GUARANTY  dated as of April  14, 1997 made by  INTEGRATED  HEALTH
SERVICES,  INC.,  a  Delaware  corporation  (the  "Guarantor")  and  HEALTH  AND
RETIREMENT  PROPERTIES  TRUST, a Maryland real estate investment trust (with its
successor and assigns, "HRP").

                                   WITNESSETH:

     WHEREAS, Community Care of America, Inc. ("CCA") and its subsidiaries (with
CCA, collectively, the "CCA Companies") have entered into certain loan and lease
financings with HRP governed by certain documents, instruments and agreements to
which the various CCA Companies  and/or HRP are a party (as from time to time in
effect, collectively, the "CCA Documents");

     WHEREAS,  the CCA  Companies  have  requested  that HRP (a)  consent to the
waiver through February 28, 1998 of the covenants in the CCA Documents requiring
the CCA  Companies  (i) to  maintain  a  ratio  of  current  assets  to  current
liabilities of at least 1.0 to 1.0 and (ii) not to permit its tangible net worth
to be less than  $5,000,000  and (b) agree to apply a portion of the  $6,185,000
security  deposit  held  by HRP as  collateral  for the  obligations  of the CCA
Companies  under the CCA Documents  (the  "Security  Deposit") to the payment of
existing  arrearages under the CCA Documents,  to pay a restructuring fee to HRP
and to pay 50% of future monthly payments of regularly scheduled installments of
Minimum and Additional Rent, Mortgage Facilities Fees and principal and interest
on loans by HRP, as and when due;

     WHEREAS,  HRP is willing to so consent and agree,  subject to the terms and
conditions  of a letter  agreement  dated as of April 14, 1997 by HRP to the CCA
Companies (the "Letter Agreement");

     WHEREAS,  it is a condition to the  effectiveness  of the Letter  Agreement
that, among other things, the Guarantor deliver this Guaranty in favor of HRP;

     WHEREAS,  the  Guarantor  holds  warrants to purchase  ___ shares of common
stock of CCA,  the value of which  would be  adversely  affected  if the  Letter
Agreement, were not to become affected;

     NOW,  THEREFORE,  in  consideration  of the premises and for other good and
valuable   consideration,   the  receipt  and   adequacy  of  which  are  hereby
acknowledged, the Guarantor hereby agrees with HRP as follows:

1. Defined Terms.  Unless otherwise  defined herein,  terms which are defined in
the CCA  Documents and used herein are so used as so defined.  In addition,  the
following terms shall have the meanings set forth below:




                                     - 2 -
  
     "Applicable-Law" shall mean any law of any governmental authority,  whether
domestic or foreign, including without limitation all federal and state laws, to
which the Person in question is subject or by which it or any of its property is
bound,  and including  without  limitation any: (a)  administrative,  executive,
judicial,  legislative  or other action,  code,  consent  decree,  constitution,
decree, directive,  enactment, finding, guideline,  injunction,  interpretation,
judgment, law, order, ordinance, policy statement,  proclamation,  promulgation,
regulation,  requirement,  rule, rule of law, rule of public policy,  settlement
agreement, statute, or writ, of any governmental authority, domestic or foreign,
whether  or not  having  the  force of law;  (b)  common  law or other  legal or
quasi-legal  precedent;  or (c)  arbitrator's,  mediator's  or referee's  award,
decision,  finding or recommendation,  or, in any case, any particular  section,
part or provision thereof

     "CCA  Event of  Default"  shall  mean an  "Event of  Default"  under and as
defined in any CCA Document.

     "Default  Amount" shall mean $10,000,000 or such lesser amount to which the
Guarantor's  maximum liability hereunder has been reduced pursuant to the second
paragraph of Section 2 hereof.

     "Default Rate" shall mean 4% per annum above the prime rate or base rate on
corporate loans at large U.S. money center  commercial banks as published in The
Wall  Street  Joumal  or, if  publication  of such rate  shall be  suspended  or
terminated,  the annual rate of interest,  determined  daily and  expressed as a
percentage,   from  time  to  time   announced   by  one  of  the  five  largest
national-chartered  banking  institutions  having their principal  office in New
York, New York and selected by HRP at the time such  publication is suspended or
terminated.  Each change in the Interest  Rate shall take effect  simultaneously
with  the  date  of  publication  or  announcement,   as  applicable,   of  each
corresponding change in such prime rate or base rate.

     "Material  Adverse  Effect"  means a  material  adverse  effect  on (a) the
business, operations,  property, condition (financial or otherwise) or prospects
of the Guarantor, or of the Guarantor and its Subsidiaries taken as a whole, (b)
the ability of the Guarantor to perform its obligations under this Guaranty,  or
(c) the  validity  or  enforceability  of this  Guaranty,  or the  rights of HRP
hereunder.

     "Obligations"  shall mean the  payment  and  performance  of each and every
obligation and liability of any CCA Company to HRP, whether under a CCA Document
or  otherwise,  whether now existing or hereafter  arising or created,  joint or
several,  direct or  indirect,  absolute  or  contingent,  due or to become due,
matured or unmatured, liquidated or unliquidated, arising by contract, operation
of law or otherwise,  and  including,  without  limitation,  (i) all  principal,
premium or prepayment fee and interest (including,  without limitation,  Minimum
Interest and Additional  Interest,  as such terms are defined in the various CCA
Documents)  under any  promissory  note payable to HRP,  (ii) all rent under any
lease with HRP as landlord  (including,  without  limitation,  any Minimum Rent,
Additional Rent and Additional Charges, as such terms are defined in the



                                     - 3 -

various  CCA  Documents),  and (iii)  all fees and  charges  (including  without
limitation,  any Mortgage Facilities Fee, as such term is defined in the various
CCA Documents).

2. Guaranty.  The Guarantor hereby unconditionally and irrevocably guarantees to
HRP the prompt and complete  payment and  performance  by the CCA Companies (and
each of  them),  when due  (whether  at  stated  maturity,  by  acceleration  or
otherwise), of the Obligations.  The Guarantor further agrees to pay any and all
reasonable  expenses  (including,  without  limitation,  all reasonable fees and
disbursements  of  counsel  to HRP)  which  may be paid  or  incurred  by HRP in
enforcing any of its rights under this Guaranty.  This Guaranty is a guaranty of
payment and not of  collectibility  and is absolute and in no way conditional or
contingent.  The Guarantor's liability hereunder is direct and unconditional and
(without  limiting the  provisions  of Section 15 hereof) may be enforced  after
nonpayment  or  nonperformance  by any CCA  Company  of any  Obligation  without
requiring HRP to resort to any other Person (including  without  limitation such
CCA Company) or any other  right,  remedy or  collateral.  This  Guaranty  shall
remain in full force and effect until the Obligations are paid in full.

     Notwithstanding the aggregate amount of the Obligations at any time or from
time to time payable or to be payable by the CCA Companies to HRP, the liability
of the Guarantor to HRP hereunder in respect of the Obligations shall not exceed
$10,000,000 in the aggregate.  The Guarantor  agrees that the Obligations may at
any time  and from  time to time  exceed  the  amount  of the  liability  of the
Guarantor  hereunder without impairing this Guaranty or affecting the rights and
remedies of HRP hereunder.  The Guarantor agrees that whenever,  at any time, or
from time to time,  it shall make any payment to HRP on account of its liability
hereunder,  it will notify HRP in writing  that such  payment is made under this
Guaranty for such purpose. No payment or payments made by any CCA Company or any
other  Person or received or  collected by HRP from any CCA Company or any other
Person by virtue of any action or proceeding or any set-off or  appropriation or
application,  at any time or from time to time, in reduction of or in payment of
the Obligations shall be deemed to modify,  reduce,  release or otherwise affect
the liability of the Guarantor  hereunder which shall,  notwithstanding any such
payment or payments,  remain liable for the amount of the Obligations  until the
Obligations are paid in full.

3. Costs and Expenses of Collection.  The Guarantor agrees, as principal obligor
and not as a guarantor only, to pay to HRP forthwith upon demand, in immediately
available  funds, all costs and expenses  (including,  without  limitation,  all
court  costs and all fees and  disbursements  of  counsel  to HRP)  incuffed  or
expended by HRP in connection  with the  enforcement of this Guaranty,  together
with  interest  on such  amounts  from the time such  amounts  become  due until
payment at the Default Rate. The Guarantor's  covenants and agreements set forth
in this Section 3 shall survive the termination of this Guaranty.

4. Right of Setoff.  Regardless of the adequacy of any collateral or other means
of obtaining  repayment of the Obligations,  HRP is hereby  authorized,  without
notice to the Guarantor or compliance with any other condition  precedent now or
hereafter imposed by Applicable Law (all of which are hereby expressly waived to
the extent  permitted by Applicable Law) and to the fullest extent  permitted by
Applicable Law, to set off and apply any securities,  deposits or other property
belonging to the Guarantor now or hereafter held by HRP against the  obligations
of the



                                     - 4 -

Guarantor  under  this  Guaranty,  whether or not HRP shall have made any demand
under this Guaranty, at any time and from time to time after the occurrence of a
Guarantor  Event of Default,  in such manner as HRP in its sole  discretion  may
determine, and the Guarantor hereby grants HRP a continuing security interest in
such  securities,  deposits and property for the payment and performance of such
obligations.

5. Subrogation and Contribution.  Until the Obligations shall have been paid and
performed in full, the Guarantor irrevocably and unconditionally  waives any and
all rights to which it may be entitled, by operation of law or otherwise,  to be
subrogated,  with respect to any payment made by the Guarantor hereunder, to the
rights  of  HRP  against  any  CCA  Company,  or  otherwise  to  be  reimbursed,
indemnified  or exonerated  by any CCA Company in respect  thereof or to receive
any payment,  in the nature of  contribution  or for any other reason,  from any
other  guarantor  of the  Obligations  with  respect to any payment  made by the
Guarantor hereunder. Until the Obligations shall have been paid and performed in
full,  the  Guarantor  waives any defense it may have based upon any election of
remedies  by  HRP  which  impairs  the  Guarantor's  subrogation  rights  or the
Guarantor's  rights  to  proceed  against  any  CCA  Company  for  reimbursement
(including  without  limitation  any loss of rights the  Guarantor may suffer by
reason of any rights,  powers or remedies of such CCA Company in connection with
any anti-deficiency  laws or any other laws limiting,  qualifying or discharging
any indebtedness to HRP). Until the Obligations shall have been paid,  performed
and  satisfied in full,  the Guarantor  further  waives any right to enforce any
remedy which HRP now has or may in the future have against any CCA Company,  any
other  guarantor  or any  other  Person  and any  benefit  of,  or any  right to
participate in, any security whatsoever now or in the future held by HRP.

6.  Effect of  Bankruptcy  Stay.  If  acceleration  of the time for  payment  or
performance of any of the Obligations is stayed upon the insolvency, bankruptcy
or reorganization of any CCA Company or any other Person or otherwise,  all such
amounts  otherwise  subject to acceleration  shall nonetheless be payable by the
Guarantor under this Guaranty forthwith upon demand.

7.  Receipt of CCA  Documents,  etc.  The  Guarantor  confirms,  represents  and
warrants  to HRP  that  (i) it has  received  true and  complete  copies  of all
existing CCA Documents from the CCA Companies, has read the contents thereof and
reviewed the same with legal counsel of its choice;  (ii) no  representations or
agreements  of any kind have been made to the  Guarantor  which  would  limit or
qualify in any way the terrns of this Guaranty;  (iii) this Guaranty is executed
at the CCA  Companies'  request and not at the request of HRP; (iv) HRP has made
no  representation  to the  Guarantor  as to  the  creditworthiness  of any  CCA
Company;  and (v) the Guarantor has established adequate means of obtaining from
each CCA Company on a continuing basis information  regarding such CCA Company's
financial condition.  The Guarantor agrees to keep adequately informed from such
means of any facts,  events, or circumstances  which might in any way affect the
Guarantor's risks under this Guaranty, and the Guarantor further agrees that HRP
shall have no  obligation  to  disclose  to the  Guarantor  any  information  or
documents  acquired  by HRP in the  course  of its  relationship  with  the  CCA
Companies .

8.  Amendments,  etc. with Respect to the  Obligations.  The  obligations of the
Guarantor  under this  Guaranty  shall  remain in full force and effect  without
regard to, and shall not be




                                      - 5 -

released,  altered,  exhausted,  discharged  or  in  any  way  affected  by  any
circumstance  or  condition  (whether  or not any CCA  Company  shall  have  any
knowledge or notice thereof),  including without limitation (a) any amendment or
modification of or supplement to any CCA Document,  or any  obligation,  duty or
agreement  of the CCA  Companies or any other  Person  thereunder  or in respect
thereof;  (b) any  assignment  or  transfer  in  whole  or in part of any of the
Obligations; any fumishing,  acceptance, release, nonperfection or invalidity of
any direct or indirect security or guaranty for any of the Obligations;  (c) any
waiver, consent, extension, renewal, indulgence, settlement, compromise or other
action or inaction  under or in respect of any CCA Document,  or any exercise or
nonexercise of any right,  remedy, power or privilege under or in respect of any
such instrument (whether by operation of law or otherwise);  (d) any bankruptcy,
insolvency, reorganization,  arrangement, readjustment, composition, liquidation
or similar proceeding with respect to any CCA Company or any other Person or any
of  their  respective  properties  or  creditors  or any  resulting  release  or
discharge of any Obligation  (including  without limitation any rejection of any
lease pursuant to Section 365 of the Federal  Bankruptcy  Code);  (e) any new or
additional  financing  arrangements  entered  into by any CCA  Company or by any
other Person on behalf of or for the benefit of any CCA Company;  (f) the merger
or  consolidation  of any CCA  Company  with or into any other  Person or of any
other Person with or into any CCA Company; (g) the voluntary or involuntary sale
or other  disposition of all or substantially  all the assets of any CCA Company
or any other Person; (h) the voluntary or involuntary  liquidation,  dissolution
or  termination  of any CCA Company or any other Person;  (i) any  invalidity or
unenforceability,  in  whole  or in  part,  of any  term  hereof  or of any  CCA
Document,  or any obligation,  duty or agreement of any CCA Company or any other
Person thereunder or in respect thereof; (j) any provision of any applicable law
or  regulation  purporting  to prohibit  the payment or  performance  by any CCA
Company or any other  Person of any  Obligation;  (k) any failure on the part of
any CCA Company or any other Person for any reason to perform or comply with any
term of any CCA Document or any other agreement;  or (1) any other act, omission
or occurrence  whatsoever, whether  similar or dissimilar to the foregoing.  The
Guarantor  authorizes  each CCA Company,  each other guarantor in respect of the
Obligations and HRP at any time in its discretion,  as the case may be, to alter
any of the terms of any of the Obligations.

9. Guarantor as Principal.  If for any reason the CCA Companies, or any of them,
or any other Person is under no legal obligation to discharge any Obligation, or
if any other moneys included in the Obligations have become  unrecoverable  from
the CCA  Companies,  or any of them,  or any other Person by operation of law or
for  any  other  reason,  including,   without  limitation,  the  invalidity  or
irregularity  in whole or in part of any Obligation or of any CCA Document,  the
legal  disability  of any  CCA  Company  or any  other  obligor  in  respect  of
Obligations,  any discharge of or limitation on the liability of any CCA Company
or any other Person or any  limitation  on the method or terms of payment  under
any Obligation,  or of any CCA Document, which may now or hereafter be caused or
imposed in any manner whatsoever  (whether consensual or arising by operation of
law or  otherwise),  this Guaranty shall  nevertheless  remain in full force and
effect  and shall be binding  upon the  Guarantor  to the same  extent as if the
Guarantor at all times had been the principal obligor on all Obligations.

10. Waiver of Demand,  Notice,  Etc, The Guarantor hereby waives,  to the extent
not prohibited by applicable  law, all  presentments,  demands for  performance,
notice of




                                      - 6 -

nonperformance,  protests,  notices  of  protests  and  notices of  dishonor  in
connection with the  Obligations or any CCA Document,  including but not limited
to (a) notice of the  existence,  creation or incurring of any new or additional
obligation  or of any action or  failure to act on the part of any CCA  Company,
HRP,  any endorser or creditor of any CCA Company or any other  Person;  (b) any
notice of any  indulgence,  extensions  or renewals  granted to any obligor with
respect to the  Obligations;  (c) any  requirement of diligence or promptness in
the  enforcement  of rights under any CCA  Document,  or any other  agreement or
instrument  directly or indirectly  relating thereto or to the Obligations;  (d)
any  enforcement  of any  present or future  agreement  or  instrument  relating
directly or indirectly  thereto or to the Obligations;  (e) notice of any of the
matters  referred  to in Section 9 above;  (f) any defense of any kind which the
Guarantor may now have with respect to his liability  under this  Guaranty;  (g)
any right to require HRP, as a condition of  enforcement  of this  Guaranty,  to
proceed  against  any CCA Company or any other  Person or to proceed  against or
exhaust  any  security  held by HRP at any time or to pursue any other  right or
remedy in HRP's power before proceeding  against the Guarantor;  (h) any defense
that  may  arise  by  reason  of the  incapacity,  lack of  authority,  death or
disability  of any other  Person or  Persons  or the  failure  of HRP to file or
enforce a claim against the estate (in administration,  bankruptcy, or any other
proceeding)  of any other  Person or  Persons;  (i) any  defense  based  upon an
election  of  remedies  by HRP;  0) any  defense  arising  by reason of any "one
action" or  "anti-deficiency"  law or any other law which may  prevent  HRP from
bringing any action,  including a claim for  deficiency,  against the Guarantor,
before or after HRP's  commencement  of  completion of any  foreclosure  action,
either  judicially or by exercise of a power of sale; (k) any defense based upon
any lack of diligence by HRP in the collection of any  Obligation;  (1) any duty
on the  part  of HRP to  disclose  to the  Guarantor  any  facts  HRP may now or
hereafter  know  about  any CCA  Company  or any other  obligor  in  respect  of
Obligations;  (m) any defense  arising  because of an election made by HRP under
Section 1 1 1 1 (b) (2) of the Federal Bankruptcy Code; (n) any defense based on
any borrowing or grant of a security  interest  under Section 364 of the Federal
Bankruptcy  Code;  (o) and any defense  based upon or arising out of any defense
which any CCA Company or any other Person may have to the payment or performance
of the  Obligations  (including  but not  limited to  failure of  consideration,
breach of warranty, fraud, payment, accord and satisfaction, strict foreclosure,
statute of frauds, bankruptcy, infancy, statute of limitations, lender liability
and usury). Guarantor acknowledges and agrees that each of the waivers set forth
herein on the part of the Guarantor is made with  Guarantor's  full knowledge of
the significance and consequences thereof and that, under the circumstances, the
waivers  are  reasonable.  If any such  waiver is  determined  to be contrary to
Applicable  Law such waiver shall be effective only to the extent not prohibited
by such Applicable Law.

ii.  Reinstatement.  This  Guaranty  shall  continue  to  be  effective,  or  be
reinstated,  as the case may be, if at any time payment, or any part thereof, of
any of the Obligations is rescinded or must otherwise be restored or returned by
HRP upon the insolvency, bankruptcy, dissolution,  liquidation or reorganization
of any CCA  Company  or upon or as a result of the  appointment  of a  receiver,
intervenor or conservator of, or trustee or similar officer for, any CCA Company
or any  substantial  part of its  property,  or  otherwise,  all as though  such
payments had not been made.



                                     - 7 -

12. The Guarantor hereby agrees that the Obligations will be paid to HRP without
set-off or  counterclaim  in U.S.  Dollars  at the office of HRP  located at 400
Centre Street,  Newton,  Massachusetts  02158,  or to such other location as HRP
shall notify the Guarantor.

13. Representations and Warranties. The Guarantor represents and warrants that:

                      (i)  Corporate  Existence.  The Guarantor is a corporation
                duly  incorporated  and validly  existing  under the laws of the
                jurisdiction  of its  incorporation,  and is  duly  licensed  or
                qualified  as a foreign  corporation  in all states  wherein the
                nature of its property owned or business  transacted by it makes
                such  licensing  or  qualification  necessary,  except where the
                failure  to be  licensed  or to so  qualify  could  not  have  a
                Material Adverse Effect.

                      (ii) No Violation. The execution, delivery and performance
                of this  Guaranty  will not  contravene  any  provision  of law,
                statute, rule or regulation to which the Guarantor or any of its
                Subsidiaries  is subject  or any  judgment,  decree,  franchise,
                order  or  permit  applicable  to  the  Guarantor  or any of its
                Subsidiaries,  or conflict or be inconsistent  with or result in
                any  breach  of,  any of the  terms,  covenants,  conditions  or
                provisions of, or constitute a default  under,  or result in the
                creation  or  imposition  of (or the  obligation  to  create  or
                impose) any lien or security  interest  upon any of the property
                or assets of the Guarantor or any of its  Subsidiaries  pursuant
                to the  terms  of any  agreement  or  instrument  to  which  the
                Guarantor or any of its  Subsidiaries  is party,  or violate any
                provision of the respective  corporate charters or bylaws of the
                Guarantor or any of its Subsidiaries.

                      (iii)  Corporate   Authority  and  Power.  The  execution,
                delivery  and   performance  of  this  Guaranty  is  within  the
                corporate  powers of the Guarantor and has been duly  authorized
                by all necessary corporate action.

                      (iv) Enforceability.  This Guaranty has been duly executed
                and delivered by the  Guarantor,  and this Guaranty  constitutes
                the valid and binding  obligation of the  Guarantor  enforceable
                against the  Guarantor in accordance  with its terms,  except as
                enforceability   may  be  limited  by   applicable   bankruptcy,
                insolvency, reorganization, moratorium or similar laws affecting
                the  enforcement  of creditors'  rights  generally and except as
                enforceability  may be subject to general  principles of equity,
                whether such  principles  are applied in a court of equity or at
                law.

                      (v) Governmental Approvals. No order, permission, consent,
                approval, license, authorization, registration or validation of,
                or filing with, or exemption by, any  governmental  authority is
                required to authorize,  or is required in connection  with,  the
                execution,  delivery and  performance of this  Guaranty,  or the
                taking of any action contemplated hereby or thereby.

                      (vi) Litigation.  The Guarantor has no notice or knowledge
                of any action,  suit or proceeding pending or threatened against
                or  affecting  it at  law  or in  equity  or  before  or by  any
                governmental  department,   court,  commission,  board,  bureau,
                agency or




                                     - 8 -

                instrumentality,  domestic or foreign,  or before any arbitrator
                of any kind that would, if adversely determined, have a Material
                Adverse Effect.

14.  Subordination  of  Claims  against  CCA  Companies.  Without  limiting  the
provisions of Section 5 hereof, the Guarantor hereby irrevocably agrees that any
and all claims which the  Guarantor  may now or  hereafter  have against any CCA
Company  or  any  other  guarantor  of  the  Obligations,   including,   without
limitation,  the  benefit  of any  set-off  or  counterclaim  or  proof  against
dividend,  composition  or payment by any CCA  Company or such other  guarantor,
shall be  subject  and  subordinate  to the prior  payment in full of all of the
Obligations  to HRP.  After the  occurrence  of an Event of Default under and as
defined in any CCA Document,  or any event or condition  that with the giving of
notice or lapse of time or both  could  become  such an Event of Default (a "CCA
Default"),  the  Guarantor  shall not claim  from any CCA  Company or such other
guarantor, or with respect to any of their respective properties, any sums which
may  be  owing  to the  Guarantor,  or  have  the  benefit  of  any  set-off  or
counterclaim  or proof  against  dividend,  composition  or  payment by such CCA
Company or such other guarantor,  until all Obligations  shall have been paid in
full.  Should any payment or distribution or security or the benefit of proceeds
thereof be received by the Guarantor  upon or with respect to amounts due to the
Guarantor from any CCA Company or any other guarantor of the Obligations after a
CCA Default has  occurred  and prior to the payment in full of all  Obligations,
the  Guarantor  shall  forthwith  deliver the same to HRP in precisely  the form
received (except for endorsement or assignment where necessary), for application
in or towards  repayment of the  Obligations  and, until so delivered,  the same
shall be held in trust as  property  of HRP.  In the event of the failure of the
Guarantor to make any such endorsement or assignment,  HRP is hereby irrevocably
authorized to make the same on behalf of the Guarantor.

15.  Guarantor  Events of  Default.  If one or more of the  following  events (a
"Guarantor Event of Default") shall have occurred:



                      (i) a CCA Event of  Default  shall  have  occurred  and be
                continuing for more than three Business Days after notice by HRP
                to the Guarantor;


                      (ii) the Guarantor shall fail to make punctual  payment of
                any amount  payable  hereunder  as the same shall become due and
                payable; or

                      (iii) any  representation  or  warranty  of the  Guarantor
                contained in this  Guaranty,  or any  statement  or  certificate
                furnished  pursuant  to any  provision  of this  Guaranty or the
                Amendment, shall have been false, incorrect or misleading in any
                material respect when made or so certified to; or

                      (iv) the Guarantor  shall breach any of the provisions of,
                or fail duly to observe or perform any  covenant,  agreement  or
                provision  contained  in, this  Guaranty,  and such breach shall
                continue for ten days after notice by HRP to the Guarantor; or

                      (v)  the  Guarantor  shall  apply  for or  consent  to the
                appointment  of, or the  taking of  possession  by, a  receiver,
                custodian, trustee or liquidator of itself or of all or a



                                     - 9 -

                substantial part of its property,  make a general assignment for
                the benefit of its  creditors,  commence a voluntary  case under
                the Bankruptcy  Code, file a petition  seeking to take advantage
                of  any   other  law   relating   to   bankruptcy,   insolvency,
                reorganization,  winding-up,  or composition or  readjustment of
                debts, fail to controvert in a timely and appropriate manner, or
                acquiesce  in writing to, any  petition  filed  against it in an
                involuntary   case  under  the  Bankruptcy  Code,  or  take  any
                corporate  action  for  the  purpose  of  effecting  any  of the
                foregoing; or



                      (vi) a proceeding or case shall be commenced,  without the
                application or consent of the Guarantor  thereof in any court of
                competent jurisdiction, seeking its liquidation, reorganization,
                dissolution or winding-up, or the composition or readjustment of
                its debts,  the appointment of a trustee,  receiver,  custodian,
                liquidator  or  the  like  of  the  Guarantor  or of  all or any
                substantial part of its assets,  or similar relief in respect of
                the Guarantor under any law relating to bankruptcy,  insolvency,
                reorganization,  winding-up,  or  composition  or  adjustment of
                debts,  and such proceeding or case shall continue  undismissed,
                or an order, judgment or decree approving or ordering any of the
                foregoing shall be entered and continue  unstayed and in effect,
                for a period of 60 days;  or an order  for  relief  against  the
                Guarantor  shall be  entered  in an  involuntary  case under the
                Bankruptcy Code;

THEN,  irrespective of whether a CCA Event of Default may then have occurred and
be  continuing,  (a) in the event of a Guarantor  Event of Default  described in
paragraph (v) or (vi) above,  there shall become due and payable to HRP, and the
Guarantor  shall  immediately  pay HRP,  without  notice  or  demand of any kind
whatsoever,  an amount  in  immediately  available  funds  equal to the  Default
Amount,  and (b) in the  event of any other  Guarantor  Event of  Default,  upon
notice from HRP specifying such Guarantor  Event of Default,  there shall become
due and payable to HRP, and the Guarantor  shall  immediately pay HRP, an amount
in immediately  available funds equal to Default Amount.  The amounts so paid to
HRP shall be held as  collateral  for the  payment  of the  Obligations  and the
obligations of the Guarantor hereunder.  Such amounts shall be applied by HRP to
the  payment and  performance  of the  Obligations  and the  obligations  of the
Guarantor  hereunder  as and when the same become due and payable in  accordance
with the provisions thereof and hereof.

16.  Severability.  Any  provision  of this  Guaranty  which  is  prohibited  or
unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective
to the extent of such prohibition or unenforceability  without  invalidating the
remaining provisions hereof, and any such prohibition or unenforceability in any
jurisdiction shall not invalidate or render  unenforceable such provision in any
other jurisdiction.

17.  Additional  Guaranties.  This  Guaranty  shall be in  addition to any other
guaranty or other security for the  Obligations,  and it shall not be prejudiced
or  rendered  unenforceable  by the  invalidity  of any such other  guaranty  or
security.



                                      - 10-

18.  Paragraph  Headings.  The paragraph  headings used in this Guaranty are for
convenience of reference only and are not to affect the  construction  hereof or
be taken into consideration in the interpretation hereof.

19. No  Waiver,  Cumulative  Remedies.  HRP shall  not by any act  (except  by a
written instrument pursuant to Paragraph-20 hereof), delay, indulgence, omission
or otherwise,  be deemed to have waived any right or remedy hereunder or to have
acquiesced  in any  Default or in any breach of any of the terms and  conditions
hereof. No failure to exercise, nor any delay in exercising, on the part of HRP,
any right,  power or privilege  hereunder shall operate as a waiver thereof.  No
single or partial  exercise of any right,  power or  privilege  hereunder  shall
preclude  any other or further  exercise  thereof or the  exercise  of any other
right,  power or privilege.  A waiver by HRP of any right or remedy hereunder on
any one  occasion  shall not be  construed as a bar to any right or remedy which
HRP would otherwise have on any future occasion.  The rights and remedies herein
provided are cumulative,  may be exercised  singly or  concurrently  and are not
exclusive of any rights or remedies provided by law.

20. Waivers and Amendments. None of the terms or provisions of this Guaranty may
be waived,  amended,  supplemented  or  otherwise  modified  except by a written
instrument  executed by the  Guarantor  and HRP,  provided that any provision of
this  Guaranty may be waived by HRP in a letter or agreement  executed by HRP or
by telecopy  from HRP. This Guaranty  shall be binding upon the  successors  and
assigns  of the  Guarantor  and  shall  inure  to the  benefit  of HRP  and  its
successors and assigns.

21. WAIVER OF JURY TRIAL; CONSENT TO JURISDICTION;  GOVERNING LAW. THE GUARANTOR
HEREBY  EXPRESSLY  WAIVES ANY RIGHT IT MAY NOW OR HEREAFTER HAVE TO A JURY TRIAL
IN ANY  SUIT,  ACTION OR  PROCEEDING  WHICH  ARISES  OUT OF OR BY REASON OF THIS
GUARANTY, ANY CCA DOCUMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY AND THEREBY.

     BY ITS EXECUTION AND DELIVERY OF THIS  GUARANTY,  THE GUARANTOR (1) ACCEPTS
FOR ITSELF AND IN CONNECTION WITH ITS PROPERTIES, GENERALLY AND UNCONDITIONALLY,
THE  NONEXCLUSIVE  JURISDICTION  OF ANY  STATE OR  FEDERAL  COURT  OF  COMPETENT
JURISDICTION  IN THE  COMMONWEALTH  OF  MASSACHUSETTS  IN ANY  ACTION,  SUIT  OR
PROCEEDING  OF ANY KIND  AGAINST  IT WHICH  ARISES  OUT OF OR BY  REASON OF THIS
GUARANTY,  ANY CCA DOCUMENT OR THE TRANSACTIONS  CONTEMPLATED HEREBY OR THEREBY,
IN ADDITION TO ANY OTHER COURT IN WHICH SUCH ACTION,  SUIT OR PROCEEDING  MAY BE
BROUGHT; (2) IRREVOCABLY AGREES TO BE BOUND BY ANY JUDGMENT RENDERED BY ANY SUCH
COURT IN ANY SUCH ACTION,  SUIT OR PROCEEDING IN WHICH IT SHALL HAVE BEEN SERVED
WITH PROCESS IN THE MANNER HEREINAFTER  PROVIDED;  (3) TO THE EXTENT THAT IT MAY
LAWFULLY DO SO, WAIVES AND AGREES NOT TO ASSERT,  BY WAY OF MOTION, AS A DEFENSE
OR OTHERWISE, IN SUCH ACTION SUIT OR


                                     - 11 -

PROCEEDING ANY CLAIM THAT IT IS NOT PERSONALLY  SUBJECT TO THE  JURISDICTION  OF
SUCH COURT,  THAT ITS PROPERTY IS EXEMPT OR IMMUNE FROM ATTACHMENT OR EXECUTION,
THAT THE ACTION,  SUIT OR PROCEEDING IS BROUGHT IN AN INCONVENIENT FORUM OR THAT
THE VENUE THEREOF IS IMPROPER; AND (4) AGREES THAT PROCESS MAY BE SERVED UPON IT
IN ANY SUCH ACTION, SUIT OR PROCEEDING IN THE MANNER PROVIDED BY CHAPTER 223A OF
THE GENERAL LAWS OF MASSACHUSETTS,  RULE 4 OF THE  MASSACHUSETTS  RULES OF CIVIL
PROCEDURE OR RULE 4 OF THE FEDERAL RULES OF CIVIL PROCEDURE.

      THIS GUARANTY  SHALL BE GOVERNED BY AND  CONSTRUED IN ACCORDANCE  WITH THE
LAWS OF THE COMMONWEALTH OF MASSACHUSETTS.

22. Notices.  All notices under this Guaranty shall be in writing,  and shall be
delivered by hand,  by a nationally  recognized  commercial  overnight  delivery
service,  by  first  class  mail  or  by  telecopy,   delivered,   addressed  or
transmitted,  if to HRP,  at 400 Centre  Street,  Newton,  Massachusetts  02158,
Attention:  President  (telecopy  no.  617-332-2261),  with a copy to Sullivan &
Worcester LLP, One Post Office Square, Boston,  Massachusetts 02109,  Attention:
Alexander  A.  Notopoulos,  Esq.  (telecopy  no.  617-338-2880),  and  if to the
Guarantor, at its address or telecopy number set out below its signature in this
Guaranty. Such notices shall be effective: in the case of hand deliveries,  when
received; in the case of an overnight delivery service, on the next business day
after being placed in the  possession  of such delivery  service,  with delivery
charges  prepaid;  in the case of mail,  three days after  deposit in the postal
system, first class postage prepaid;  and in the case of telecopy notices,  when
electronic  indication  of  receipt  is  received.  Either  party may change its
address  and  telecopy  number  by  written  notice to the  other  delivered  in
accordance with the provisions of this Section.




                                     - 12 -
               IN WITNESS  WHEREOF,  the undersigned has caused this Guaranty to
be duly executed and delivered as of the date first above written.

                                       INTEGRATED HEALTH SERVICES, INC.



                                       By /s/ W. Bradley Bennett
                                          -------------------------------------
                                          Name: W. Bradley Bennett
                                          Title: Executive Vice President and
                                                 Chief Accounting Officer

                                          Address for Notices:

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                                         Telecopy No.:____________