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 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇
▇▇▇▇▇ ("Owner") and INTEGRATED  HEALTH  SERVICES,  INC., a Delaware  corporation
with offices at ▇▇▇▇▇ ▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ("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.
                  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").
                                   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,
▇▇▇▇▇▇▇'▇  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,
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
         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;
                           (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
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.
                                   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.
                                    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.
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;
                    (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
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
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
         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
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:
                    (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
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
         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).
                                   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
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
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.
                  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.
                                   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.
                                               ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
                                               ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
                                               Attention: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇,
                                                            President
                                               Fax:  ▇▇▇-▇▇▇-▇▇▇▇
                       With a copy to:         J. ▇▇▇▇▇ ▇▇▇▇▇▇
                                               ▇▇▇▇▇▇▇▇▇▇ & ▇▇▇▇▇ LLP
                                               ▇▇ ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
                                               ▇▇▇ ▇▇▇▇, ▇▇▇ ▇▇▇▇  ▇▇▇▇▇
                                               Fax:  ▇▇▇-▇▇▇-▇▇▇▇
                       To the Manager:         Integrated Health Services, Inc.
                                               ▇▇▇▇▇ ▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇▇
                                               ▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇  ▇▇▇▇▇
                                               Attention:▇▇▇▇▇▇▇▇ ▇.▇▇▇▇▇▇, Esq.
                                               Fax:  ▇▇▇-▇▇▇-▇▇▇▇
                       With a copy to:         IHS Financial Holdings, Inc.
                                               ▇▇▇▇▇ ▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇▇
                                               ▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇  ▇▇▇▇▇
                                               Attention:  ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇
                                               Fax:  ▇▇▇-▇▇▇-▇▇▇▇
                                     - and -
                                 ▇▇▇▇▇ ▇▇▇▇▇▇▇▇
                                  ▇▇▇▇ ▇▇▇▇▇▇▇▇
                                ▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇
                              ▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
                                Fax: ▇▇▇-▇▇▇-▇▇▇▇
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
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.
                  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.
                  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:   _________________
                                    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.