REIMBURSEMENT AGREEMENT


      REIMBURSEMENT AGREEMENT (the "Agreement"),  dated as of April 14, 1997, by
and between INTEGRATED HFALTH SERVICES,  INC., a Delaware  corporation having an
address at 10065 Red Run Boulevard,  Owings Mills,  Maryland 21117 ("IHS"),  and
COMMUNITY  CARE OF AMERICA,  INC., a Delaware  corporation  having an address at
3050 N. Horseshoe Drive, Naples, Florida 33942 ("CCA").

                                  WITNESSETH.

      WHEREAS,  CCA has entered into that  certain  Loan and Security  Agreement
with Daiwa  Healthco-2  LLC  ("Daiwa")  dated as of December 23, 1996 (the "Loan
Agreement");

      WHEREAS, as a condition to extending to CCA certain  accommodations  under
the Loan  Agreement,  Daiwa has required that IHS provide a guaranty (the "Daiwa
Guaranty")  securing the  repayment of all amounts owing from CCA to Daiwa under
the Loan  Agreement  in  excess of the Basic  Borrowing  Amount,  as well as the
payment  of any and all  reasonable  costs and  expenses  (including  reasonable
counsel fees and  expenses)  paid or incurred by Daiwa in  enforcing  its rights
under the Daiwa Guaranty;

      WHEREAS,  CCA  has  entered  into  a  letter  agreement  with  Health  and
Retirement  Properties,  Trust  ("HRPT") dated as of April 14, 1997 (the "Letter
Agreement"),

      WHEREAS,  in accordance with the Letter Agreement,  HRPT has required that
IHS provide a guaranty (the "HRPT Guaranty")  securing certain  obligations owed
by CCA to HRPT,

      WHEREAS,  as a condition  to  providing  the Daiwa  Guaranty  and the HRPT
Guaranty,  IHS  requires  that CCA agree to  reimburse  IHS for any amounts that
become payable by IHS in respect of the Daiwa Guaranty and the HRPT Guaranty.

      NOW,  THEREFORE,  in consideration of the mutual promises  hereinafter set
forth, and for other good and valuable  consideration,  the parties hereby agree
as follows:

      1.  Subject  to  any  waiver  by  IHS  of  the  right  to  subrogation  or
reimbursement  contained in the Daiwa  Guaranty  and/or the HRPT  Guaranty,  CCA
shall, on demand,  reimburse IHS for any amounts paid by IHS on behalf of CCA in
accordance  with the  terms of the Daiwa  Guaranty  and/or  the HRPT  Guarantee,
including any costs, fees, charges and expenses (including reasonable legal fees
and expenses of counsel) arising out of the negotiation, preparation or issuance
of,  or  performance  under,  the  Daiwa  Guaranty  and/or  the  HRPT  Guarantee
(collectively, the "Reimburstment Obligations").


      2. Any and all amounts  which became owing to IHS by CCA in respect of the
Reimbursement  Obligations  shall bear interest,  from the date such amounts are
advanced by IHS under the applicable guaranty until paid in full, at the rate of
fifteen (15%) percent per annum.





         3. This  Agreement  shall  remain in full force and effect until all of
the  Reimbursement  Obligations  shall have been fully,  finally and irrevocably
satisfied  and IHS has been fully,  finally and  irrevocably  released  from all
obligations with respect to the Daiwa Guaranty and the HRPT Guaranty.

         4. All  agreements  between  CCA and IHS herein  are  hereby  expressly
limited so that in  contingency  or event  whatsoever,  shall the amount paid or
agreed  to be paid to IHS  for  the  use,  forbearance  or  detention  of  money
hereunder  exceed the maximum  permissible  under  applicable  law. If, from any
circumstance  whatsoever,  the  fulfillment  of any provision  hereof,  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 IHS 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  Reimbursement  Obligations  and not to the payment of
interest.

         5. 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 CCA:           Community Care of America, Inc.
                           3050 North Horseshoe Drive, Suite 260
                           Naples, Florida 33942
                           Attention: President

         To IHS:           Integrated Health Services, Inc.
                           10065 Red Run Boulevard
                           Owings Mills, MD 21117
                           Attention: General Counsel

or to such other  address,  and to the attention of such other person or officer
as either party may designate in writing by notice.

         6. 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.   Whenever  possible,   each  provision  of  this  Agreement  shall  be
interpreted  in such manner as to be effective and valid under  applicable  law,
but if any  provision of this  Agreement  shall be  prohibited  or invalid under
applicable law, such provision  shall be ineffective  only to the extent of such
prohibition or invalidity,  without invalidating the remainder of such provision
or the remaining provisions of this Agreement.

                                        2



      7. Neither this Agreement nor any provision hereof may be changed, waived,
discharged or terminated  orally, but only by an instrument in writing signed by
the  party  against  which  enforcement  of the  change,  waiver,  discharge  or
termination  is  sought.  This  Agreement  shall  be  binding  upon  CCA and its
successors and assigns,  and shall inure to the benefit of and be enforceable by
the IHS and its successors and assigns.

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


                                      INTEGRATED HEALTH  SERVICES, INC



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



                                     COMMUNITY CARE OF AMERICA, INC



                                      By: /s/ Debbie Lau
                                          -------------------------------------
                                          Name:  Debbie Lau
                                          Title: Chief Operating Officer