shall give written  notice to the  Registered  Holder at
least  thirty (30) days prior to the date on which the Company  closes its books
or takes a record (A) with  respect to any  subdivision  or  combination  of the
Common  Stock  that  is  subject  to  Section  4.2,  or any  other  dividend  or
distribution   upon  the  Common  Stock,  (B)  with  respect  to  any  pro  rata
subscription  offer to holders of Common Stock or (C) for determining  rights to
vote with respect to any Organic Change, dissolution or liquidation.

     (iv) The Company shall also give written notice to the Registered Holder at
least  thirty  (30)  days  prior  to the  date  on  which  any  Organic  Change,
dissolution or liquidation shall take place.

     4.6 Excluded Transactions. The provisions of this Section 4 shall not apply
to the exercise of the IHS Warrants.

     4.7 Expression of Purchase Price and Number of Shares.  Irrespective of any
adjustments or change in the Purchase Price or the number of securities actually
purchasable  under the Warrant,  the Warrants  theretofore and thereafter issued
may  continue  to  express  the  purchase  price and the  number  of  securities
purchasable  thereunder  as the  Purchase  Price and the  number  of  securities
purchasable were expressed in the Warrant when initially issued.

     5. No  Rights or  Liabilities  as  Stockholders  and  Notice to  Registered
Holder.

     Nothing  contained  herein  shall  be  construed  as  conferring  upon  the
Registered  Holder the right to vote or to  consent  or to  receive  notice as a
stockholder  in respect of the  meetings  of  stockholders  for the  election of
directors of the Company or any other matter,  or any other rights whatsoever as
a stockholder of the Company; provided, however, that in the event that:

     (a) the Company  shall take a record of the holders of its Common  Stock or
other  stock or  securities  for the  purpose of  entitling  them to receive any
dividend or other  distribution,  or any right to subscribe  for or purchase any
shares of stock of any class or any other  securities  or to  receive  any other
right;

     (b) the Company shall take action to accomplish any capital reorganization,
or  reclassification  of the capital stock of the Company, or a consolidation or
merger of the Company into, or a sale of all or substantially  all of its assets
to, another corporation;

     (c) the  Company  shall  take  action to redeem  or  convert  any or all of
outstanding Common Stock or other stock or securities of the Company; or

     (d) the  Company  shall take  action  looking to a  voluntary  dissolution,
liquidation or winding up of the Company;

     then,  and in each such case,  the Company shall mail or cause to be mailed
to the Registered  Holder of this Warrant a notice  specifying,  as the case may
be,  (i) the date on  which a record  is to be  taken  for the  purpose  of such
dividend,  distribution or right, or (ii) the date on which such reorganization,
reclassification,   spin-off  consolidation,  merger,  conveyance,  dissolution,
liquidation,  winding-up,  redemption or  conversion  is to take place,  and the
time, if any, is to be fixed,  as of which the holders of record of Common Stock
or such other stock or securities  shall be entitled to exchange their shares of
Common Stock or such other stock or securities  for securities or other property
deliverable upon such reorganization,  reclassification,  consolidation, merger,
conveyance, dissolution, liquidation, winding-up, conversion or redemption. Such
notice  shall be  delivered  at least thirty (30) days prior to the date therein
specified.

     6. Duty to Register Common Stock.

     The shares of Common  Stock  issuable  under this  Warrant are subject to a
Registration Rights Agreement with the Company dated of even date herewith.

     7. Transfers and Exchanges.

     7.1 Warrant Transferable. Subject to the transfer conditions referred to in
the legend endorsed  hereon,  this Warrant and all rights  hereunder  (including
those  under the  Purchase  Agreement)  are  transferable,  in whole or in part,
without charge to the Registered  Holder,  upon surrender of this Warrant with a
properly executed  Assignment (in the form of Exhibit B hereto) at the principal
office of the Company.  The Company shall record on its books the  transferee as
the  Registered  Holder of the portion of this Warrant  transferred  pursuant to
this Section 7.1.

     7.2 Warrant  Exchangeable  for  Different  Denominations.  This  Warrant is
exchangeable,  upon  the  surrender  hereof  by  the  Registered  Holder  at the
principal office of the Company,  for new Warrants of like terms representing in
the aggregate the purchase rights hereunder, and each of such new Warrants shall
represent such portion of such rights as is designated by the Registered  Holder
at the time of such  surrender.  The  date the  Company  initially  issues  this
Warrant  shall be deemed to be the "Date of Issuance"  hereof  regardless of the
number of times new  certificates  representing  the unexpired  and  unexercised
rights  formerly  represented  by this  Warrant  shall be issued.  All  Warrants
representing  portions  of the rights  hereunder  are  referred to herein as the
"Warrants."

     8. Valid Issuance and Payment of Taxes.

     All shares of Common Stock  issued upon the exercise of this Warrant  shall
be validly issued, fully paid and non-assessable,  and the Company shall pay all
taxes and other governmental charges that may be imposed in respect of the issue
or delivery  thereof.  The Company shall not be required to pay any tax or other
charge imposed in connection  with any transfer  involved in the issuance of any
certificate  for  shares  of  Common  Stock in any name  other  than that of the
Registered  Holder of this  Warrant,  and in such case the Company  shall not be
required to issue or deliver any stock certificate or security until such tax or
other  charge has been  paid,  or it has been  established  that no tax or other
charge is due.

     9. Mutilated or Missing Warrants.

     In case any of the Warrants shall be mutilated,  lost, stolen or destroyed,
the Company shall issue and deliver in exchange and  substitution  for, and upon
cancellation of the mutilated  Warrant,  or in lieu of, and in substitution for,
the  Warrant  lost,  stolen  or  destroyed,  a new  Warrant  of like  tenor  and
representing  an  equivalent  right  or  interest,  but  only  upon  receipt  of
reasonable evidence of such loss, theft, or destruction of such Warrant.

     10. Reserve.

     The Company hereby represents and covenants that it has reserved and at all
times there shall be reserved for issuance such number and type of securities as
the  Registered  Holders  are  entitled  to  receive  upon  exercise  of the IHS
Warrants.  Prior to the  issuance of any equity  securities  (or any  instrument
exercisable for or convertible  into equity  securities) and whenever  otherwise
required to satisfy this Section 10, the Company will amend its  Certificate  of
Incorporation  to the extent  necessary  to ensure  that there is  reserved  for
issuance a sufficient number and type of securities as the Registered Holders of
the IHS  Warrants  are  entitled  to  receive  upon  exercise  thereof.  11.  No
Impairment.


     The Company will not, by amendment of its Certificate of  Incorporation  or
bylaws, or through reorganization,  consolidation, merger, dissolution, issue or
sale of securities,  sale of assets or any other voluntary action, avoid or seek
to avoid the observance or performance of any of the terms of this Warrant,  but
will at all times in good faith assist in the carrying out of all such terms and
in the taking of all such action as may be necessary or  appropriate in order to
protect  the  rights  of the  Registered  Holders  against  impairment.  Without
limiting the generality of the foregoing, the Company (a) shall not increase the
par  value of any  shares  issuable  upon  exercise  of this  Warrant  above the
Purchase  Price  and (b) will  take  all  such  action  as may be  necessary  or
appropriate  in order that the Company may validly and legally  issue fully paid
and non-assessable shares of Common Stock upon exercise of this Warrant.

     12. Appraisal.

     In case of any dispute as to valuation of a security under this  Agreement,
the fair value of such security shall be determined by an appraiser  without any
discount for liquidity or restrictions  under the Securities Act. This appraisal
process  shall be  instituted  within  fourteen  (14) days after a party to this
Agreement  notifies  the other  party of its  desire  to submit  the issue to an
appraiser.  In the  event  that,  within  seven  (7) days  after a party to this
Agreement  notifies  the other  party of its  desire  to submit  the issue to an
appraiser,  the parties do not agree on a single appraiser to determine the fair
value of such  security,  the fair value of such security  shall be  determined,
without any discount for liquidity or restrictions  under the Securities Act, by
the  majority  determination  of a panel of three  (3)  appraisers  who shall be
selected in the following manner: the Company shall select one (1) appraiser and
the Registered  Holder entitled to exercise this Warrant for the greatest number
of shares of Common Stock (in the event there shall be more than one  Registered
Holder),  on behalf  of all of the  Registered  Holders,  shall  select  one (1)
appraiser and the two (2) appraisers  selected by the Company and the Registered
Holder shall jointly select a third appraiser. The appraiser selected jointly by
the parties and, if applicable,  each member of the appraisal  panel shall be an
individual  who  personally  and  whose  Affiliates  shall  not have a  previous
business  relationship with either party. The appraiser and, if applicable,  the
appraisal panel shall endeavor to complete the appraisal as soon as practicable.
The  determination  of such appraiser and, if  applicable,  the appraisal  panel
shall be final and binding on the Company and the  Registered  Holders,  and the
fees and expenses of such  appraisal  shall be borne equally by the Company,  on
the one hand, and the Registered Holders, on the other.

     13. Notices.

Except as may be otherwise provided herein, all notices and other communications
required or permitted  hereunder  shall be in writing and shall be  conclusively
deemed to have been duly given (a) when hand  delivered to the other party,  (b)
when  received  when sent by  facsimile  to number  set forth  below  (provided,
however,  that notices given by facsimile  shall not be effective  unless either
(i) a duplicate  copy of such  facsimile  notice is promptly given by one of the
other methods described in this Section 13, or (ii) the receiving party delivers
a written  confirmation  of receipt for such notice  either by  facsimile or any
other method  described in this Section 13) and (c) the next  business day after
deposit with a national overnight delivery service,  postage prepaid,  addressed
to the parties as set forth below with  next-business-day  delivery  guaranteed,
provided that the sending  party  receives a  confirmation  of delivery from the
delivery service provider.

    To: the Registered Holder                   To: the Company

    Integrated Health Services, Inc.            Community Care of America, Inc.
    10065 Red Run Boulevard                     3050 North Horseshoe Drive
    Owings Mills, MD  21117                     Naples, FL  33942
    Fax No.:  (410) 998-8747                    Fax No.:  (941) 435-0087
    Attn:  Marshall A. Elkins, Esq.             Attn:  Gary Singleton, President

A party may  change or  supplement  the  addresses  given  above,  or  designate
additional addresses,  for purposes of this Section 13 by giving the other party
written notice of the new address in the manner set forth above.

     14. Headings.

     The headings in this Warrant are for purposes of  convenience  in reference
only, and shall not be deemed to constitute a part hereof.

     15. Governing Law.

     This  Warrant  shall be  construed  and enforced in  accordance  with,  and
governed  by,  the laws of the State of New York  without  regard to  provisions
regarding choice of laws.

     16. Severability.

     If any term, provision,  covenant or restriction of this Warrant is held by
a court of competent  jurisdiction  to be invalid,  void or  unenforceable,  the
remainder of the terms,  provisions,  covenants and restrictions of this Warrant
shall remain in full force and effect and shall in no way be affected,  impaired
or invalidated.

     17. No Inconsistent Agreements.

     The Company  will not on or after the date of this  Warrant  enter into any
agreement  which is  inconsistent  with the  rights  granted  to the  Registered
Holders of this Warrant or otherwise  conflicts with the provisions  hereof. The
Company hereby represents and warrants that the rights granted to the Registered
Holders  hereunder do not in any way conflict with and are not inconsistent with
the  rights  granted  to holders  of the  Company's  securities  under any other
agreements, except rights that have been waived.

     18. Saturdays, Sundays and Holidays.

     If the Expiration  Date falls on a Saturday,  Sunday or legal holiday,  the
Expiration  Date  shall  automatically  be  extended  until  5:00 p.m.  the next
business day.


     IN WITNESS WHEREOF, Community Care of America, Inc. has caused this Warrant
to be signed manually by a duly  authorized  officer of the Company on this 13th
day of January, 1997.

                                       COMMUNITY CARE OF AMERICA, INC
                                       
                                       By: 
                                       Name:
                                       Title:






<PAGE>



                                    EXHIBIT A


                              ELECTION TO PURCHASE

                      To: Community Care of America, Inc.
     
                      __________________________________
                      __________________________________
                      __________________________________

The undersigned hereby elects to exercise the Warrant  represented by the within
Warrant  Certificate to purchase  __________ shares of the Common Stock issuable
upon the exercise of the Warrant and requests that  certificates for such shares
shall be issued in the name of:



                                     (Name)



                                    (Address)



                                (Taxpayer number)

                              and be delivered to:



                                     (Name)

                                       at

                                    (Address)

         and, if said number of shares of the Common  Stock shall not be all the
shares of the Common Stock evidenced by the within Warrant  Certificate,  that a
new  Warrant  Certificate  for the  balance  remaining  of such  said  shares be
registered in the name of:



                                     (Name)



                                    (Address)



                                (Taxpayer number)

         and delivered to the undersigned at the address below stated.

         Dated:  _______________, 19__

         Name of holder of Warrant Certificate:



                                 (please print)



                                    (Address)



                                   (Signature)







<PAGE>


                                    EXHIBIT B

                                   ASSIGNMENT

                    (to be executed by the registered holder
                   to effect a transfer of the within Warrant)

                               FOR VALUE RECEIVED

                    hereby sells, assigns and transfers unto


                                     (Name)


                                    (Address)



the right to purchase  the  ________  shares of Common  Stock  evidenced by this
Warrant, and does hereby irrevocably constitute and appoint to transfer the said
right on the books of the Company, with full power of substitution.

                         Dated: _______________________

                                                     (Signature)



         /




<PAGE>



                                    EXHIBIT 2
                                SERIES B Warrant



Warrant No. B-1                                             ___________ Shares

            No sale, offer or transfer of this warrant shall be made
            unless a registration statement under the Securities Act
                    of 1933, as amended, with respect to such
                      transaction is then in effect or such
                             transfer is exempt from
                          registration under such Act.

                                     Warrant
                     To Subscribe for and Purchase Shares of
                                 Common Stock of

                         COMMUNITY CARE OF AMERICA, INC.

         This certifies that, for value received,  Integrated  Health  Services,
Inc., a Delaware  corporation  (the  "Holder")  or its  registered  assigns,  is
entitled,  subject to the terms and  conditions of this Warrant,  at any time or
from time to time at or after the time the  Purchase  Price (as defined  herein)
has been established (the  "Commencement  Date") and at or before 5:00 P.M., New
York time,  on January 13, 2002 (the  "Expiration  Date"),  to subscribe for and
purchase an aggregate of _____________ (_________) fully paid and non-assessable
shares of the common stock, $.0025 par value ("Common Stock"), of Community Care
of America,  Inc. (the  "Company"),  at the Purchase Price (as defined  herein),
upon  surrender of this Warrant and payment of the Purchase Price to the Company
at the  address  set forth  herein for  notices to the  Company or at such other
place as the Company may designate by written notice to the  Registered  Holder.
The number of shares of Common Stock  issuable upon exercise of this Warrant and
the Purchase Price are subject to adjustment and change as provided  herein (any
reference  hereinafter  to  Purchase  Price  shall  mean the  Purchase  Price as
adjusted pursuant the terms of this Warrant). This Warrant is issued pursuant to
that certain Warrant Acquisition Agreement, dated of even date herewith, between
the Company and the Holder (the "Purchase Agreement").


     1.Certain Definitions.

As used in this Warrant the following terms shall have the following  respective
meanings:





<PAGE>




     "Common Stock Deemed  Outstanding"  means, at any given time, the number of
shares of Common Stock  actually  outstanding  at such time,  plus the number of
shares of Common Stock deemed to be outstanding  pursuant to Sections 4.1(i) and
4.1(ii) hereof  regardless of whether the Options or Convertible  Securities are
actually  exercisable  at such time,  but  excluding  any shares of Common Stock
issuable upon exercise of the IHS Warrants.  "Convertible Securities" shall mean
any stock or securities directly or indirectly convertible into Common Stock.

     "IHS Warrants"  shall mean this Warrant and Warrant No. W-2,  issued to the
Holder on even date  herewith,  and any warrants  delivered in  substitution  or
exchange therefor as provided





<PAGE>


herein and therein.

     "Market  Price" as to any  security on any day shall mean the closing  sale
price of such  security as reported  for such day  pursuant to the  consolidated
quotation  system or any other  transaction  reporting plan under Section 11A of
the  Securities  Exchange Act of 1934, as amended (the "Exchange  Act"),  or, if
there have been no sales so reported  for such day,  the average of the best bid
and best offer prices  quoted  under the  consolidated  quotation  system or any
other such  transaction  reporting  plan as of 4:00 P.M., New York time, on such
day, or, if on any day such  security is not so quoted,  the average of the best
bid and best offered prices on such day in the domestic  over-the-counter market
as reported by any electronic  communications  network,  as such term is used in
Rule  11Ac1-1(a)(8)  under the Exchange Act or by the National Quotation Bureau,
Incorporated,  or any similar  successor or comparable  organization.  If at any
time such security is not listed on any domestic  securities  exchange or quoted
under a transaction reporting plan or in the domestic  over-the-counter  market,
the "Market  Price" shall be the fair value  thereof  determined  jointly by the
Company and the Registered Holders;  provided that if such parties are unable to
reach agreement as to the Market Price,  the Market Price shall be determined by
appraisal as set forth in Section 12 of this Warrant.

     "Note"  shall mean the  Subordinated  Note,  dated as of December 27, 1996,
executed by the Company  pursuant to that certain  Revolving  Credit  Agreement,
dated as of December 27, 1996, between the Company and the Holder.

     "Options"  means any  rights,  warrants  or  options  to  subscribe  for or
purchase Common Stock or Convertible Securities. "Person" shall mean any natural
person and any corporation,  partnership,  limited  liability  company,  limited
liability  partnership,  joint venture,  association,  joint-stock  partnership,
trust,  unincorporated  organization  or government or other agency or political
subdivision thereof.

     "Purchase  Price"  shall  mean two times  the price per share  equal to the
average of the high and low trading  price of the Common  Stock  reported in The
Wall  Street  Journal,  Eastern  edition,  for the first two full  trading  days
following  the Date of Issuance  (as such term is defined in Section 7.2 hereof)
of this  Warrant,  as such price may be adjusted  from time to time  pursuant to
Section 4 hereof.

     "Registered  Holder"  shall mean any  Person in whose name this  Warrant is
registered upon the books and records maintained by the Company.

     "Subsidiary"  shall  mean,  with  respect to any Person,  any  corporation,
limited liability company, partnership,  association or other business entity of
which (i) if a  corporation,  a majority of the total  voting power of shares of
stock entitled  (without regard to the occurrence of any contingency) to vote in
the election of directors,  managers or trustees thereof is at the time owned or
controlled,  directly or indirectly,  by that Person or one or more of the other
Subsidiaries  of that  Person  or a  combination  thereof,  or (ii) if a limited
liability company, partnership, association or other business entity, a majority
of the partnership or other similar  ownership  interest  thereof is at the time
owned or  controlled,  directly  or  indirectly,  by that  Person or one or more
Subsidiaries of that Person or a combination  thereof.  For purposes  hereof,  a
Person or Persons  shall be deemed to have a majority  ownership  interest  in a
limited liability company, partnership,  association or other business entity if
such  Person or  Persons  shall be  allocated  a majority  of limited  liability
company,  partnership,  association or other business  entity gains or losses or
shall be or control any  managing  director or general  partner of such  limited
liability company, partnership, association or other business entity.

     "Underlying  Common Stock" shall mean (i) the shares of Common Stock issued
or issuable  upon  exercise of the Warrant and (ii) any Common  Stock  issued or
issuable with respect to the  securities  referred to in clause (i) above by way
of stock dividend or stock split or in connection  with a combination of shares,
recapitalization, merger, consolidation or other reorganization.

     "Warrant"  as used  herein,  shall  include  this  Warrant  and any warrant
delivered in substitution or exchange therefor as provided herein.

     2. Exercise.

     2.1 Exercise  Period.  The Warrant shall be exercisable in whole or in part
from and after 9:00 A.M., New York time, on the Commencement Date.

     2.2 Exercise Procedure.

     (i) This Warrant  shall be deemed to have been  exercised  when the Company
has received all of the following items:

     (a) an  Election  to  Purchase  in the form  attached  hereto as Exhibit A,
properly  completed and executed by the Person (the "Purchaser")  exercising all
or part of the purchase rights represented by this Warrant;

     (b) this Warrant;

     (c) if this  Warrant is not  registered  in the name of the  Purchaser,  an
Assignment or Assignments  in the form set forth in Exhibit B hereto  evidencing
the  assignment of this Warrant to the  Purchaser,  in which case the Registered
Holder shall have complied with the  provisions set forth in Section 7.1 hereof;
and

     (d) either (1) a check or wire transfer payable to the Company in an amount
equal to the product of the Purchase Price multiplied by the number of shares of
Common  Stock  being  purchased  upon such  exercise  (the  "Aggregate  Exercise
Price"),  (2) a written  notice to the Company that the  Purchaser is exercising
the Warrant (or a portion  thereof) by authorizing  the Company to withhold from
issuance a number of shares of Common Stock  issuable  upon such exercise of the
Warrant  which when  multiplied  by the Market Price of Common Stock is equal to
the Aggregate  Exercise Price (and such withheld shares of Common Stock shall no
longer be issuable under this  Warrant),  or (3) if the Holder holds the Note, a
written  notice to the Company that the Holder is  exercising  the Warrant (or a
portion thereof) by authorizing the Company to withhold and apply such amount of
principal  or accrued but unpaid  interest  under the Note  (whether or not then
due) as is equal to the Aggregate  Purchase  Price (and such amount of principal
or accrued and unpaid  interest under the Note shall no longer be payable to the
Holder).

     (ii)  Certificates  for shares of Common Stock  purchased  upon exercise of
this Warrant shall be delivered by the Company to the Purchaser within three (3)
business days after the date of the exercise,  together with cash in lieu of any
fraction of a share of Common Stock that would be issuable upon such exercise in
an amount equal to the Market Price of such  fractional  share as of the date of
exercise. No fractional shares of Common Stock or scrip representing  fractional
shares of Common Stock shall be issued upon an exercise of this Warrant.  Unless
this Warrant has expired or all of the purchase rights  represented  hereby have
been exercised, the Company shall prepare a new Warrant, substantially identical
hereto,  representing the rights formerly represented by this Warrant which have
not  expired or been  exercised  and shall  within such three (3)  business  day
period deliver such new Warrant to the Purchaser.

     (iii) The shares of Common Stock issuable upon the exercise of this Warrant
shall be deemed to have been issued to the  Purchaser  at the time of  exercise,
and the  Purchaser  shall be deemed for all  purposes  to have become the record
holder of such Common Stock at such time.

     (iv) The Company  shall not close its books  against  the  transfer of this
Warrant or of any share of Common Stock issued or issuable  upon the exercise of
this Warrant in any manner  which  interferes  with the timely  exercise of this
Warrant.  The  Company  shall  from time to time take all such  action as may be
necessary  to assure that the par value per share of the  unissued  Common Stock
acquirable  upon  exercise of this Warrant is at all times equal to or less than
the Purchase Price then in effect.

     (v) The Company shall assist and cooperate  with any  Registered  Holder or
Purchaser to make any governmental filings or obtain any governmental  approvals
required prior to or in connection with any exercise of this Warrant (including,
without limitation,  making at the Company's own expense any filings required to
be made by the Company).

     3. Expiration Date.

     The Warrant  evidenced hereby may not be exercise after 5:00 P.M., New York
time, on the  Expiration  Date with respect to the shares of the Common Stock as
to which the Warrant may be  exercised  and, to the extent not  exercised by the
Expiration Date, the Warrant evidenced hereby shall become void.

     4. Adjustments.

     Subject to the  provisions  of this Section 4, the  Purchase  Price and the
number of shares of the Common  Stock as to which the Warrant  may be  exercised
shall be subject to adjustment from time to time as hereinafter set forth:

     4.1 Effect on Purchase Price and Number of Shares of Certain Events. If and
whenever on or after the  Commencement  Date, the Company issues or sells, or in
accordance  with this Section 4.1 is deemed to have issued or sold, any share of
Common  Stock for a  consideration  per share less than one half of the Purchase
Price in effect  immediately  prior to such  time,  then  immediately  upon such
issuance or sale the  Purchase  Price shall be reduced  pursuant to this Section
4.1 to a new  Purchase  Price  determined  by  dividing  (A)  the sum of (x) the
product  derived  by  multiplying  one  half of the  Purchase  Price  in  effect
immediately  prior to such  issue or sale  times the  number of shares of Common
Stock Deemed  Outstanding  immediately prior to such issue or sale, plus (y) the
consideration,  if any,  received by the Company upon such issue or sale, by (B)
the number of shares of Common Stock Deemed  Outstanding  immediately after such
issue or sale, and  multiplying  the result by two. Upon each such adjustment of
the  Purchase  Price,  the number of shares of Common  Stock  issuable  upon the
exercise of this  Warrant  (to the extent not  theretofore  exercised)  shall be
increased to a number  determined  by  multiplying  the number of such shares so
purchasable immediately prior to such adjustment by a fraction, the numerator of
which shall be the Purchase Price in effect immediately prior to such adjustment
and the  denominator of which shall be the Purchase Price in effect  immediately
after such  adjustment.  For  purposes  of  determining  the  Purchase  Price as
adjusted under this Section 4.1, the following shall be applicable:

     (i) Issuance of Rights or Options. If on or after the Commencement Date the
Company  in any manner  issues,  grants or sells any  Options  and the price per
share for which a share of Common  Stock is  issuable  upon the  exercise of any
such Option, or upon conversion or exchange of any Convertible Security issuable
upon  exercise of such Option,  is less than one half of the  Purchase  Price in
effect  immediately  prior to the time of the  granting or sale of such  Option,
then the total  maximum  number of shares  of  Common  Stock  issuable  upon the
exercise of such  Options,  or upon  conversion or exchange of the total maximum
amounts  of such  Convertible  Securities  issuable  upon the  exercise  of such
Options,  shall be deemed to be  outstanding  for  purposes of  determining  the
Common Stock Deemed  Outstanding and to have been issued and sold by the Company
at such time for such price per share. For purposes of this Section 4.1(i),  the
"price per share for which a share of Common Stock is  issuable"  shall be equal
to the sum of the amount of consideration (if any) received or receivable by the
Company  with  respect to the  issuance,  grant or sale of the Option,  plus the
amount of  consideration  (if any) that would be received  by the  Company  with
respect to exercise of the Option in full plus the amount of  consideration  (if
any) that  would be  received  by the  Company  with  respect to  conversion  or
exchange in full of any  Convertible  Security  issuable  upon  exercise of such
Option,  all divided by the total number of shares of Common Stock issuable upon
exercise of the Option and conversion or exchange of the  Convertible  Security.
No further  adjustment of the Purchase Price shall be made upon the actual issue
of such Common Stock or of such  Convertible  Security upon the exercise of such
Options  or upon the  actual  issue of such  Common  Stock  upon  conversion  or
exchange of such Convertible Security.

     (ii) Issuance of Convertible  Securities.  If on or after the  Commencement
Date the Company in any manner issues,  grants or sells any Convertible Security
and the price per share  for  which a share of  Common  Stock is  issuable  upon
conversion  or exchange  thereof is less than one half of the Purchase  Price in
effect  immediately  prior to the time of such issue or sale,  then the  maximum
number of shares of Common Stock  issuable  upon  conversion or exchange of such
Convertible  Securities  shall be  deemed  to be  outstanding  for  purposes  of
determining the Common Stock Deemed Outstanding and to have been issued and sold
by the Company at such time for such price per share.  For the  purposes of this
Section  4.1(ii),  the  "price  per share  for which a share of Common  Stock is
issuable"  shall be equal to the sum of the  amount  of  consideration  (if any)
received or  receivable  by the Company with respect to the  issuance,  grant or
sale of the Convertible  Security plus the amount of consideration (if any) that
would be received by the Company with respect to the  conversion  or exchange of
such Convertible  Security in full, all divided by the total number of shares of
Common Stock issuable upon conversion or exchange of the  Convertible  Security.
No further  adjustment of the Purchase Price shall be made upon the actual issue
of such Common Stock upon  conversion or exchange of any  Convertible  Security,
and if any such issue or sale of such Convertible Security is made upon exercise
of any Options for which  adjustments of the Purchase Price has been or is to be
made pursuant to other  provisions  of this Section 4, no further  adjustment of
the Purchase  Price shall be made under this  Section  4.1(ii) by reason of such
issue or sale.

     (iii)  Change in  Option  Price or  Conversion  Rate.  If the  amount to be
received by the Company upon the exercise of any Options  outstanding  as of the
Commencement  Date,  the  additional  consideration,  if any,  payable  upon the
issuance, conversion or exchange of any Convertible Securities outstanding as of
the  Commencement  Date,  or  the  rate  at  which  any  Convertible  Securities
outstanding as of the Commencement Date are convertible into or exchangeable for
Common Stock changes at any time after the  Commencement  Date, then such Option
or  Convertible  Security and the Common Stock deemed  issuable  upon  exercise,
conversion or exchange  thereof shall be deemed for purposes of this Section 4.1
to have been  issued,  granted  or sold as of the date of such  changes  and the
Purchase  Price  shall be adjusted as  provided  herein;  provided  that no such
change shall at any time cause the Purchase Price hereunder to be increased.

     (iv) Treatment of Expired Options and Unexercised  Convertible  Securities.
Upon the expiration of any Option described in Section 4.1(i) or the termination
of any right to convert or exchange  any  Convertible  Securities  described  in
Section  4.1(ii)  without the exercise or conversion in whole or in part of such
Option or Convertible Security, the Purchase Price then in effect and the number
of shares of Common Stock issuable  hereunder  shall be adjusted  immediately to
the  Purchase  Price and the number of shares of Common  Stock  which would have
been in effect at the time of such  expiration or termination had such Option or
Convertible  Securities,  never been issued,  granted or sold;  provided that if
such expiration or termination would result in an increase in the Purchase Price
then in effect,  such  increase  shall not be  effective  until thirty (30) days
after  written  notice  thereof  has been given to the  Registered  Holder.  For
purposes of this Section 4.1, the  expiration  or  termination  of any Option or
Convertible Security which was outstanding as of the Commencement Date shall not
cause the Purchase Price hereunder to be adjusted unless, and only to the extent
that, a change in the term of such Option or Convertible  Security  caused it to
be deemed to have been issued after the  Commencement  Date  pursuant to Section
4.1(iii).

     (v) Calculation of Consideration  Received. If any Common Stock, Options or
Convertible  Securities are issued or sold or deemed to have been issued or sold
for cash,  the  consideration  received  therefor  shall be deemed to be the net
amount received by the Company  therefor.  In case any Common Stock,  Options or
Convertible  Securities are issued or sold for a consideration  other than cash,
the amount of the consideration other than cash received by the Company shall be
the fair value of such consideration,  except where such consideration  consists
of securities, in which case the amount of consideration received by the Company
shall be the Market Price thereof as of the date of receipt.  In case any Common
Stock,  Options  or  Convertible  Securities  are  issued  to the  owners of the
non-surviving  entity in connection  with any merger in which the Company is the
surviving  corporation,  the amount of consideration therefor shall be deemed to
be the  fair  value  of such  portion  of the net  assets  and  business  of the
non-surviving  entity  as is  attributable  to such  Common  Stock,  Options  or
Convertible Securities,  as the case may be. The fair value of any consideration
other than cash or securities shall be determined jointly by the Company and the
Registered  Holder.  If such  parties are unable to reach  agreement,  such fair
value shall be determined by appraisal pursuant to Section 12.

     (vi)  Integrated  Transactions.  In case any Option is issued in connection
with the issue or sale of other securities of the Company,  together  comprising
one integrated  transaction in which no specific  consideration  is allocated to
such Options by the parties  thereto,  the Options  shall be deemed to have been
issued without consideration.

     (vii) Each Series a Separate  Security.  In case an  agreement  relating to
Options or Convertible  Securities  provides that more than one Purchase  Price,
conversion or exchange  provisions  are  applicable to the  securities  issuable
thereunder,  then the  securities  subject  to each  different  exercise  price,
conversion  or  exchange  provisions  shall be deemed to be subject to  separate
Options or Convertible Securities for purposes of applying this Section 4.1.

     (viii) Treasury Shares. The Common Stock outstanding at any given time does
not  include  shares  owned or held by or for the  account of the Company or any
Subsidiary,  and the  disposition  of any  shares  so  owned  or held  shall  be
considered an issue or sale of Common Stock.

     (ix) Record  Date.  If the Company  takes a record of the holders of Common
Stock for the  purpose of  entitling  them (A) to  receive a  dividend  or other
distribution  payable in Common Stock,  Options or in Convertible  Securities or
(B)  to  subscribe  for  or  purchase  Common  Stock,   Options  or  Convertible
Securities, then such record date shall be deemed to be the date of the issue or
sale of the shares of Common  Stock  deemed to have been issued or sold upon the
declaration  of such  dividend or the making of such other  distribution  or the
date of the granting of such right of subscription or purchase,  as the case may
be.

     4.2  Subdivision or Combination of Common Stock. If the Company at any time
subdivides (by any stock split, stock dividend,  recapitalization  or otherwise)
one or more  classes of its  outstanding  shares of Common  Stock into a greater
number  of  shares,  the  Purchase  Price in  effect  immediately  prior to such
subdivision shall be proportionately  reduced and the number of shares of Common
Stock  obtainable  upon exercise of this Warrant (to the extent not  theretofore
exercised)  shall  be  proportionally  increased.  If the  Company  at any  time
combines  (by  reverse  stock  split or  otherwise)  one or more  classes of its
outstanding shares of Common Stock into a smaller number of shares, the Purchase
Price  shall be  proportionately  increased  and the  number of shares of Common
Stock  issuable  upon  exercise of this  Warrant (to the extent not  theretofore
exercised) shall be proportionally decreased.

     4.3 Reorganization,  Reclassification,  Consolidation,  Merger or Sale. Any
recapitalization,  reorganization,  reclassification,  spin-off,  consolidation,
merger,  sale or distribution of the Company's assets or other  transaction,  in
each case which is effected  in such a way that the holders of Common  Stock are
entitled to receive  (either  directly or upon  subsequent  liquidation)  stock,
securities or assets with respect to or in exchange for Common Stock is referred
to herein as "Organic  Change." Prior to the consummation of any Organic Change,
the Company shall make appropriate provision (in form and substance satisfactory
to the Registered  Holders) to insure that each of the Registered  Holders shall
thereafter  have the right to acquire and receive,  in lieu of or in addition to
(as  the  case  may be) the  shares  of  Common  Stock  immediately  theretofore
acquirable  and  receivable  upon the exercise of such  Warrant,  such shares of
stock,  securities  or assets as may be issued or payable  with respect to or in
exchange  for the  number  of shares of  Common  Stock  immediately  theretofore
issuable upon  exercise of the Warrant had such Organic  Change not taken place.
In any such case,  the Company  shall make  appropriate  provision  (in form and
substance  satisfactory to the Registered Holders) with respect to such Holders'
rights and interests to insure that the  provisions of this Section 4, Section 5
and Section 6 hereof shall  thereafter be applicable to the Warrant  (including,
in the case of any such  consolidation,  merger or sale in which  the  successor
entity or purchasing entity is other than the Company, an immediate reduction in
the Purchase  Price to the value of the Common  Stock  reflected by the terms of
such consolidation,  merger or sale, and a corresponding immediate adjustment in
the number of shares of Common Stock  issuable upon exercise of this Warrant (to
the extent not  theretofore  exercised),  if the value so reflected is less than
one  half  of  the  Purchase   Price  in  effect   immediately   prior  to  such
consolidation,  merger or sale). The Company shall not effect any such spin-off,
consolidation,  merger or sale,  unless prior to the consummation  thereof,  the
successor   entity  (if  other  than  the  Company)   resulting  from  spin-off,
consolidation or merger or the entity  purchasing such assets assumes by written
instrument (in form and substance  satisfactory to the Registered Holders),  the
obligation  to deliver to each such holder such shares of stock,  securities  or
assets as, in  accordance  with the  foregoing  provisions,  such  holder may be
entitled to acquire.

     4.4 Certain  Events.  If any event occurs of the type  contemplated  by the
provisions of this Section 4 but not expressly  provided for by such  provisions
(including,  without  limitation,  the  granting of stock  appreciation  rights,
phantom  stock  rights or other  rights  with equity  features  or  equity-based
valuation or any  dividend or  distribution  of the capital  stock issued by any
Person other than the Company), then the Company's Board of Directors shall make
an  appropriate  adjustment  in the  Purchase  Price  and the  number  of shares
issuable upon exercise of this Warrant (to the extent not theretofore exercised)
so as to protect the rights of the  Registered  Holders;  provided  that no such
adjustment shall increase the Purchase Price as otherwise determined pursuant to
this Section 4.

     4.5 Calculation of Purchase Price; Notices.

     (i) All  calculations  of the Purchase  Price under this Section 4 shall be
computed to the nearest One-Thousandth (1/1000th) of a cent.

     (ii)  Immediately  upon any adjustment of the Purchase  Price,  the Company
shall give written  notice thereof to the  Registered  Holder,  setting forth in
reasonable  detail and certifying the calculation of such  adjustment,  provided
however,  that  such  notice  shall not be  deemed  to be  conclusive  as to the
Purchase Price calculation. At the request of the Registered Holder, the Company
shall certify the Purchase Price of and the number of shares for which a Warrant
at the time may be exercised.

     (iii) The Company  shall give written  notice to the  Registered  Holder at
least  thirty (30) days prior to the date on which the Company  closes its books
or takes a record (A) with  respect to any  subdivision  or  combination  of the
Common  Stock  that  is  subject  to  Section  4.2,  or any  other  dividend  or
distribution   upon  the  Common  Stock,  (B)  with  respect  to  any  pro  rata
subscription  offer to holders of Common Stock or (C) for determining  rights to
vote with respect to any Organic Change, dissolution or liquidation.

     (iv) The Company shall also give written notice to the Registered Holder at
least  thirty  (30)  days  prior  to the  date  on  which  any  Organic  Change,
dissolution or liquidation shall take place.

     4.6 Excluded Transactions. The provisions of this Section 4 shall not apply
to the exercise of the IHS Warrants.

     4.7 Expression of Purchase Price and Number of Shares.  Irrespective of any
adjustments or change in the Purchase Price or the number of securities actually
purchasable  under the Warrant,  the Warrants  theretofore and thereafter issued
may  continue  to  express  the  purchase  price and the  number  of  securities
purchasable  thereunder  as the  Purchase  Price and the  number  of  securities
purchasable were expressed in the Warrant when initially issued.

     5. No  Rights or  Liabilities  as  Stockholders  and  Notice to  Registered
Holder.

     Nothing  contained  herein  shall  be  construed  as  conferring  upon  the
Registered  Holder the right to vote or to  consent  or to  receive  notice as a
stockholder  in respect of the  meetings  of  stockholders  for the  election of
directors of the Company or any other matter,  or any other rights whatsoever as
a stockholder of the Company; provided, however, that in the event that:

     (a) the Company  shall take a record of the holders of its Common  Stock or
other  stock or  securities  for the  purpose of  entitling  them to receive any
dividend or other  distribution,  or any right to subscribe  for or purchase any
shares of stock of any class or any other  securities  or to  receive  any other
right;

     (b) the Company shall take action to accomplish any capital reorganization,
or  reclassification  of the capital stock of the Company, or a consolidation or
merger of the Company into, or a sale of all or substantially  all of its assets
to, another corporation;

     (c) the  Company  shall  take  action to redeem  or  convert  any or all of
outstanding Common Stock or other stock or securities of the Company; or

     (d) the  Company  shall take  action  looking to a  voluntary  dissolution,
liquidation or winding up of the Company;

     then,  and in each such case,  the Company shall mail or cause to be mailed
to the Registered  Holder of this Warrant a notice  specifying,  as the case may
be,  (i) the date on  which a record  is to be  taken  for the  purpose  of such
dividend,  distribution or right, or (ii) the date on which such reorganization,
reclassification,   spin-off  consolidation,  merger,  conveyance,  dissolution,
liquidation,  winding-up,  redemption or  conversion  is to take place,  and the
time, if any, is to be fixed,  as of which the holders of record of Common Stock
or such other stock or securities  shall be entitled to exchange their shares of
Common Stock or such other stock or securities  for securities or other property
deliverable upon such reorganization,  reclassification,  consolidation, merger,
conveyance, dissolution, liquidation, winding-up, conversion or redemption. Such
notice  shall be  delivered  at least thirty (30) days prior to the date therein
specified.

     6. Duty to Register Common Stock.

     The shares of Common  Stock  issuable  under this  Warrant are subject to a
Registration Rights Agreement with the Company dated of even date herewith.

     7. Transfers and Exchanges.

     7.1 Warrant Transferable. Subject to the transfer conditions referred to in
the legend endorsed  hereon,  this Warrant and all rights  hereunder  (including
those  under the  Purchase  Agreement)  are  transferable,  in whole or in part,
without charge to the Registered  Holder,  upon surrender of this Warrant with a
properly executed  Assignment (in the form of Exhibit B hereto) at the principal
office of the Company.  The Company shall record on its books the  transferee as
the  Registered  Holder of the portion of this Warrant  transferred  pursuant to
this Section 7.1.

     7.2 Warrant  Exchangeable  for  Different  Denominations.  This  Warrant is
exchangeable,  upon  the  surrender  hereof  by  the  Registered  Holder  at the
principal office of the Company,  for new Warrants of like terms representing in
the aggregate the purchase rights hereunder, and each of such new Warrants shall
represent such portion of such rights as is designated by the Registered  Holder
at the time of such  surrender.  The  date the  Company  initially  issues  this
Warrant  shall be deemed to be the "Date of Issuance"  hereof  regardless of the
number of times new  certificates  representing  the unexpired  and  unexercised
rights  formerly  represented  by this  Warrant  shall be issued.  All  Warrants
representing  portions  of the rights  hereunder  are  referred to herein as the
"Warrants."

     8. Valid Issuance and Payment of Taxes.

     All shares of Common Stock  issued upon the exercise of this Warrant  shall
be validly issued, fully paid and non-assessable,  and the Company shall pay all
taxes and other governmental charges that may be imposed in respect of the issue
or delivery  thereof.  The Company shall not be required to pay any tax or other
charge imposed in connection  with any transfer  involved in the issuance of any
certificate  for  shares  of  Common  Stock in any name  other  than that of the
Registered  Holder of this  Warrant,  and in such case the Company  shall not be
required to issue or deliver any stock certificate or security until such tax or
other  charge has been  paid,  or it has been  established  that no tax or other
charge is due.

     9. Mutilated or Missing Warrants.

     In case any of the Warrants shall be mutilated,  lost, stolen or destroyed,
the Company shall issue and deliver in exchange and  substitution  for, and upon
cancellation of the mutilated  Warrant,  or in lieu of, and in substitution for,
the  Warrant  lost,  stolen  or  destroyed,  a new  Warrant  of like  tenor  and
representing  an  equivalent  right  or  interest,  but  only  upon  receipt  of
reasonable evidence of such loss, theft, or destruction of such Warrant.

     10. Reserve.

     The Company hereby represents and covenants that it has reserved and at all
times there shall be reserved for issuance such number and type of securities as
the  Registered  Holders  are  entitled  to  receive  upon  exercise  of the IHS
Warrants.  Prior to the  issuance of any equity  securities  (or any  instrument
exercisable for or convertible  into equity  securities) and whenever  otherwise
required to satisfy this Section 10, the Company will amend its  Certificate  of
Incorporation  to the extent  necessary  to ensure  that there is  reserved  for
issuance a sufficient number and type of securities as the Registered Holders of
the IHS  Warrants  are  entitled  to  receive  upon  exercise  thereof.  11.  No
Impairment.


     The Company will not, by amendment of its Certificate of  Incorporation  or
bylaws, or through reorganization,  consolidation, merger, dissolution, issue or
sale of securities,  sale of assets or any other voluntary action, avoid or seek
to avoid the observance or performance of any of the terms of this Warrant,  but
will at all times in good faith assist in the carrying out of all such terms and
in the taking of all such action as may be necessary or  appropriate in order to
protect  the  rights  of the  Registered  Holders  against  impairment.  Without
limiting the generality of the foregoing, the Company (a) shall not increase the
par  value of any  shares  issuable  upon  exercise  of this  Warrant  above the
Purchase  Price  and (b) will  take  all  such  action  as may be  necessary  or
appropriate  in order that the Company may validly and legally  issue fully paid
and non-assessable shares of Common Stock upon exercise of this Warrant.

     12. Appraisal.

     In case of any dispute as to valuation of a security under this  Agreement,
the fair value of such security shall be determined by an appraiser  without any
discount for liquidity or restrictions  under the Securities Act. This appraisal
process  shall be  instituted  within  fourteen  (14) days after a party to this
Agreement  notifies  the other  party of its  desire  to submit  the issue to an
appraiser.  In the  event  that,  within  seven  (7) days  after a party to this
Agreement  notifies  the other  party of its  desire  to submit  the issue to an
appraiser,  the parties do not agree on a single appraiser to determine the fair
value of such  security,  the fair value of such security  shall be  determined,
without any discount for liquidity or restrictions  under the Securities Act, by
the  majority  determination  of a panel of three  (3)  appraisers  who shall be
selected in the following manner: the Company shall select one (1) appraiser and
the Registered  Holder entitled to exercise this Warrant for the greatest number
of shares of Common Stock (in the event there shall be more than one  Registered
Holder),  on behalf  of all of the  Registered  Holders,  shall  select  one (1)
appraiser and the two (2) appraisers  selected by the Company and the Registered
Holder shall jointly select a third appraiser. The appraiser selected jointly by
the parties and, if applicable,  each member of the appraisal  panel shall be an
individual  who  personally  and  whose  Affiliates  shall  not have a  previous
business  relationship with either party. The appraiser and, if applicable,  the
appraisal panel shall endeavor to complete the appraisal as soon as practicable.
The  determination  of such appraiser and, if  applicable,  the appraisal  panel
shall be final and binding on the Company and the  Registered  Holders,  and the
fees and expenses of such  appraisal  shall be borne equally by the Company,  on
the one hand, and the Registered Holders, on the other.

     13. Notices.

     Except  as  may  be  otherwise  provided  herein,  all  notices  and  other
communications  required or permitted hereunder shall be in writing and shall be
conclusively deemed to have been duly given (a) when hand delivered to the other
party,  (b) when  received  when sent by  facsimile  to number  set forth  below
(provided,  however,  that  notices  given by  facsimile  shall not be effective
unless either (i) a duplicate copy of such facsimile notice is promptly given by
one of the other  methods  described in this  Section 13, or (ii) the  receiving
party  delivers a written  confirmation  of receipt  for such  notice  either by
facsimile  or any other  method  described  in this Section 13) and (c) the next
business day after deposit with a national overnight  delivery service,  postage
prepaid,  addressed  to the  parties as set forth  below with  next-business-day
delivery guaranteed,  provided that the sending party receives a confirmation of
delivery from the delivery service provider.

       To: the Registered Holder                To: the Company

       Integrated Health Services, Inc.         Community Care of America, Inc.
       10065 Red Run Boulevard                  3050 North Horseshoe Drive
       Owings Mills, MD  21117                  Naples, FL  33942
       Fax No.:  (410) 998-8747                 Fax No.:  (941) 435-0087
       Attn:  Marshall A. Elkins, Esq.          Attn:  Gary Singleton, President

A party may  change or  supplement  the  addresses  given  above,  or  designate
additional addresses,  for purposes of this Section 13 by giving the other party
written notice of the new address in the manner set forth above.

     14. Headings.

     The headings in this Warrant are for purposes of  convenience  in reference
only, and shall not be deemed to constitute a part hereof.

     15. Governing Law.

        I This Warrant shall be construed and enforced in  accordance  with, and
governed  by,  the laws of the State of New York  without  regard to  provisions
regarding choice of laws.

     16. Severability.

     If any term, provision,  covenant or restriction of this Warrant is held by
a court of competent  jurisdiction  to be invalid,  void or  unenforceable,  the
remainder of the terms,  provisions,  covenants and restrictions of this Warrant
shall remain in full force and effect and shall in no way be affected,  impaired
or invalidated.

     17. No Inconsistent Agreements.

     The Company  will not on or after the date of this  Warrant  enter into any
agreement  which is  inconsistent  with the  rights  granted  to the  Registered
Holders of this Warrant or otherwise  conflicts with the provisions  hereof. The
Company hereby represents and warrants that the rights granted to the Registered
Holders  hereunder do not in any way conflict with and are not inconsistent with
the  rights  granted  to holders  of the  Company's  securities  under any other
agreements, except rights that have been waived.

     18. Saturdays, Sundays and Holidays.

     If the Expiration  Date falls on a Saturday,  Sunday or legal holiday,  the
Expiration  Date  shall  automatically  be  extended  until  5:00 p.m.  the next
business day.


IN WITNESS WHEREOF,  Community Care of America,  Inc. has caused this Warrant to
be signed manually by a duly authorized  officer of the Company on this 13th day
of January, 1997.
                                        
                                                COMMUNITY CARE OF AMERICA, INC.
                              
                                                By:
                                                Name:
                                                Title:






<PAGE>



                                    EXHIBIT A


                              ELECTION TO PURCHASE

                      To: Community Care of America, Inc.
                      __________________________________
                      __________________________________
                      __________________________________
   
The undersigned hereby elects to exercise the Warrant  represented by the within
Warrant  Certificate to purchase  __________ shares of the Common Stock issuable
upon the exercise of the Warrant and requests that  certificates for such shares
shall be issued in the name of:



                                     (Name)



                                    (Address)



                                (Taxpayer number)

                              and be delivered to:



                                     (Name)

                                       at

                                    (Address)

and, if said number of shares of the Common Stock shall not be all the shares of
the Common Stock evidenced by the within Warrant Certificate, that a new Warrant
Certificate  for the balance  remaining of such said shares be registered in the
name of:



                                     (Name)



                                    (Address)



                                (Taxpayer number)

         and delivered to the undersigned at the address below stated.

         Dated:  _______________, 19__

         Name of holder of Warrant Certificate:



                                 (please print)



                                    (Address)



                                   (Signature)







<PAGE>


                                    EXHIBIT B

                                   ASSIGNMENT

                    (to be executed by the registered holder
                   to effect a transfer of the within Warrant)

                               FOR VALUE RECEIVED

                    hereby sells, assigns and transfers unto


                                     (Name)


                                    (Address)



the right to purchase  the  ________  shares of Common  Stock  evidenced by this
Warrant, and does hereby irrevocably constitute and appoint to transfer the said
right on the books of the Company, with full power of substitution.

                         Dated: _______________________

                                                     (Signature)



         /







<PAGE>



                                    EXHIBIT 3

                          REGISTRATION RIGHTS AGREEMENT


                                [TO BE INSERTED]
                          REGISTRATION RIGHTS AGREEMENT

         THIS  REGISTRATION  RIGHTS  AGREEMENT  is  made as of the  13th  day of
January 1997 (the "Effective  Date"),  by and between Community Care of America,
Inc., a Delaware corporation (the "Company"),  on the one hand, and on the other
hand,   Integrated   Health   Services,   Inc.,  a  Delaware   Corporation  (the
"Stockholder").

                                    RECITALS

         WHEREAS,  the  Company  and the  Stockholder  are  parties to a Warrant
Acquisition  Agreement,  dated of even date herewith (the "Warrant  Agreement"),
pursuant to which the  Company  issued  Series A Warrants  and Series B Warrants
(collectively, the "Warrants") to the Stockholder;

         WHEREAS,  the Stockholder may acquire shares of the Common Stock of the
Company, $0.0025 par value (the "Common Stock"), under the Warrants; and

         WHEREAS,  the Warrant Agreement  provides that the Company shall extend
certain registration rights to the Stockholder;

         NOW, THEREFORE, the parties hereby agrees as follows:

     1.1 Definitions. For purposes of this Agreement:

     (a) The  term  "register",  "registered",  and  "registration"  refer  to a
registration  affected  by  preparing  and filing a  registration  statement  or
similar  document in compliance with the Securities Act of 1933, as amended (the
"Act"),  and  the  use,  by the  Company,  of its  best  efforts  to  cause  the
declaration  or ordering of  effectiveness  of such  registration  statement  or
document.

     (b) The term  "Underlying  Common  Stock"  means  (1) any of the  shares of
Common Stock  issued upon  exercise of the  Warrants,  and (2) any shares of the
Common  Stock of the  Company  issued as (or  issuable  upon the  conversion  or
exercise of any warrant,  right or other security which is issued as) a dividend
or other  distribution with respect to, or in exchange for or in replacement of,
the shares of Common Stock issued or issuable  under the Warrants,  excluding in
all  cases,  however,  any  Underlying  Common  Stock  sold  by  a  person  in a
transaction in which his, her or its rights under Section 1 are not assigned.

     (c) The term  "Holder"  means any  person  owning  or  having  the right to
acquire  Underlying  Common Stock or any  assignee  thereof in  accordance  with
Section 1.10 hereof.

                                                


<PAGE>




     (d)  The  term  "Person"  means  a  natural  person  and  any  corporation,
partnership,  limited liability company,  limited liability  partnership,  joint
venture,   association,    joint-stock   partnership,    trust,   unincorporated
organization or a government or any department or agency thereof.

     1.2 Registration Rights. The Company covenants and agrees as follows:

     (a)  Piggyback  Registration  Rights.  If,  at any  time  after  the  first
anniversary  of the  Effective  Date (but without any  obligation to do so), the
Company proposes to register (including for this purpose a registration effected
by the  Company for  stockholders  other than the  Holders)  any of its stock or
other  securities  under the Act in connection  with the public offering of such
securities  solely for cash (other than a registration  statement or Form S-8 or
Form S-4 or any  successor  form  thereto),  the  Company  shall,  at such time,
promptly  give each  Holder  written  notice of such  registration.  The Company
shall,  subject to the provisions of Section 1.6(b), cause all of the Underlying
Common  Stock  owned by each  Holder  to be  registered  under the Act under the
proposed registration  statement,  except that the Company shall not be required
to register the Underlying Common Stock owned by a Holder if, within twenty (20)
days after the Company gives notice of the proposed  registration to the Holder,
the Holder gives the Company  written notice in accordance with Section 2.5 that
he does not want all or a portion of the Underlying  Common Stock held by him to
be so registered.

     (b) Demand Registration Rights for Firm Commitment  Underwritten Offerings.
At any time after the first  anniversary  of the  Effective  Date,  the  Holders
representing  a majority  of the Common  Stock  issued  and  issuable  under the
Warrants  (regardless of whether representing a majority of the then outstanding
Underlying Common Stock) may demand that the Company register under the Act, all
or a portion  of the  shares  of  Common  Stock  issued  or  issuable  under the
Warrants,  for sale pursuant to a firm commitment  underwritten public offering,
provided that the Company shall not be obligated to effect such registration and
firm commitment  underwritten  public offering and sale of the Underlying Common
Stock on more than two  occasions  in the  aggregate  for all of the Holders (it
being  understood that any firm  commitment  public offering that does not close
for whatever reason shall not count against such limit).

     (c)  Registration  Rights for Shelf Offerings Not Involving Firm Commitment
Underwritings.

(1) If at any time after the first anniversary of the Effective Date the Company
is eligible to register on Form S-3 under the Act (or any successor "short form"
registration  statement) securities which are to be offered or sold solely by or
on behalf of persons  other than the Company,  then the Holders of a majority of
the  outstanding  Underlying  Common Stock may demand that the Company  register
under the Act all or a portion of the Common Stock issued and issuable under the
Warrants  for offer and sale in  transactions  not  involving a firm  commitment
underwritten  offering.  The Company shall as soon as practicable after the date
thereof  register with the Commission on a Form S-3  registration  statement (or
any successor "short form"  registration  statement) the Common Stock issued and
issuable  under the  Warrants.  Thereafter,  the  Holders of a  majority  of the
outstanding Underlying Common Stock may, subject to the limitations set forth in
Section 1.2(c)(2) hereof,  demand that the Company,  on one occasion during each
twelve month period from the Effective  Date,  prepare and file a post effective
amendment to such registration statement, pursuant to Rule 424(b) under the Act,
containing a  prospectus  meeting the  requirements  of Section 10 of the Act in
order to permit the Holders to sell or distribute their Underlying  Common Stock
in transactions  not involving a firm commitment  underwritten  public offering,
and the Company shall  prepare and file such other  amendments  and  supplements
thereto, and take such other actions as may be necessary to keep such prospectus
and  registration  statement  accurate  and  effective  and to  comply  with the
provisions of the Act with respect to the  disposition of the Underlying  Common
Stock for a period of not less than  ninety (90) days,  provided  that such time
period shall be extended by the amount of time that any Holder is prevented from
selling Underlying Common Stock under such registration statement as a result of
Section 1.2(c)(2) hereof.

(2)  Notwithstanding  the provisions of Section  1.2(c)(1) to the contrary,  the
Company  shall  not be  obligated  to file a post  effective  amendment  to such
registration statement pursuant to Rule 424(b) under the Act and/or a prospectus
meeting  the  requirements  of Section 10 of the Act  pursuant  to this  Section
1.2(c)  during  any  period if (i) the  Company  shall  furnish  to the  Holders
requesting  such  registration  a  certificate  signed by the  President  of the
Company  stating that,  in the good faith  judgment of the Board of Directors of
the Company,  it would be seriously  detrimental at such time to the Company and
its  stockholders  to file such  amendments  to such  registration  statement or
prospectus (including by filing information  incorporated by reference into such
registration  statement and/or prospectus) necessary to meet the requirements of
Section 10 of the Act, in which event the Company  shall have the right to defer
the  filing of such  amendments  for a period of not more than  sixty  (60) days
after  presentation of such certificate to the Holders,  (ii) if the Company has
within  twelve  (12)  months  preceding  the  date of such  request  effected  a
registration  of its  securities in which  Holders were entitled to  participate
pursuant to Section 1.2(a) or (b) hereof,  or (iii) if the requesting  Holder or
Holders receive an opinion from counsel to the Company that registration of such
Holder's or Holders'  Underlying  Common Stock is not required  under the Act in
order to effect the sale or other  distribution  contemplated  by such Holder or
Holders.

     1.3 Obligations of the Company.  Whenever  undertaking under this Section 1
to effect the registration of any Underlying Common Stock, the Company shall, as
expeditiously as reasonably possible:

     (a) Prepare and file with the  Commission  a  registration  statement  with
respect to such  Underlying  Common Stock and use its best efforts to cause such
registration  statement to become effective and keep such registration statement
effective  for  ninety  (90) days or such  shorter  period as  requested  by the
Holders of a majority of the Underlying Common Stock registered thereunder.

     (b) Prepare and file with the Commission such amendments and supplements to
such  registration  statement and the  prospectus  used in connection  with such
registration  statement as may be necessary to comply with the provisions of the
Act  with  respect  to  the  disposition  of  all  securities  covered  by  such
registration statement.

     (c)  Furnish  to the  Holders  such  numbers  of  copies  of a  prospectus,
including a preliminary  prospectus,  in conformity with the requirements of the
Act,  and such  other  documents  as they  may  reasonably  request  in order to
facilitate the disposition of Underlying Common Stock owned by them.

     (d) Use its best efforts to register and qualify the securities  covered by
such registration statement under such other securities or Blue Sky laws of such
jurisdictions as the Holders shall reasonably request, provided that the Company
shall not be  required in  connection  therewith  or as a  condition  thereto to
qualify to do business or to file a general consent to service of process in any
such states or jurisdictions.

     (e) In the event that a firm  commitment  underwritten  public  offering is
utilized under the  registration  described in Section 1.2(a) or is demanded for
the  registration  described in Section  1.2(b),  include the Underlying  Common
Stock in such firm  commitment  underwritten  public offering and enter into and
perform its obligations under an underwriting  agreement, in usual and customary
form, with the managing underwriter of such offering.  Each Holder participating
in such  underwriting  shall also enter into and perform its  obligations  under
such an agreement.

     (f) Immediately  notify each Holder of the Underlying  Common Stock covered
by such registration statement at any time when a prospectus relating thereto is
required to be delivered under the Act of the happening of any event as a result
of which the  prospectus  included in such  registration  statement,  as then in
effect,  includes  an untrue  statement  of a material  fact or omits to state a
material fact required to be stated  therein or necessary to make the statements
therein not  misleading in the light of the  circumstances  then  existing,  and
promptly  prepare and furnish to the Holders a reasonable  number of copies of a
prospectus  supplement  or amendment  so that,  as  thereafter  delivered to the
purchasers of such Underlying Common Stock, such prospectus shall not include an
untrue statement of a material fact or omit to state a material fact required to
be stated therein or necessary to make the statements  therein not misleading in
the light of the circumstances then existing.

     (g)  Furnish,  at the  request of any  Holder  requesting  registration  of
Underlying  Common  Stock  pursuant  to this  Section  1, on the date  that such
Underlying  Common Stock is delivered to the underwriters for sale in connection
with a  registration  pursuant to this Section 1, if such  securities  are being
sold through  underwriters,  or, if such  securities  are not being sold through
underwriters,  on the date that the registration  statement with respect to such
securities  becomes effective,  (i) an opinion,  dated such date, of the counsel
representing  the Company for the  purposes  of such  registration,  in form and
substance  as  is  customarily  given  to  underwriters  in  a  firm  commitment
underwritten public offering, addressed to the underwriters,  if any, and to the
Holders requesting registration of the Underlying Common Stock and (ii) a letter
dated  such date,  from the  independent  certified  public  accountants  of the
Company, in form and substance as is customarily given by independent  certified
public  accountants to  underwriters in a firm  commitment  underwritten  public
offering,  addressed to the underwriters,  if any, and to the Holders requesting
registration of the Underlying Common Stock.

     (h) If the Common  Stock of the Company is listed on a national  securities
exchange  or  quoted  on  NASDAQ,  use its  best  efforts  to  comply  with  the
requirements  of such exchange or NASDAQ to include shares of Underlying  Common
Stock covered by such registration statement for listing on each such securities
exchange or for quotation on NASDAQ.





<PAGE>



     1.4 Furnish Information.

     (a) It shall be a condition  precedent to the obligations of the Company to
take any action pursuant to this Section 1 with respect to the Underlying Common
Stock of any selling  Holder that such Holder shall  furnish to the Company such
information  regarding  itself,  the Underlying Common Stock held by it, and the
intended method of disposition of such securities as shall be required to effect
the registration of such Holder's Underlying Common Stock.

     (b) The Company shall give the Holders registering  Underlying Common Stock
and  their  underwriters,   if  any,  the  opportunity  to  participate  in  the
preparation of the registration  statement,  each prospectus included therein or
filed with the Commission and each amendment thereof or supplement thereto,  and
will  give  each  of  them  such  access  to its  books  and  records  and  such
opportunities  to discuss the  business of the Company with its officers and the
independent  public  accountants who have certified its financial  statements as
shall be  necessary,  in the opinion of such  Holders and such  underwriters  or
their  respective  counsel,  to conduct a  reasonable  investigation  within the
meaning of the Act.

     1.5 Expenses of  Registration.  The Company shall bear and pay all expenses
incurred in connection with any registration,  filing or  qualification,  to the
extent set forth in Section 1.3, of the Underlying  Common Stock with respect to
each  registration  pursuant to Section 1.2 for each Holder  (which right may be
assigned  as provided  in Section  1.10),  including  (without  limitation)  all
registration,  filing, and qualification  fees,  printers,  legal and accounting
fees relating or apportionable thereto, but excluding underwriting discounts and
commissions  relating  to  Underlying  Common  Stock  (in  the  case  of a  firm
commitment underwritten public offering).

     1.6 Underwritten Offers.

     (a) Whenever a registration  requested pursuant to Section 1.2(b) hereof is
for a firm commitment underwritten offering, the Holder(s) holding a majority of
the  Underlying  Common Stock so  requested to be included in such  registration
shall select the managing  underwriter(s)  of recognized  standing to administer
the offering,  and each Holder requesting  registration of its Underlying Common
Stock for  disposition  in a firm  commitment  underwritten  offering  agrees to
include  such  Underlying  Common  Stock in such  firm  commitment  underwritten
offering and shall be bound by the terms of the  underwriting  as agreed between
the majority of Holders requesting registration and the underwriters.

     (b) In  connection  with a firm  commitment  underwritten  offering  of the
Company's  capital stock under Section 1.2(a)  hereof,  the Company shall not be
required to include any of the Holders'  securities in such underwriting  unless
they accept the terms of the underwriting as agreed upon between the Company and
the  underwriters  selected  by it (or by other  persons  entitled to select the
underwriters),  and then only in such quantity as the underwriters  determine in
good faith will not  jeopardize  the success of the offering by the Company.  If
the total amount of securities,  including Underlying Common Stock, requested by
stockholders  to be included in such  offering  exceeds the amount of securities
sold other than by the Company  that the  underwriters  determine  in their sole
discretion  is  compatible  with the success of the  offering,  then the Company
shall  be  required  to  include  in the  offering  only  that  number  of  such
securities,  including Underlying Common Stock, which the underwriters determine
in good faith will not jeopardize the success of the offering (the securities so
included to be apportioned pro rata among the selling stockholders  according to
the total amount of  securities  entitled to be included  therein  owned by each
selling  stockholder or in such other proportions as shall mutually be agreed to
by such  selling  stockholders).  For  purposes of the  preceding  parenthetical
concerning  apportionment,  for any  selling  stockholder  which is a holder  of
Underlying Common Stock and which is a partnership or corporation, the partners,
retired  partners and  stockholders  of such  holder,  or the estates and family
members of any such partners and retired partners and any trusts for the benefit
of any of  the  foregoing  persons  shall  be  deemed  to be a  single  "selling
stockholder",  and  any  pro  rata  reduction  with  respect  to  such  "selling
stockholder"  shall be based  upon  the  aggregate  amount  of  shares  carrying
registration  rights  owned by all  entities  and  individuals  included in such
"selling stockholder", as defined in this sentence.

     1.7 Delay of Registration. No Holder shall have any right to obtain or seek
an injunction  restraining or otherwise  delaying any such  registration  as the
result of any controversy that might arise with respect to the interpretation or
implementation of this Section 1.

     1.8  Indemnification.  In the event any Underlying Common Stock is included
in a registration statement under this Section 1:

     (a) To the extent  permitted by law, the Company  will  indemnify  and hold
harmless each Holder who is not a director or executive  officer of the Company,
any underwriter (as defined in the Act) for such Holder and each person, if any,
who  controls  such Holder or  underwriter  within the meaning of the Act or the
Securities  Exchange Act of 1934, as amended (the "Exchange  Act"),  against any
losses,  claims,  damages,  or liabilities  (joint or several) to which they may
become subject under the Act, or the Exchange Act or other federal or state law,
insofar as such losses,  claims,  damages, or liabilities (or actions in respect
thereof)  arise  out of or are  based  upon  any  of the  following  statements,
omissions or violations  (collectively a "Violation"):  (i) any untrue statement
or alleged untrue  statement of a material fact  contained in such  registration
statement,  including any preliminary  prospectus or final prospectus  contained
therein or any amendments or supplements  thereto,  (ii) the omission or alleged
omission to state  therein a material  fact  required to be stated  therein,  or
necessary to make the statements therein not misleading,  or (iii) any violation
or alleged  violation  by the Company of the Act,  the  Exchange  Act, any state
securities  law or any rule or  regulation  promulgated  under  the Act,  or the
Exchange Act or any state  securities law; and the Company will pay to each such
Holder,  underwriter  or  controlling  person,  as incurred,  any legal or other
expenses  reasonably  incurred  by  them in  connection  with  investigating  or
defending any such loss, claim, damage, liability, or action; provided, however,
that the indemnity agreement contained in this subsection 1.8(a) shall not apply
to amounts paid in settlement of any such loss,  claim,  damage,  liability,  or
action if such  settlement is effected  without the consent of the Company,  nor
shall the Company be liable in any such case for any such loss,  claim,  damage,
liability,  or action to the  extent  that it arises  out of or is based  upon a
Violation  which  occurs  in  reliance  upon  and  in  conformity  with  written
information  furnished expressly for use in connection with such registration by
any such Holder, underwriter or controlling person.

     (b) To the extent  permitted by law, each selling Holder will indemnify and
hold harmless the Company,  each of its directors,  each of its officers who has
signed the registration statement, each person, if any, who controls the Company
within  the  meaning  of the Act,  any  underwriter,  any other  Holder  selling
securities in such registration statement and any controlling person of any such
underwriter or other Holder,  against any losses, claims,  damages,  liabilities
(joint or several) or actions to which any of the  foregoing  persons may become
subject,  under the Act,  or the  Exchange  Act or other  federal  or state law,
insofar as such losses,  claims,  damages or liabilities  (or actions in respect
thereto)  arise  out of or are  based  upon any  Violation,  in each case to the
extent (and only to the extent) that such Violation  occurs in reliance upon and
in conformity with written  information  furnished by such Holder  expressly for
use in  connection  with such  registration;  and each such  Holder will pay, as
incurred, any legal or other expenses reasonably incurred by any person intended
to be  indemnified  pursuant  to this  subsection  1.8(b),  in  connection  with
investigating or defending any such loss, claim, damage,  liability,  or action;
provided,  however,  that the indemnity  agreement  contained in this subsection
1.8(b) shall not apply to amounts paid in  settlement  of any such loss,  claim,
damage,  liability or action if such settlement is effected  without the consent
of the Holder.

     (c) Promptly after receipt by an  indemnified  party under this Section 1.8
of notice of the commencement of any action (including any governmental  action)
such indemnified party will, if a claim in respect thereof is to be made against
any indemnifying party under this Section 1.7, deliver to the indemnifying party
a written notice of the commencement  thereof and the  indemnifying  party shall
have the right to participate in, and, to the extent the  indemnifying  party so
desires,  jointly with any other indemnifying party similarly noticed, to assume
the defense thereof with counsel mutually satisfactory to the parties; provided,
however,  that an indemnified party (together with all other indemnified parties
which may be represented  without  conflict by one counsel) shall have the right
to retain one  separate  counsel,  with the fees and  expenses to be paid by the
indemnifying  party, if  representation of such indemnified party by the counsel
retained  by the  indemnifying  party  would be  inappropriate  due to actual or
potential differing interests between such indemnified party and any other party
represented by such counsel in such  proceeding.  The failure to deliver written
notice to the indemnifying party within a reasonable time of the commencement of
any such action,  if  prejudicial  to its ability to defend such  action,  shall
relieve such indemnifying  party of any liability to the indemnified party under
this  Section  1.8,  but  the  omission  so to  deliver  written  notice  to the
indemnifying  party will not relieve it of any liability that it may have to any
indemnified party otherwise than under this Section 1.8.

     (d) If the  indemnification  provided  for in this Section 1.8 is held by a
court of competent  jurisdiction to be unavailable to an indemnified  party with
respect to any loss,  liability,  claim, damage, or expense referred to therein,
then the  indemnifying  party, in lieu of indemnifying  such  indemnified  party
hereunder,  shall  contribute to the amount paid or payable by such  indemnified
party as a result of such loss,  liability,  claim,  damage,  or expense in such
proportion as is appropriate  to reflect the relative fault of the  indemnifying
party on the one hand and of the  indemnified  party on the other in  connection
with the statements or omissions that resulted in such loss,  liability,  claim,
damage, or expense as well as any other relevant equitable  considerations.  The
relative fault of the indemnifying  party and of the indemnified  party shall be
determined by reference  to, among other  things,  whether the untrue or alleged
untrue  statement of a material  fact or the  omission to state a material  fact
relates to information  supplied by the indemnifying party or by the indemnified
party and the parties' relative intent,  knowledge,  access to information,  and
opportunity to correct or prevent such statement or omission.

     (e)  Notwithstanding  the  foregoing,  to the extent that the provisions on
indemnification and contribution contained in the underwriting agreement entered
into in connection with the firm commitment  underwritten public offering are in
conflict  with the foregoing  provisions,  the  provisions  in the  underwriting
agreement shall control.

     (f) The obligations of the Company and Holders under this Section 1.8 shall
survive  the  completion  of  any  offering  of  Underlying  Common  Stock  in a
registration statement under this Section 1, and otherwise.

     1.9 Reports Under  Securities  Exchange Act of 1934.  With a view to making
available to the Holders the benefits of Rule 144 promulgated  under the Act and
any other rule or  regulation  of the  Commission  that may at any time permit a
Holder to sell securities of the Company to the public without registration, the
Company agrees to:

     (a)  make  and keep  public  information  available,  as  those  terms  are
understood and defined in Commission Rule 144 promulgated under the Act;

     (b) file with the  Commission  in a timely  manner  all  reports  and other
documents required of the Company under the Act and the Exchange Act; and

     (c) furnish to any Holder, so long as the Holder owns any Underlying Common
Stock, forthwith upon request (i) a written statement by the Company that it has
complied with the reporting  requirements of Rule 144 promulgated  under the Act
and the  Exchange  Act,  (ii) a copy of the most  recent  annual  and  quarterly
reports of the  Company  and such other  report  and  documents  so filed by the
Company,  and (iii) such other  information  as may be  reasonably  requested in
availing any Holder of any rule or  regulation of the  Commission  which permits
the selling of any such securities without registration.

     1.10 Assignment of Registration  Rights. The rights to cause the Company to
register Underlying Common Stock pursuant to this Section 1 may be assigned (but
only with all related  obligations)  by a Holder to a transferee  or assignee of
such  securities,  provided the Company is, within a reasonable  time after such
transfer,  furnished  with  written  notice  of the  name  and  address  of such
transferee  or  assignee  and  the   securities   with  respect  to  which  such
registration  rights  are  being  assigned;  and  provided,  further,  that such
assignment  shall be effective only if  immediately  following such transfer the
further  disposition  of  such  securities  by the  transferee  or  assignee  is
restricted or subject to volume or manner of sale limitations under the Act.

     2. Miscellaneous.

     2.1 Successors and Assigns.  Except as otherwise provided herein, the terms
and  conditions of this  Agreement  shall inure to the benefit of and be binding
upon the respective successors and assigns of the parties (including transferees
of the Warrants and the  Underlying  Common Stock).  Nothing in this  Agreement,
express or implied,  is intended to confer upon any party other than the parties
hereto  or  their  respective  successors  and  assigns  any  rights,  remedies,
obligations,  or  liabilities  under or by reason of this  Agreement,  except as
expressly provided in this Agreement.

     2.2 Governing Law. This Agreement  shall be governed by and construed under
the laws of the State of New York.

     2.3   Counterparts.   This  Agreement  may  be  executed  in  two  or  more
counterparts,  each of  which  shall be  deemed  an  original,  but all of which
together shall constitute one and the same instrument.

     2.4 Titles and  Subtitles.  The titles and subtitles used in this Agreement
are used for  convenience  only and are not to be  considered  in  construing or
interpreting this Agreement.

     2.5 Notices.  Except as may be otherwise  provided herein,  all notices and
other  communications  required or permitted  hereunder  shall be in writing and
shall be conclusively  deemed to have been duly given (a) when hand delivered to
the other  party,  (b) when sent by facsimile to the number set forth below such
party's signature (provided,  however, that notices given by facsimile shall not
be effective  unless  either (i) a duplicate  copy of such  facsimile  notice is
promptly  given by one of the other  methods  described  in this Section 2.5, or
(ii) the  receiving  party  delivers a written  confirmation  of receipt of such
notice  either by facsimile  or any other method  described in this Section 2.5)
and (c) the next business day after deposit with a national  overnight  delivery
service,  postage  prepaid,  addressed  to the  parties as set forth  below such
party's signature, with next-business-day delivery guaranteed, provided that the
sending party receives a confirmation of delivery from the service  provider.  A
party may change or supplement the address given above, or designate  additional
addresses,  for purposes of this  Section 2.5 by giving the other party  written
notice of the new address in the manner set forth above.

     2.6 Expenses.  If any action at law or in equity is necessary to enforce or
interpret the terms of this Agreement, the prevailing party shall be entitled to
reasonable attorneys' fees, costs and necessary disbursements in addition to any
other relief to which such party may be entitled.

     2.7  Amendments  and Waivers.  The Company and Holders of a majority of the
Underlying  Common Stock (to the extent issued and  outstanding) can agree to an
amendment of, or a waiver to, the terms of this Agreement.

     2.8  Severability.  If one or more provisions of this Agreement are held to
be  unenforceable  under  applicable  law, such provision shall be excluded from
this Agreement and the balance of the Agreement  shall be interpreted as if such
provision  were so excluded  and shall be  enforceable  in  accordance  with its
terms.





<PAGE>


         IN WITNESS WHEREOF,  the parties have executed this Agreement as of the
date first above written.



INTEGRATED HEALTH SERVICES, INC.            COMMUNITY CARE OF AMERICA, INC.




By:
Name:                                       By:
Title:                                      Name:
         Address for Notice:                Title:
                                                       Address for Notice:
10065 Red Run Boulevard
Owings Mills, MD  21117                     3050 North Horseshoe Drive
Fax No. (410) 998-8747                      Naples, FL  33942
Attn:  Marshall A. Elkins, Esq.             Fax No. (941) 435-0087
                                            Attn:  Gary Singleton, President


                                           




<PAGE>


                                    EXHIBIT 4

                                CCA PRESS RELEASE
                             DATED JANUARY 13, 1997

                                [TO BE INSERTED]













                              MANAGEMENT AGREEMENT

                  THIS  MANAGEMENT  AGREEMENT  (this  "Agreement")  is made  and
entered into as of December 27, 1996, by and between  COMMUNITY CARE OF AMERICA,
INC., a Delaware corporation with offices at 3050 N. Horseshoe Drive, Naples, FL
33942 ("Owner") and INTEGRATED  HEALTH  SERVICES,  INC., a Delaware  corporation
with offices at 10065 Red Run Boulevard, Owings Mills, MD 21117 ("Manager").

                  WHEREAS,  the Owner is a publicly-traded  corporation that is,
directly and  indirectly  through its  subsidiaries,  engaged in the business of
owning,  operating and managing skilled nursing facilities,  hospitals and other
health care related facilities (the "Business"); and

                  WHEREAS, the Manager is a publicly-traded  corporation engaged
in the ownership  and  operation of similar  facilities  and is  experienced  in
various phases of the management,  operation and ownership  thereof,  including,
without  limitation,  the management of the financial and  accounting  functions
related thereto, and arranging and negotiation of contracts for the provision of
ancillary services for health care facilities; and

                  WHEREAS, the Owner desires to engage the Manager to manage the
financial,  accounting and ancillary services contracting  functions for Owner's
account during the term herein provided,  and the Manager desires to accept such
engagement, upon the terms and subject to the conditions contained herein.






<PAGE>







                  NOW, THEREFORE, in consideration of the premises and covenants
herein contained, and intending to be legally bound hereby, the parties agree as
follows:


                                    ARTICLE I
                            EMPLOYMENT OF THE MANAGER

                  1.1 Employment. For and during the term of this Agreement, the
Owner hereby grants to the Manager the sole and exclusive right, and employs the
Manager to  supervise,  manage,  and operate  the  financial,  accounting,  MIS,
reimbursement  and ancillary  services  contracting  functions (the  "Applicable
Functions")  in the name and for the  account  of the  Owner  upon the terms and
conditions hereinafter set forth.

                  1.2 Acceptance. The Manager accepts such employment and agrees
that it will (a) faithfully perform its duties and  responsibilities  hereunder,
(b) use  its  best  efforts  to  supervise  and  direct  the  management  of the
Applicable  Functions in an efficient manner, and (c) consult with the Owner and
keep the Owner advised of all major policy matters relating to the management of
the Applicable Functions. The Manager shall report to the principal financial or
chief accounting officer of the Owner, whose approval shall be required prior to
the public issuance or filing with the Securities and Exchange  Commission ("the
SEC") of any financial or accounting report.


                                   ARTICLE II
                                      TERM

     The initial term of this  Agreement  shall  commence on January 1, 1997, or
such earlier date as Manager and Owner shall agree (the "Commencement Date") and
shall extend until December 31, 2001 ("Term").

<PAGE>

                                   ARTICLE III

                        RIGHTS AND DUTIES OF THE MANAGER

                  During  the term of this  Agreement,  and in the course of its
management of the Applicable Functions:

                  3.1 Employees. The Manager, on the Owner's behalf, shall hire,
promote,  discharge,  and  supervise  the  work  of all  employees  involved  in
performing services related to the Applicable  Functions below the Owner officer
level. All of such employees shall be employees of the Manager,  except for such
employees of the Owner as the Owner and Manager shall mutually agree,  provided,
however, that the compensation of any such employees of Owner,  including fringe
benefits,  with respect to such employees,  shall be deducted from the amount of
the Management Fee. The term "fringe  benefits" as used herein shall include but
not  be  limited  to  the   employer's   contribution   of  FICA,   unemployment
compensation,   and  other  employment  taxes,  retirement  plan  contributions,
workman's  compensation,  group life,  accident,  and health insurance  premium,
profit sharing  contributions,  disability,  and other similar  benefits paid or
payable by the Manager  with  respect to its own  business  or other  businesses
managed  by it,  but  shall in any  event be  consistent  with the  compensation
provided to other similarly situated employees of the Owner.


                  3.2  Ancillary  Services,  Utilities,  Etc. The Manager  shall
enter into such  contracts in the name of and at the expense of the Owner as may
be deemed  necessary or advisable for the furnishing of all ancillary  services,
including,  without  limitation,  utilities,  concessions,  supplies  and  other
services as may be needed from time to time for the maintenance and operation of
the  Business.  Manager is  authorized  to  contract  for or  provide  ancillary
services,





<PAGE>







including,  but not limited to, rehabilitation and respiratory therapy services,
and mobile  diagnostic  services,  through  providers that are affiliates of the
Manager,  provided  that such  services  are  rendered  at levels of quality and
pricing that are competitive with those available in the community.

                  3.3  Deposit and  Disbursement  of Funds.  The  Manager  shall
deposit in a banking  institution  which is a member of the FDIC in  accounts in
the Manager's name as agent for Owner,  all monies arising from the operation of
the Business or otherwise received by the Manager for and on behalf of the Owner
("Business  Funds"),  and shall  disburse and pay the same from said accounts on
behalf and in the name of Owner in the following  order of priority and, in each
case,  such  amounts  and at such times as the same are  required  to be made in
connection with:

                           (a) Payment of Debt Service (as hereinafter  defined)
         and all costs and expenses  arising out of the ownership,  maintenance,
         expansion,   and   operation  of  the  Business,   including,   without
         limitation,  the  reimbursable  expenses of the Manager  hereunder  set
         forth in Exhibit A hereto;

                           (b)  Payment  of the  Manager's  Management  Fee  (as
         hereinafter  defined)  provided for in Article V, below  (including any
         accrued and unpaid Management Fees for prior periods);

                           (c) The balance of such funds,  after  provision  for
         such adequate  working capital  reserves on a monthly basis as shall be
         determined by the Manager in its reasonable business




<PAGE>







         judgment,  shall be  invested by the Manager on behalf of the Owner or,
         if directed by the Owner,  shall be used to reduce existing debt of the
         Owner (including, without limitation, any debt due to Manager or any of
         its affiliates or subsidiaries),  to make  distributions to the Owner's
         stockholders or to repurchase outstanding shares of its capital stock.

                  As used herein, "Debt Service" means scheduled payments of the
principal and interest with respect to:

                           (x)          existing debt service payments; and

                           (y) any additional indebtedness incurred by the Owner
         for the  improvement,  maintenance,  or  operation  of the  Business as
         mutually agreed upon by Owner and Manager.

                           "Debt Service" includes payments made with respect to
         any  revolving  credit  line with the  Manager or others,  but does not
         include any other amounts payable by reason of voluntary prepayments or
         the acceleration of such indebtedness for any reason.

                  3.4  Statements.  The Manager shall deliver or cause
to be delivered to the Owner statements as follows:

                           (a) Within thirty (30) days following the end of each
         calendar month, a profit and loss statement and balance sheet statement
         (both prepared on an accrual basis in accordance with GAAP) showing the
         results of operation of the  Business for such  calendar  month and the
         year-to-date,   and  having  annexed   thereto  a  computation  of  the
         Management  Fee (as  determined  under  Article  VI  hereof)  for  such
         preceding month and the year-to-date;





<PAGE>








                           (b) On or before  ninety (90) days after the close of
         each fiscal year during the term of this  Agreement,  the Manager  will
         also deliver or cause to be delivered to the Owner a balance  sheet and
         related statement of profit and loss certified by an independent public
         accounting firm and prepared in accordance with GAAP showing the assets
         employed in the operation of the Business and the liabilities  incurred
         in  connection  therewith  as of the end of the  fiscal  year,  and the
         results of the operation of the Business  during the  preceding  twelve
         (12) months then ended,  and having  annexed  thereto (i) a copy of all
         Medicare and Medicaid cost reports prepared by the Manager with respect
         to each facility  constituting any part of the Business for such twelve
         month period,  and (ii) a computation  of the  Management  Fee for such
         twelve (12) month period; and

                           (c) all other  financial and  accounting  reports and
         statements  that the Owner is required  to prepare or file  pursuant to
         applicable law, including, without limitation, any required pursuant to
         the  Securities  Exchange  Act of 1934,  as  amended  and the rules and
         regulations  promulgated  thereunder (the "Exchange  Act"). All of such
         reports and  statements  shall be  delivered  to the Owner a reasonable
         amount of time prior to the date on which such report or  statement  is
         required  to  be  reported,  filed  or  disclosed  in  accordance  with
         applicable law.

                  3.5 Data Processing. The Manager shall, directly or through an
affiliate,  provide the data  processing  required to  maintain  the  financial,
payroll, and accounting records of the Business;  except that the Manager agrees
that the Business




<PAGE>







payroll will not be moved to Manager's central payroll administration until same
can be accomplished without a material disruption to Business cash flow.

                  3.6  Books and  Records.  The  Manager  on behalf of the Owner
shall  manage the keeping of full and  accurate  books of account and such other
records reflecting the results of operation of the Business as required by law.

                  3.7 Taxes. The Manager shall cause all taxes, assessments, and
charges of every kind imposed upon the Business by any  governmental  authority,
including  interest  and  penalties  thereon,  to be paid  when due if funds are
available,  except that the Manager  shall not cause such  payment to be made if
(a) same is in good faith being  contested  by the Owner at its sole expense and
without  cost to the Manager,  (b)  enforcement  thereof is stayed,  and (c) the
Owner shall have given the Manager  written  notice of such contest and stay and
authorized  the  non-payment  thereof,  not less than ten (10) days prior to the
date on which such tax  assessment,  or charge is due and  payable.  Interest or
penalty payments shall be reimbursed by the Manager to the Owner if imposed upon
the Owner by reason  of  negligence  on the part of the  Manager  in making  the
payment if funds are  available  therefor.  Manager  shall  notify  Owner of all
taxes,  assessments or penalties assessed against the Business other than in the
normal course of business.

<PAGE>



                                   ARTICLE IV
                         RIGHTS AND DUTIES OF THE OWNER

                  During the term of this Agreement:




                  4.1 Right of Inspection. The books and records of the Business
shall be the property of Owner.  The books and records of the Business shall not
be  removed  by the  Manager  without  the  consent  of  the  Owner.  The  Owner
acknowledges  that some books and records will be  maintained  at the  Manager's
principal place of business.

                  4.2 Cooperation  with Manager.  The Owner will fully cooperate
with the Manager in connection  with the management of the Applicable  Functions
and will  reimburse  the  Manager for all funds  expended or costs and  expenses
incurred  to which the  Manager is  entitled  to  reimbursement  as set forth in
Exhibit A of this Agreement.

                  4.3 Operating  Capital.  To any extent  necessary after taking
into account Manager's loans under Article V, below, the Owner shall provide the
Manager with such amount of working capital as may be required from time to time
for the  operation of the Business on a sound  financial  basis  (including  the
payment  of all  amounts  owed to Manager  including,  but not  limited  to, the
payment of all management fees,  reimbursable expenses and amounts due under the
Line of Credit).  If additional  working capital is required,  the Manager shall
notify the Owner thereof in writing and the Owner shall provide the Manager with
such increase in working  capital  within fifteen (15) days  thereafter.  If the
Owner fails to provide such additional working capital,  Manager may, but is not
obligated to, provide the same as a loan to the Owner.

<PAGE>

                                    ARTICLE V



                         COMPENSATION AND DISTRIBUTIONS

                  5.1 As full and exclusive compensation for all of the services
to be rendered by Manager during the Term of this Agreement, the Owner shall pay
to the Manager at its  principal  office,  or at such other place as the Manager
may  from  time to time  designate  in  writing,  and at the  times  hereinafter
specified a monthly fee (the  "Management  Fee").  The  aggregate  amount of the
Management  Fee  for the  period  commencing  with  the  effective  date of this
Agreement and ending on December 31, 1997 shall be an amount equal to the lesser
of (a) two percent  (2%) of Gross  Revenues or (b) twice the amount of the total
direct  and  indirect  costs of Owner for the  Applicable  Functions  during the
period July 1, 1996 through  December  31, 1996  ("Owner's  Cost").  The monthly
payment of the  Management  Fee for such period shall be based on the percentage
of Gross Revenue  specified in clause (a), with an adjustment  being made to the
amount of  Management  Fee  payable  for the final  month of such  period if the
amount in clause (b) shall be less than clause (a).  The Lender and Borrower may
by mutual  agreement  increase the  percentages in clause (a) above to an amount
not  greater  than two and one  half  percent  (2.5%)  following  completion  of
Lender's due diligence review. The Management Fee for periods commencing January
1, 1998 and thereafter shall be an amount equal to the lesser of (a) two percent
(2%) of Gross  Revenues or (b) a  percentage  of Gross  Revenues  determined  by
dividing  (x) an amount  equal to Owner's  Cost,  by (y) an amount  equal to the
Gross Revenues for the period July 1, 1996 through December 31, 1996. The Lender
and Borrower may by mutual  agreement  increase  the  percentages  in clause (a)
above to an amount not greater  than two and one half percent  (2.5%)  following
completion of Lender's due diligence  review. At the completion of its review of
Owner's  books and records,  Managers  will notify Owner of its  calculation  of
Owner's Cost.





<PAGE>







If Owner disagrees with Manager's calculation of Owner's Cost, the parties agree
that KPMG  Peat  Marwick  shall  recompute  Owner's  Cost for  purposes  of this
Agreement using generally accepted  accounting  principals,  which recomputation
shall be final and binding on the parties hereto. All fees incurred by KPMG Peat
Marwick shall be borne by the Owner.  The  Management  Fee shall be payable five
days after delivery to Owner of the monthly financial  statement  referred to in
Section  3.4(a)  (each such date  being  hereinafter  referred  to as a "Payment
Date") and shall be calculated  based upon the Business's  Gross Revenues during
the preceding month as set forth in such financial statements.

                  5.2 For the  purposes  of  determining  the  Management  Fees,
"Gross Revenues" for any period shall be determined on the basis of all revenues
of any kind derived  directly or indirectly from the Business during such period
(including rental or other payment from concessionaires, licensees, tenants, and
other users of the Business) as determined in accordance with generally accepted
accounting principles consistently applied, excluding, however:

                    (a) federal,  state,  and municipal  excise,  sales, and use
               taxes  collected  directly  from  patients as a part of the sales
               prices of any goods or services;

                    (b)  proceeds  of any life or casualty  insurance  policies,
               condemnation or eminent domain;

                    (c)  gains  or  losses   arising  from  the  sale  or  other
               disposition of capital assets;





<PAGE>







                    (d)  any  reversal  or  accrual  of any  contingency  or tax
               reserve;

                    (e)  interest  earned on  sinking  funds,  Special  Security
               Accounts, bonds funds, etc. originally and specifically formed as
               a requirement  of any bond issue  utilized to finance any part of
               the Business;

                    (f) patient trust accounts;

                    (g) tax refunds;

                    (h)  uncollectible  accounts  receivable,  in the reasonable
               judgment of Manager and in accordance with industry standards;

                    (i)   miscellaneous   revenues   arising   from   dividends,
               discounts,  or refunds related to items previously expensed;  and
               bequests, gifts, or similar donations.

                  The proceeds of business interruption insurance or proceeds as
a result of Medicare and Medicaid  audits shall be included in Gross Revenues of
the Business.  However,  funds required to be repaid as a result of Medicare and
Medicaid audits shall be deducted from Gross Revenues of the Business.

                  5.3   Notwithstanding   the  foregoing,   the  Management  Fee
(including any amount carried over pursuant to the succeeding  sentence  hereof)
shall be payable on each Payment Date only to the extent that the Business Funds
(as defined in Section 3.3) shall be sufficient  as of such date;  provided that
the Manager shall be entitled to cause a draw-down  under any  revolving  credit
facility of the Owner to make payment of





<PAGE>







any Management  Fee then payable or accrued from prior  periods.  Any portion of
the  Management  Fee not paid due to the foregoing  shall be carried over and be
payable on the immediately  succeeding  Payment Date;  provided,  however,  that
Owner shall pay Manager interest on such unpaid portion of the Management Fee at
the rate specified in the Subordinated  Note of even date herewith made by Owner
in favor of IHS Financial Holdings, Inc.


                                   ARTICLE VI
                     REPRESENTATIONS AND WARRANTIES OF OWNER

          The Owner represents and warrants to the Manager as follows:

                  6.1  Organization and Standing of the Owner.  The
Owner is a corporation duly organized, validly existing and in
good standing under the laws of the State of Delaware. Copies
of the Articles of Incorporation and By-Laws of the Owner, and
all amendments thereof to date, have been, if requested,
delivered to Manager and are complete and correct.  The Owner
and its subsidiaries have the power and authority to own the
property and assets now owned by them and to conduct the
business presently being conducted by them.

                  6.2 Absence of Conflicting  Agreements.  Neither the execution
or delivery of this Agreement,  including all Schedules and Exhibits hereto,  or
any of the other instruments and documents  required or contemplated  hereby and
thereby ("Transaction Documents") by the Owner, nor the performance by the Owner
of  the  transactions  contemplated  hereby  and  thereby,  conflicts  with,  or
constitutes a breach of or a default or




<PAGE>







requires the consent of any third party under (i) the Articles of  Incorporation
or By-Laws of the Owner (or any of its subsidiaries); or (ii) to the best of its
knowledge after due inquiry,  any applicable law, rule,  judgment,  order, writ,
injunction, or decree of any court, currently in effect; or (iii) to the best of
its  knowledge  after due inquiry,  any  applicable  rule or  regulation  of any
administrative  agency or other governmental  authority  currently in effect; or
(iv) any agreement, indenture, contract or instrument to which the Owner (or any
of its  subsidiaries) is now a party or by which the assets of the Owner (or any
of its subsidiaries) are bound.

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

                  6.4  Financial Statements.

                           (a) The audited  consolidated  balance  sheets of the
         Business  as of  December  31,  1995,  and the  related  statements  of
         operations  and cash flow for the year then ended,  filed with the SEC,
         present  fairly in all material  respects the  financial  condition and
         results of  operations  of the Business at and for the periods  therein
         specified and were prepared in accordance with GAAP.

                           (b) The unaudited consolidated balance sheets and the
         related  statements  of  operations of the Business as of September 30,
         1996, and cash flow for the 9-month period then





<PAGE>







         ended,  filed with the SEC, present fairly in all material respects the
         financial  condition  and results of  operations of the Business at and
         for the periods therein  specified and were prepared in accordance with
         GAAP.

                  6.5 Material Changes.  Since September 30, 1996, except as set
forth in  reports  filed by the  Owner  with  the  SEC,  there  has not been any
material adverse change in the condition (financial or otherwise) of the assets,
properties or operations of the Owner on a  consolidated  basis,  whether or not
covered by insurance,  and during such period of time the Owner has and from the
date of this Agreement through the Commencement  Date, will have,  conducted the
Business only in the ordinary and normal course,  and made no  distributions  to
any  shareholders of the Owner other than wages paid and expenses  reimbursed in
the ordinary and normal course of business.

                  6.6  Legal  Proceedings.  Other  than as may be set  forth  in
reports filed by the Owner with the SEC, there are no claims,  actions, suits or
proceedings or arbitrations,  either administrative or judicial, pending, or, to
the knowledge of Owner,  overtly  threatened against or affecting the Owner, its
subsidiaries  or  affiliates,  of a nature  required to be  disclosed in reports
filed with the SEC, or affecting  Owner's ability to consummate the transactions
contemplated herein.

                  6.7 Tax  Returns.  The Owner  have filed all  Federal,  state,
county and local  income,  excise,  property,  employment-related  and other tax
returns  and  abandoned  property  reports  (if  any) to date  that  are due and
required to be filed by it, and there are no claims,  liens,  or  judgments  for
taxes due




<PAGE>







from the Owner,  and to the knowledge of the Owner, no basis for any such claim,
lien, or judgment exists.


                                   ARTICLE VII
                    REPRESENTATIONS AND WARRANTIES OF MANAGER

          The Manager represents and warrants to the Owner as follows:

                  7.1  Organization and Standing of the Manager.  The
Manager is a corporation duly organized, validly existing and
in good standing under the laws of the State of Delaware.
Copies of the Articles of Incorporation and By-Laws of the
Manager, and all amendments thereof to date, have been, if
requested, delivered to the Owner and are complete and
correct.  The Manager has the power and authority to own the
property and assets now owned by it and to conduct the
business presently being conducted by it.


                                  ARTICLE VIII
                               TERMINATION RIGHTS

                  This Agreement may be terminated and, except as to liabilities
or claims of either party hereto which shall have theretofore accrued or arisen,
the  obligations  of the parties  hereto with respect to this  Agreement  may be
terminated, upon the happening of any of the following events:

                  8.1  Termination by the Owner:  If at any time or from time to
time during the term of this  Agreement any of the following  events shall occur
and not be  remedied  within the  applicable  period of time  herein  specified,
namely:






<PAGE>







                    (a)  The   Manager   shall  apply  for  or  consent  to  the
               appointment of a receiver,  trustee, or liquidator of the Manager
               of all or a  substantial  part of its  assets,  file a  voluntary
               petition in bankruptcy, make a general assignment for the benefit
               of creditors, file a petition or an answer seeking reorganization
               or arrangement with creditors or take advantage of any insolvency
               law, or if an order,  judgment or decree  shall be entered by any
               court  of  competent  jurisdiction,   on  the  application  of  a
               creditor,  adjudicating  the Manager as bankrupt or  insolvent or
               approving  a petition  seeking  reorganization  of the Manager or
               appointing a receiver,  trustee,  or liquidator of the Manager or
               of  all or  substantial  part  of its  assets,  and  such  order,
               judgment or decree shall continue  unstayed and in effect for any
               period of ninety (90) consecutive days;

                    (b) The Manager shall fail to keep,  observe, or perform any
               material covenant, agreement, term or provision of this Agreement
               to be kept,  observed,  or  performed  by the  Manager,  and such
               default  shall  continue  for a period of sixty  (60) days  after
               written notice thereof by the Owner to the Manager; or

                    (c) There shall occur a "Fundamental Event" of the Owner;

then in case of any such  event and upon the  expiration  of the period of grace
applicable  thereto,  the term of this  Agreement  shall expire,  at the Owner's
option and upon ten (10) days written notice to the Manager; provided,  however,
that, upon  termination,  pursuant to Section 8.1(c),  Owner shall pay Manager a
termination fee equal to the Management Fee for the





<PAGE>







six months  immediately  preceding the date notice of termination is given.  For
purposes  of  Section  8.1(c) a  "Fundamental  Event"  shall  have  the  meaning
attributed to it in the Subordinated Note of even date herewith made by Owner in
favor of IHS Financial Holdings, Inc.
                  8.2 Termination by the Manager: If at any time or from time to
time during the term of this  Agreement any of the following  events shall occur
and not be  remedied  within the  applicable  period of time  herein  specified,
namely:

                           (a) The Owner shall fail to keep, observe, or perform
         any material covenants,  agreement, term or provision of this Agreement
         to be kept, observed,  or performed by the Owner and such default shall
         continue for a period of sixty (60) days after written  notice  thereof
         by the  Manager to the Owner,  except for  Owner's  duty to provide for
         adequate working capital under Section 4.3 hereof, which shall continue
         uncured for a period of thirty (30) days after written notice thereof;

                           (b) The Owner (or any of its principal  subsidiaries)
         shall apply for or consent to the  appointment of a receiver,  trustee,
         or liquidator (or any principal subsidiary of the Owner) or of all or a
         substantial part of its assets, file a voluntary petition in bankruptcy
         or admit in writing its  inability to pay its debts as they become due,
         make a general assignment for the benefit of creditors, file a petition
         or any answer seeking  reorganization  or arrangement with creditors or
         to take  advantage of any insolvency  law, or if an order,  judgment or
         decree  shall be entered by a court of competent  jurisdiction,  on the
         application  of a creditor,  adjudicating  the Owner (or any  principal
         subsidiary of the Owner) bankrupt or appointing a receiver, trustee, or
         liquidator with respect to all or substantial part of the





<PAGE>







         assets of the Owner (or any  principal  subsidiary  of the Owner),  and
         such order,  judgment or decree shall  continue  unstayed and in effect
         for any period of ninety (90) consecutive days;

                           (c)  Business  Funds  shall be  insufficient  for the
         payment of the  management  fees to the  Manager  pursuant to Article V
         hereof for a period of at least six (6) consecutive months;

then in case of any such  event and upon the  expiration  of the period of grace
applicable  thereto,  the term of this Agreement shall expire,  at the Manager's
option and upon ten (10) days written notice to the Owner.
                  8.3  Material  Adverse  Change.  Manager  shall be entitled to
terminate  this  Agreement  forthwith upon notice to the Owner in the event that
(a) there shall have occurred since the date hereof any material  adverse change
in the financial or operating condition of the Business or its prospects, or (b)
any  representation or warranty of the Owner herein shall have ceased to be true
and correct in any material respect.

                  8.4  Surviving  Rights  Upon  Termination.   If  either  party
exercises  its option to  terminate  pursuant to this Article  VIII,  each party
shall forthwith account for and pay to the other all sums due and owing pursuant
to the terms of this Agreement.  All other rights and obligations of the parties
under this Agreement shall terminate (except as set forth in Article IX hereof).




<PAGE>



                                   ARTICLE IX
                                 INDEMNIFICATION

                  9.1 Indemnification of Owner by Manager.  Manager shall at all
times indemnify and hold harmless the Owner, its officers, directors, employees,
and  shareholders,  from and against any and all  claims,  losses,  liabilities,
actions, proceedings, and expenses (including reasonable attorneys fees) arising
out of any breach by the Manager of its obligations  under this  Agreement.  The
provisions  of this Section 9.1 shall survive the  termination  or expiration of
this Agreement.

                  9.2  Indemnification  of Manager by Owner.  The Owner shall at
all times  indemnify  and hold harmless the Manager,  its  officers,  directors,
employees,  and  shareholders,  from and  against  any and all  claims,  losses,
liabilities,  actions, proceedings, and expenses (including reasonable attorneys
fees) (i)  arising  out of any breach of the  obligations,  representations  and
warranties  made by Owner in this  Agreement  and (ii)  asserted  by  customers,
vendors or  shareholders  of Owner  based  upon the entry by  Manager  into this
Agreement  and not  related to the  performance  by  Manager  of the  Applicable
Functions,  including  but  not  limited  to  medical  malpractice  claims.  The
provisions  of this Section 9.2 shall survive the  termination  or expiration of
this Agreement.

                  9.3  Control  of  Defense  of  Indemnifiable  Claims.  A party
seeking  indemnification under this Article IX shall give the other party prompt
written notice of the claim for which it seeks  indemnification.  Failure of the
party seeking  indemnification  to give such prompt notice shall not relieve the
other party of its indemnification obligation, provided





<PAGE>







that such indemnification obligation shall be reduced by any damages suffered by
such other party resulting from a failure to give prompt notice  hereunder.  The
party  receiving  the  aforementioned  notice shall  provide the defense of such
claim, including, without limitation, retention and payment of attorneys.

                  9.4  Period  of  Limitation.  Any  claim  for  indemnification
herewith must be asserted within twelve (12) months  following  discovery of the
indemnifiable  event,  except that no such  limitation  shall apply to any claim
based upon (a) any liability of the Owner to the Medicare and Medicaid programs,
or to any other  third party  payor,  for excess  reimbursement  received by the
Owner  prior  to  the   Commencement   Date,   or  (b)  any  breach  of  Owner's
representations and warranties pertaining to litigation or tax matters.


                                    ARTICLE X
                                   ARBITRATION

                  If  any  controversy  should  arise  between  the  parties  in
performance, interpretation, or application of this Agreement which involves any
matter, either party may serve upon the other a written notice stating that such
party desires to have the controversy reviewed by an arbitrator.  If the parties
cannot agree  within  fifteen (15) days from the service of such notice upon the
selection of such  arbitrator,  an arbitrator shall be selected or designated by
the  American  Arbitration  Association  upon  written  request of either  party
hereto.  Arbitration  of such  controversy,  disagreement,  or dispute  shall be
conducted in accordance with the Commercial  Arbitration  Rules then in force of
the American Arbitration




<PAGE>







Association  and the decision and award of the  arbitrator so selected  shall be
binding upon the Owner and Manager.  The  arbitration  will be held in New York,
New York.

                  As a condition  precedent to the appointment of any arbitrator
both  parties  shall be  required  to make a good faith  effort to  resolve  the
controversy  which effort shall  continue for a period of thirty (30) days prior
to any demand for arbitration.  The cost of any such arbitration shall be shared
equally by the parties.  Each party shall pay its own costs incurred as a result
of its participation in any such arbitration.

                  If the issue to be arbitrated is Manager's  alleged  breach of
this  Agreement and as a result  thereof,  Owner has the right to terminate this
Agreement,  Manager shall continue to manage the Applicable  Functions hereunder
pending the outcome of such arbitration.

                  The  Arbitrator  shall  have no  authority  to award  punitive
damages or any other damages in excess of the prevailing party's actual damages,
and may not make any ruling, finding or award that does not conform to the terms
and conditions of this Agreement.


                                   ARTICLE XI
                             SUCCESSORS AND ASSIGNS

                  11.1  Assignments  by the Manager.  The  Manager,  without the
consent of the Owner,  shall have the right to assign this Agreement to a wholly
or majority  owned  subsidiary  provided  that the Manager  shall not thereby be
released from its obligations hereunder.





<PAGE>








                  In the event that all or  substantially  all the assets of the
Manager or its capital stock shall during the term of this Agreement be acquired
by another corporation  (hereinafter referred to as the "Acquiring Corporation")
as a result of a merger,  consolidation,  reorganization,  or other transaction,
the Acquiring  Corporation  assumes all of the  obligations  of the Manager then
accrued hereunder, if any, and Manager shall be relieved of all such obligations
(and such Acquiring  Corporation shall be relieved of liability  hereunder if it
subsequently is involved in such an acquisition).

                  Except as otherwise  permitted herein,  the Manager shall have
no right to assign this Agreement.

                  11.2 Sale,  Assignment,  or Sub-Lease by the Owner.  Any sale,
sub-lease,  or  assignment  with  respect  to the  Business,  other  than to the
Manager,  shall  be  expressly  subject  to the  terms  and  provisions  of this
Agreement  and  shall not  relieve  the Owner of its  liability  or  obligations
hereunder,  and Owner shall cause any  purchaser,  assignee,  or  sub-lessee  to
deliver  to the  Manager  written  acknowledgment  of its  agreement  to perform
hereunder including the payment of the management fee described herein.

                  The  Owner  may not at any time,  without  the  prior  written
consent of the Manager, incur any additional debt that is secured by the lien of
one or more deeds of trust, mortgages, or other security instruments.

<PAGE>

                                   ARTICLE XII
                            MISCELLANEOUS PROVISIONS

                  12.1  Notices.  Any  notice or other  communication  by either
party to the other  shall be in writing and shall be given and be deemed to have
been duly given,  upon the date  delivered if delivered  personally  or upon the
date  received  if mailed  postage  pre-paid,  registered,  or  certified  mail,
addressed as follows:


                         To the Owner:         Community Care of America, Inc.
                                               3050 N. Horseshoe Drive
                                               Naples, FL 33942
                                               Attention: Gary Singleton,
                                                            President
                                               Fax:  941-435-0087

                       With a copy to:         J. Allen Miller
                                               Chadbourne & Parke LLP
                                               30 Rockefeller Plaza
                                               New York, New York  10022
                                               Fax:  212-541-5369

                       To the Manager:         Integrated Health Services, Inc.
                                               10065 Red Run Boulevard
                                               Owings Mills, MD  21117
                                               Attention:Marshall A.Elkins, Esq.
                                               Fax:  410-998-8747

                       With a copy to:         IHS Financial Holdings, Inc.
                                               10065 Red Run Boulevard
                                               Owings Mills, MD  21117
                                               Attention:  Eleanor Harding
                                               Fax:  410-998-8716



<PAGE>








                                     - and -


                                 Frank Agostino

                                  Calo Agostino
                                27 Warren Street
                              Hackensack, NJ 07601
                                Fax: 201-488-5855

or to such other  address,  and to the attention of such other person or officer
as either party may designate in writing by notice.

                  12.2 No Partnership or Joint Venture. Nothing contained in the
Agreement  shall  constitute  or be construed to be or create a  partnership  or
joint venture between the Owner, its successors,  or assigns on the one part and
the Manager, its successors,  or assigns on the other part.  Notwithstanding the
foregoing,  the parties  hereby agree that they shall each have a duty to act in
good faith and to deal fairly with the other party hereto.

                  12.3  Modifications  and  Changes.  This  Agreement  cannot be
changed or modified  except by another  agreement in writing signed by the party
sought to be charged therewith or by its duly authorized agent.

                  12.4  Understanding and Agreements.  This Agreement
constitutes the entire understanding and agreements of




<PAGE>







whatsoever  nature or kind  existing  between  the parties  with  respect to the
Manager's management of the Business.

                  12.5 Headings.  The article and paragraph  headings  contained
herein are for  convenience  of  reference  only and are not intended to define,
limit, or describe the scope of intent of any provision of this Agreement.

                  12.6  Approval or Consent.  Whenever  under any  provisions of
this  Agreement,  the  approval  or consent  of either  party is  required,  the
decision  thereon shall be promptly given and such approval or consent shall not
be  unreasonably  withheld.  It is further  understood  and agreed that whenever
under any  provisions of this  Agreement the approval or consent of the Owner is
required,  such  approval  or  consent  is given by the person or any one of the
persons, as the case may be, designated in a notification signed by or on behalf
of the Owner. For all purposes under this Agreement, the Manager shall determine
solely  from the latest such  notification  received by it the person or persons
authorized to give such approval or consent.  The Manager shall rely exclusively
and   conclusively  on  the   designation   set  forth  in  such   notification,
notwithstanding any notice of knowledge to the contrary.

                  12.7  Governing  Law. This  Agreement  shall be deemed to have
been made and shall be construed and  interpreted in accordance with the laws of
the State of Maryland.

                  12.8 Enforceability. Should any provision of this Agreement be
unenforceable as between the parties, such unenforceability shall not affect the
enforceability of the other provisions of this Agreement.





<PAGE>








                  12.9  Counterparts.  This  Agreement may be executed in two or
more counterparts,  each of which shall be deemed an original,  but all of which
together shall constitute one and the same instrument.

                  12.10 Construction.  The parties have participated  jointly in
the  negotiation  and drafting of this  Agreement.  In the event an ambiguity or
question of intent or interpretation  arises,  this Agreement shall be construed
as if drafted jointly by the parties and no presumption or burden of proof shall
arise  favoring or  disfavoring  any party by virtue of the authorship of any of
the provisions of this Agreement.  If any party has breached any representation,
warranty,  or  covenant  contained  herein in any  respect,  the fact that there
exists  another  representation,  warranty,  or  covenant  relating  to the same
subject matter  (regardless  of the relative  levels of  specificity)  which the
party has not  breached  shall not detract  from or  mitigate  the fact that the
party is in breach of the first representation, warranty, or covenant.





<PAGE>







                  IN WITNESS  WHEREOF,  the  parties  hereto have  executed  and
delivered this Management Agreement effective as of the day and year first above
written.

Owner:                                                Manager:
COMMUNITY CARE OF AMERICA, INC.                       INTEGRATED HEALTH
                                                      SERVICES, INC.

By:        ____________________                       By:      _________________

Title:     ____________________                       Title:A  _________________

Attest:    ____________________                       Attest:  _________________


Title:     ____________________                       Title:   _________________


<PAGE>




                                    EXHIBIT A

The  following  is a list of items and travel  expenses  not included in the IHS
management  fee.  These  facility-specific  expenses are passed  directly to the
Owner incurred.
              a)      Computer hardware and software purchased for Owner.

              b)      Owner specific legal and accounting fees.

              c)      Owner specific fees associated with union organization
              attempts, elections, etc.

              d)      Other owner specific expenses, including travel and
              other out-of-pocket costs.




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