EXHIBIT 1


                                                                DRAFT OF 5/28/98

                        INTEGRATED HEALTH SERVICES, INC.

                 6% CONVERTIBLE SUBORDINATED DEBENTURES DUE 2003

                                STANDBY AGREEMENT

                                                             New York, New York
                                                             May 29, 1998

Smith Barney Inc.
388 Greenwich Street
New York, New York 10013

Ladies and Gentlemen:

                  Integrated Health Services,  Inc., a Delaware corporation (the
"Company"),  intends to call for  redemption  on June 29, 1998 (the  "Redemption
Date")  all  of  its  6%  Convertible  Subordinated  Debentures  due  2003  (the
"Debentures")  at a total  redemption  price of $1,059.83  per $1,000  principal
amount of Debentures  (which  amount  includes  accrued  interest to the date of
redemption and the required  redemption  premium) (the "Redemption  Price"). The
Debentures are convertible into shares of the Common Stock,  $.001 par value, of
the Company ("Common  Stock"),  at any time prior to the close of business (5:00
P.M., New York City time) on the Redemption Date.

                  In order  to  ensure  that the  Company  will  have  available
sufficient  funds to redeem  any  Debentures  not  converted  prior to or on the
Redemption  Date,  the Company  desires to make  arrangements  pursuant to which
Smith  Barney Inc.  (the  "Purchaser")  will,  following  the  Redemption  Date,
purchase  shares  of  Common  Stock  that  would  have  been  issuable  upon the
conversion of the Debentures that have not been surrendered for conversion prior
to 5:00 P.M., New York City time, on the Redemption Date.

                  Any  reference  herein  to  the  Registration   Statement,   a
Preliminary Prospectus or the Prospectus shall be deemed to refer to and include
the documents  incorporated by reference therein pursuant to Form S-3 which were
filed under the Exchange Act on or before the Effective Date of the Registration
Statement or the issue date of such Preliminary Prospectus or the Prospectus, as
the case may be; and any reference  herein to the terms "amend,"  "amendment" or
"supplement"  with  respect  to  the  Registration  Statement,  any  Preliminary
Prospectus or the Prospectus  shall be deemed to refer to and include the filing
of any  document  under  the  Exchange  Act  after  the  Effective  Date  of the
Registration  Statement,  or the issue date of any Preliminary Prospectus or the
Prospectus,  as the case may be, deemed to be incorporated therein by reference.
Certain terms used herein are defined in Section 17 hereof.


                  1. REPRESENTATIONS AND WARRANTIES.  The Company represents and
warrants to, and agrees with,  the  Purchaser as set forth below in this Section
1.

                     (a) The Company meets the  requirements for use of Form S-3
         under  the Act  and has  prepared  and  filed  with  the  Commission  a
         registration  statement  (file  number 333- ) on Form S-3,  including a
         related preliminary  prospectus,  for the registration under the Act of
         the issuance by the Company of the shares of Common Stock issuable upon
         conversion of Debentures and the sale by the Purchaser of any shares of
         Common Stock that may be acquired by it hereunder. The Company may have
         filed one or more amendments  thereto,  including a related preliminary
         prospectus,  each of which has  previously  been  furnished to you. The
         Company will next file with the Commission one of the following: either
         (1)  prior to the  Effective  Date of such  registration  statement,  a
         further amendment to such registration statement, including the form of
         final  prospectus or (2) after the Effective Date of such  registration
         statement,  a final  prospectus in accordance with Rule 424(b).  In the
         case of clause  (2),  the Company  has  included  in such  registration
         statement,  as amended at the Effective Date, all information  required
         by the Act and the rules thereunder to be included in such registration
         statement and the Prospectus; provided, however, that the Company makes
         no representations or warranties as to the information  contained in or
         omitted  from the  Registration  Statement  or the  Prospectus  (or any
         supplement thereto) in reliance upon and in conformity with information
         furnished  herein or in writing  to the  Company by or on behalf of the
         Purchaser  specifically for inclusion in the Registration  Statement or
         the Prospectus (or any supplement  thereto).  As filed,  such amendment
         and form of final prospectus,  or such final prospectus,  shall contain
         all such required material  information,  and, except to the extent the
         Purchaser  shall  agree in writing to a  modification,  shall be in all
         substantive  respects  in  the  form  furnished  to  you  prior  to the
         Execution  Time or, to the extent not completed at the Execution  Time,
         shall  contain  only such  specific  additional  information  and other
         changes (beyond those contained in the latest  Preliminary  Prospectus)
         as the Company has advised you,  prior to the Execution  Time,  will be
         included or made therein.  If the Registration  Statement  contains the
         undertaking  specified by Regulation S-K Item 512(a),  the Registration
         Statement,  at the Execution Time,  meets the requirements set forth in
         Rule 415(a)(1)(x).

                     (b) On the Effective Date, the  Registration  Statement did
         or will,  and when the  Prospectus  is first  filed  (if  required)  in
         accordance  with Rule  424(b) and,  on the  Redemption  Date and on the
         Closing Date (as defined  herein),  the Prospectus (and any supplements
         thereto)  will,  comply in all material  respects  with the  applicable
         requirements  of the Act and the Exchange Act and the respective  rules
         thereunder;  on the  Effective  Date  and at the  Execution  Time,  the
         Registration Statement did not or will not contain any untrue statement
         of a material  fact or omit to state any material  fact  required to be
         stated therein or necessary in order to make the statements therein not
         misleading;  and, on the Effective Date, the  Prospectus,  if not filed
         pursuant to Rule  424(b),  did not or will 

                                        2

         not,  and on the date of any filing  pursuant  to Rule  424(b),  on the
         Redemption Date and on the Closing Date, the Prospectus  (together with
         any  supplement  thereto) will not,  include any untrue  statement of a
         material  fact or omit to state a material  fact  necessary in order to
         make the statements  therein,  in the light of the circumstances  under
         which they were  made,  not  misleading;  provided,  however,  that the
         Company makes no  representations  or warranties as to the  information
         contained  in  or  omitted  from  the  Registration  Statement  or  the
         Prospectus  (or  any  supplement  thereto)  in  reliance  upon  and  in
         conformity  with  information  furnished  herein or in  writing  to the
         Company by or on behalf of the Purchaser  specifically for inclusion in
         the  Registration  Statement  or  the  Prospectus  (or  any  supplement
         thereto).

                     (c) The Debentures are  convertible  into Common Stock at a
         conversion  price of $32.125 per $1,000 principal amount of Debentures.
         At the Execution  Time,  there was outstanding  $115,000,000  aggregate
         principal  amount of Debentures.  The redemption of all the outstanding
         Debentures  has been duly  authorized  by the Company.  By the close of
         business on the Business Day  following  the date of execution  hereof,
         all of the  Debentures  will have been duly  called for  redemption  in
         accordance  with  the  terms  of that  certain  Indenture  dated  as of
         December  1,  1992  between  the  Company  and The Bank of New York (as
         successor to Signet Trust Company) (the "Indenture");  and the right to
         convert the Debentures into shares of Common Stock will, as a result of
         such calls,  expire at 5:00 P.M., New York City time, on the Redemption
         Date.  Copies  of the form of  notice  of  redemption  and the  related
         letter of transmittal (collectively,  the "Notice of Redemption")  with
         respect to the Debentures have been heretofore  delivered to you by the
         Company.  The  Debentures  have been duly and  validly  authorized  and
         issued and  constitute  valid and  binding  obligations  of the Company
         entitled to the benefits of the  Indenture,  enforceable  in accordance
         with  their  terms  except as  enforcement  thereof  may be  limited by
         bankruptcy,   fraudulent   conveyance,   insolvency,    reorganization,
         moratorium  and other laws  affecting  the  enforcement  of  creditors'
         rights generally and by general equitable principles.

                     (d) The Company has neither  taken nor will take,  directly
         or indirectly,  any action  designed to cause or result in, or that has
         constituted or that might be reasonably expected to cause or result in,
         stabilization  or  manipulation  of the  price of any  security  of the
         Company to facilitate the  conversion of the Debentures  (provided that
         the Company does not make any representation as to any actions that may
         be taken by the  Purchaser);  and the Company has not  distributed  and
         will not  distribute  any  prospectus  or other  offering  material  in
         connection  with the  issue  and  sale of the  Securities  (as  defined
         herein)  other  than  the  Registration   Statement,   any  preliminary
         prospectus  filed  with  the  Commission  or the  Prospectus  or  other
         material permitted by the Act.

                     (e) The  Registration  Statement has become  effective;  no
         stop order suspending the  effectiveness of the Registration  Statement
         is in effect; and


                                       3



         no proceedings for such purpose are pending before or, to the knowledge
         of the Company, threatened by the Commission.

                     (f) Since the respective  dates as of which  information is
         given in the  Registration  Statement  and the  Prospectus,  except  as
         otherwise stated therein, (A) there has been no material adverse change
         in the condition  (financial or other),  business,  business prospects,
         properties,  net worth or results of  operations of the Company and its
         Subsidiaries (as defined herein) taken as a whole (a "Material  Adverse
         Effect"),  and (B) there have been no transactions  entered into by the
         Company or any of its  Subsidiaries,  other than those in the  ordinary
         course of business,  which are material with respect to the Company and
         its Subsidiaries taken as a whole.

                     (g) This Agreement has been duly  authorized,  executed and
         delivered by the Company.

                     (h) All the  outstanding  shares  of  capital  stock of the
         Company have been duly  authorized and validly  issued,  are fully paid
         and  nonassessable  and are free of any  preemptive  or,  except as set
         forth in the  Prospectus,  similar  rights and were  issued and sold in
         compliance with all applicable  federal and state  securities laws; and
         the  authorized  capital stock of the Company  conforms in all material
         respects to the description thereof in the Prospectus.

                     (i) The Company is a corporation  duly  organized,  validly
         existing and in good  standing  under the laws of the State of Delaware
         with full  corporate  power and authority to own, lease and operate its
         properties and to conduct its business as described in the  Prospectus,
         and is duly  registered and qualified to conduct its business and is in
         good  standing  in each  jurisdiction  or place where the nature of its
         properties or the conduct of its business requires such registration or
         qualification,  except where the failure so to register or qualify does
         not have a Material Adverse Effect.

         (j) All the Company's  subsidiaries (as defined in the Act) included in
         Exhibit  21 to the  Company's  Annual  Report on Form 10-K for the year
         ended December 31, 1997, other than those indicated as inactive in such
         Exhibit 21, are referred to herein  individually as a "Subsidiary"  and
         collectively as the "Subsidiaries." Each Subsidiary is a corporation or
         limited  partnership  duly  organized,  validly  existing  and in  good
         standing in the jurisdiction of its  organization,  with full corporate
         or  partnership  power and  authority  to own,  lease and  operate  its
         properties and to conduct its business as described in the  Prospectus,
         and is duly  registered and qualified to conduct its business and is in
         good  standing  in each  jurisdiction  or place where the nature of its
         properties or the conduct of its business requires such registration or
         qualification, except where the failure so to register or qualify or be
         in good standing does not have a Material  Adverse Effect.  None of the
         subsidiaries  of the Company other than the  Subsidiaries is engaged in
         any business activities or operations or has any material

                                       4


          assets or liabilities.  All the outstanding shares of capital stock of
          each  of the  Subsidiaries  which  is a  corporation  have  been  duly
          authorized and validly issued, are fully paid and  nonassessable,  and
          are wholly owned by the Company directly or indirectly  through one of
          the other  Subsidiaries,  free and clear of any lien,  adverse  claim,
          security interest, equity or other encumbrance, except as described in
          the  Prospectus  and except for the shares of capital stock of certain
          Subsidiaries  pledged  to  Citibank,  N.A.,  as  administrative  agent
          ("Citibank"),  in connection with the Company's  Revolving  Credit and
          Term Loan Agreement  dated as of September 15, 1997, as amended,  with
          Citibank and the lenders from time to time party  thereto (the "Credit
          Agreement") and/or to Meditrust Mortgage Investments,  Inc. and/or any
          of  its   affiliates   (collectively,   "Meditrust").   Each   limited
          partnership  agreement  pursuant to which the Company or a  Subsidiary
          holds a general partnership interest in a limited partnership which is
          a Subsidiary  is in full force and effect and  constitutes  the legal,
          valid  and  binding  agreement  of the  parties  thereto,  enforceable
          against such parties in accordance  with the terms thereof,  except as
          enforcement thereof may be limited by bankruptcy,  insolvency or other
          similar laws affecting the enforcement of creditors'  rights generally
          and by general  equitable  principles;  and there has been no material
          breach of or default under, and no event which with notice or lapse of
          time would  constitute  a material  breach of or default  under,  such
          agreements by the Company or any  Subsidiary or, to the Company's best
          knowledge, any other party to such agreements.

                     (k) There are no legal or governmental  proceedings pending
         or, to the knowledge of the Company, threatened, against the Company or
         any  of  the  Subsidiaries,  or to  which  the  Company  or  any of the
         Subsidiaries,  or to  which  any of  their  respective  properties,  is
         subject,  that  are not  disclosed  in the  Prospectus  and  which,  if
         adversely  decided,  are reasonably  likely to cause a Material Adverse
         Effect  or  materially  affect  the  consummation  of the  transactions
         contemplated  hereby.  There  are no  material  agreements,  contracts,
         indentures,  leases or other  instruments that are not described in the
         Prospectus  or that  are  required  to be filed  as an  exhibit  to the
         Registration  Statement  or  any  document  incorporated  by  reference
         therein that are not so filed.  Neither the Company nor any  Subsidiary
         is involved in any strike,  job action or labor  dispute with any group
         of  employees,  and,  to the  Company's  knowledge,  no such  action or
         dispute is  threatened,  which is reasonably  likely to have a Material
         Adverse Effect.

                     (l) Neither the Company nor any of the  Subsidiaries is (i)
         in violation of its certificate or articles of incorporation or by-laws
         or  other   organizational   documents,   or  of  any  law,  ordinance,
         administrative  or  governmental  rule or regulation  applicable to the
         Company  or any of the  Subsidiaries  or of any  decree of any court or
         governmental agency or body having jurisdiction over the Company or any
         of the  Subsidiaries,  except where any such violation or violations in
         the  aggregate  would  not have a  Material  Adverse  Effect or (ii) in
         default in any material  respect in the  performance of any obligation,
         agreement or condition  contained in any bond,  debenture,  note or any
         other 

                                       5


         evidence of indebtedness or in any material agreement, indenture, lease
         or other  instrument to which the Company or any of the Subsidiaries is
         a party or by which any of them or any of their  respective  properties
         may be bound, except as may be disclosed in the Prospectus.

                     (m) None of the call of the Debentures for redemption,  the
         conversion or redemption thereof, the issue and sale of the Securities,
         the  execution,  delivery  and  performance  by  the  Company  of  this
         Agreement  or the  consummation  by  the  Company  of the  transactions
         contemplated  herein and compliance by the Company with its obligations
         hereunder (i) requires any consent,  approval,  authorization  or other
         order of or  registration or filing with, any court,  regulatory  body,
         administrative  agency or other  governmental  body, agency or official
         (except such as may be required for the  registration of the Securities
         under the Act, the listing of the Purchased  Securities on the New York
         Stock Exchange and  compliance  with the securities or Blue Sky laws of
         various  jurisdictions,  all of which have been or will be  effected in
         accordance with this  Agreement),  (ii) conflicts or will conflict with
         or constitutes or will constitute a breach of, or a default under,  the
         certificate   or   articles  of   incorporation   or  bylaws  or  other
         organizational  documents  of the  Company or any of its  Subsidiaries,
         (iii) conflicts or will conflict with or constitutes or will constitute
         a breach of, or a default  under,  any agreement,  indenture,  lease or
         other  instrument to which the Company or any of its  Subsidiaries is a
         party or by which any of them or any of their respective properties may
         be bound,  except for such conflicts,  breaches or defaults which would
         not, individually or in the aggregate,  have a Material Adverse Effect,
         (iv) violates or will violate any statute, law, regulation or judgment,
         injunction,  order or decree  applicable  to the  Company or any of its
         Subsidiaries,  except for such violations which would not, individually
         or in the aggregate, have a Material Adverse Effect, or (v) will result
         in the creation or  imposition  of any lien,  adverse  claim,  security
         interest, equity or other encumbrance (each a "Lien") upon any property
         or assets of the  Company or any of its  Subsidiaries  pursuant  to the
         terms of any agreement or instrument to which any of them is a party or
         by which  any of them may be bound or to which any of the  property  or
         assets of any of them is  subject,  except for such Liens  which  would
         not, individually or in the aggregate, have a Material Adverse Effect.

                     (n) The  accountants,  KPMG Peat  Marwick  LLP,  Deloitte &
         Touche LLP and Arthur Andersen LLP, who have certified or shall certify
         the financial statements  incorporated by reference in the Registration
         Statement and the Prospectus (or any amendment or supplement  thereto),
         are independent certified public accountants as required by the Act.

                           (o) The  historical  financial  statements,  together
         with the related  schedules and notes forming part of the  Registration
         Statement and the Prospectus (and any amendment or supplement thereto),
         comply as to form with the  requirements  of the Act and present fairly
         in all material respects the consolidated  financial position,  results
         of  operations  and changes in  stockholders' equity and 



                                       6


         cash flows of each of the Company and its Subsidiaries,  First American
         Health Care of Georgia,  Inc.  ("First  American"),  Community  Care of
         America,  Inc. ("CCA"),  RoTech Medical Corporation  ("RoTech") and the
         selected  facilities  operated by  Horizon/CMS  Healthcare  Corporation
         ("Horizon/CMS")  to be sold to Integrated Health Services,  Inc. on the
         basis stated in the  Registration  Statement at the respective dates or
         for the  respective  periods to which they apply;  such  statements and
         related  schedules  and notes have been  prepared  in  accordance  with
         generally   accepted   accounting   principles   consistently   applied
         throughout the periods involved,  except as disclosed therein;  and the
         other financial and  statistical  information and data set forth in the
         Registration  Statement  and  the  Prospectus  (and  any  amendment  or
         supplement  thereto) is  accurately  presented  and, to the extent such
         information and data is derived from the financial books and records of
         the  Company  and its  Subsidiaries,  First  American,  CCA,  RoTech or
         Horizon/CMS, as the case may be, is prepared on a basis consistent with
         such  financial  statements  and  books  and  records.  The  pro  forma
         financial statements and other pro forma financial information included
         or  incorporated by reference in the  Registration  Statement have been
         prepared in accordance with the Commission's  rules and guidelines with
         respect  to pro forma  financial  information  and have  been  properly
         compiled on the basis described  therein,  and the assumptions  used in
         the preparation thereof are, in the Company's opinion, reasonable.

                     (p) Each of the Company and the  Subsidiaries  has good and
         marketable  title to all property (real and personal)  described in the
         Prospectus  as being owned by it, free and clear of all liens,  claims,
         security interests or other  encumbrances  except such as are described
         in the Prospectus or in a document  incorporated by reference  therein,
         and all the property  described in the  Prospectus  as being held under
         lease by each of the Company and the  Subsidiaries  is held by it under
         valid,  subsisting and enforceable leases, with only such exceptions as
         in the aggregate are not materially  burdensome and do not interfere in
         any  material  respect  with the conduct of the business of the Company
         and the Subsidiaries taken as a whole.

                     (q) Each of the  Company and the  Subsidiaries  and, to the
         Company's knowledge,  the owners of the facilities and other businesses
         managed by the Company or any Subsidiary  have such permits,  licenses,
         franchises,  certificates  and other  approvals  or  authorizations  of
         governmental  or regulatory  authorities  ("Permits")  as are necessary
         under applicable law to own their respective  properties and to conduct
         their  respective  business in the manner  described in the  Prospectus
         (including, without limitation, such Permits as are required under such
         federal,  state and  other  health  care  laws,  and under  such HMO or
         similar licensure laws and such insurance laws and regulations,  as are
         applicable  thereto),  and with respect to those  facilities  and other
         businesses  that  participate in Medicare and/or  Medicaid,  to receive
         reimbursement under Medicare and Medicaid, subject in each case to such
         qualifications  as may be set forth in the Prospectus and except to the
         extent that the failure to have such Permits  would not have a Material
         Adverse Effect; the Company and each of the 



                                       7


         Subsidiaries  have fulfilled and performed in all material respects all
         their respective material  obligations with respect to the Permits, and
         no event has occurred  which  allows,  or after notice or lapse of time
         would allow,  revocation or termination thereof or results in any other
         material  impairment  of the rights of the  holder of any such  Permit,
         subject in each case to such  qualifications as may be set forth in the
         Prospectus  and  except  to the  extent  that  any such  revocation  or
         termination  would not have a Material  Adverse Effect;  and, except as
         described  in  the  Prospectus,   none  of  the  Permits  contains  any
         restriction that is materially  burdensome to the Company or any of the
         Subsidiaries.

                     (r) The  business  practices of the Company and each of its
         Subsidiaries  do not violate in any  material  respect  any  applicable
         provisions  of federal  or state law  governing  Medicare  or any state
         Medicaid program,  including without limitation,  Sections 1320a-7a and
         1320a-7b of Title 42 of the United States Code, and no individual  with
         an   ownership   or   control   interest,   as  defined  in  42  U.S.C.
         ss.1320a-3(a)(3),  in the Company or any of its Subsidiaries, or who is
         an officer,  director,  or managing  employee,  as defined in 42 U.S.C.
         ss.1320a-5(b),  of the Company or any of its  Subsidiaries  is a person
         described in 42 U.S.C. ss.1320a-7(b)(8)(B),  and the Company's and each
         of its Subsidiaries'  business practices do not violate in any material
         respect any  applicable  provisions  of federal or state law  regarding
         physician ownership of, or financial  relationship with, or referral to
         entities  providing  health care  related  goods or  services,  or laws
         requiring  disclosure  of financial  interests  held by  physicians  in
         entities to which they may refer  patients for the  provision of health
         care related goods or services.

                     (s) The Company  maintains a system of internal  accounting
         controls   sufficient  to  provide   reasonable   assurances  that  (i)
         transactions  are executed in accordance with  management's  general or
         specific authorization;  (ii) transactions are recorded as necessary to
         permit preparation of financial statements in conformity with generally
         accepted  accounting  principles  and to  maintain  accountability  for
         assets;  (iii) access to assets is permitted  only in  accordance  with
         management's general or specific  authorization;  and (iv) the recorded
         accountability   for  assets  is  compared  with  existing   assets  at
         reasonable  intervals and  appropriate  action is taken with respect to
         any differences.

                     (t) Neither the Company nor any of the Subsidiaries nor, to
         the  Company's  knowledge,  any employee or agent of the Company or any
         Subsidiary  has  made  any  payment  of  funds  of the  Company  or any
         Subsidiary  or received or retained  any funds in violation of any law,
         rule or  regulation,  which  violation  would have a  Material  Adverse
         Effect.

                     (u) Except as disclosed in the Prospectus,  the Company and
         each of the  Subsidiaries  have filed all tax  returns  required  to be
         filed, which returns are true and correct in all material respects, and
         neither the Company nor any  Subsidiary is in default in the payment of
         any  taxes  which  were  payable   pursuant  to  said  returns  or  any
         assessments with respect thereto, except where the 

                                       8


         failure to file such  returns and make such  payments  would not have a
         Material Adverse Effect.

                     (v) The  Company  and the  Subsidiaries  own or possess all
         patents,  trademarks,  trademark registrations,  service marks, service
         mark  registrations,  trade names,  copyrights,  licenses,  inventions,
         trade  secrets  and  rights  (collectively,   "Intellectual  Property")
         described in the  Prospectus as being owned by any of them or necessary
         for the  conduct  of their  respective  businesses,  except  where  the
         failure to own or possess  any such  Intellectual  Property  would not,
         individually or in the aggregate,  have a Material Adverse Effect,  and
         the Company is not aware of any claim to the contrary or any  challenge
         by any other  person to the rights of the Company and the  Subsidiaries
         with respect to any Intellectual  Property,  except for any such claims
         or challenges as would not,  individually  or in the aggregate,  have a
         Material Adverse Effect.

                     (w)  The  Company  is not  and,  upon  consummation  of the
         transactions  contemplated  hereby, will not be an "investment company"
         within the meaning of the Investment Company Act of 1940, as amended.

                     (x)  The  documents   incorporated   by  reference  in  the
         Registration  Statement and the Prospectus  and  heretofore  filed were
         filed  in a timely  manner  and,  when  they  were  filed  (or,  if any
         amendment  with  respect  to any such  document  was  filed,  when such
         amendment  was  filed),  conformed  in  all  material  respects  to the
         requirements  of the  Exchange  Act  and  did  not  contain  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;  and any further documents incorporated by reference in the
         Registration Statement and the Prospectus will, when so filed, be filed
         in a  timely  manner  and  conform  in  all  material  respects  to the
         requirements  of the  Exchange  Act and  will  not  contain  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.

                     (y) Except as disclosed in the  Prospectus  or as could not
         be reasonably  expected to materially and adversely affect consummation
         of the  transactions  contemplated by this Agreement,  no holder of any
         security of the Company has any right to require registration of shares
         of Common  Stock or any other  security of the  Company  because of the
         filing  of  the   Registration   Statement  or   consummation   of  the
         transactions contemplated by this Agreement. Except as described in the
         Prospectus,  there are no outstanding options, warrants or other rights
         calling  for  the  issuance  of,  and,   except  in   connection   with
         acquisitions  of healthcare  facilities or businesses  disclosed in the
         Prospectus,  there are no commitments,  plans or arrangements to issue,
         any shares of Common Stock of the Company or any  security  convertible
         into or exchangeable or exerciseable for Common Stock of the Company.



                                       9


                     (z) The  Company  has  received  the consent of the lenders
         party to the Credit  Agreement in connection  with the  consummation of
         the  transactions  contemplated  hereby,  a  copy  of  which  has  been
         previously furnished to the Purchaser.

                  2. Purchase and Conversion of Debentures. Subject to the terms
and conditions and in reliance upon the  representations  and warranties  herein
set forth:

                     (a) The Purchaser  agrees to surrender for conversion  into
         Common  Stock at or prior to 5:00  P.M.,  New York  City  time,  on the
         Redemption Date all Debentures then held by the Purchaser and purchased
         by the Purchaser  pursuant to Section 4 hereof or otherwise acquired by
         the Purchaser.  The shares of Common Stock issued to the Purchaser upon
         the conversion of Debentures are herein  referred to as the "Conversion
         Securities."

                     (b)  If  any  Debentures  have  not  been  surrendered  for
         conversion  prior to 5:00 P.M.,  New York City time, on the  Redemption
         Date,  at the option of the Company,  exercisable  by giving  notice in
         writing to the Purchaser not later than 8:00 P.M.,  New York City time,
         on the Redemption  Date,  the Company shall sell to the Purchaser,  and
         the Purchaser  shall purchase from the Company,  at a purchase price of
         $34.05 per share of Common  Stock that  would have been  issuable  upon
         conversion of Debentures not surrendered for conversion, such number of
         shares of Common Stock as shall be  specified  in such notice (but,  in
         each case,  not in excess of such  number of shares of Common  Stock as
         would have been issuable  upon the  conversion  of all  Debentures  not
         surrendered for conversion). The shares of Common Stock to be purchased
         pursuant to this Section 2(b) are herein  referred to as the "Purchased
         Securities"  and,   together  with  the  Conversion   Securities,   the
         "Securities."

                     (c) It is understood  that the Purchaser  intends to resell
         the  Securities  from  time to time at  prices  prevailing  in the open
         market. On or prior to the fifteenth day after the Redemption Date, the
         Purchaser shall remit to the Company 50% of the excess,  if any, of (i)
         the  aggregate  proceeds  received  by the  Purchaser  from the sale of
         Purchased  Securities (net of selling  concessions,  transfer taxes and
         other  expenses of sale) over (ii) an amount  equal to the average cost
         to the Purchaser of purchasing  the  Purchased  Securities  pursuant to
         paragraph (b) above  multiplied by the number of Purchased  Securities.
         Upon completion of the sale of the Purchased Securities,  the Purchaser
         shall  furnish to the Company a statement  setting  forth the aggregate
         proceeds  received  on the  sale  thereof  and the  applicable  selling
         concessions, transfer taxes and other expenses of sale. For purposes of
         the foregoing  determination,  any Purchased  Securities not sold by or
         for the account of the Purchaser  prior to the close of business on the
         tenth day after the  Redemption  Date shall be deemed to have been sold
         on such tenth day for an amount equal to the last  reported  sale price
         of the Common Stock on such day.  Nothing  contained herein shall limit
         the right of the Purchaser,  in its discretion,  to determine the price
         or prices at which, or the time or times when, 



                                       10


         any  Securities  shall be sold,  whether or not prior to the Redemption
         Date and whether or not for long or short account.

                     (d)  Delivery of and payment for the  Purchased  Securities
         shall be made at 10:00 A.M., New York City time, on July 2, 1998, which
         date and time may be postponed by agreement  between the  Purchaser and
         the  Company  (such  date  and time of  delivery  and  payment  for the
         Purchased Securities being herein called the "Closing Date").  Delivery
         of the  Purchased  Securities  shall be made to the  Purchaser  against
         payment by the  Purchaser of the purchase  price thereof to or upon the
         order of the Company by wire transfer  payable in same-day  funds to an
         account specified by the Company.  Delivery of the Purchased Securities
         shall be made through the  facilities of The  Depository  Trust Company
         unless the  Purchaser  shall  otherwise  instruct.  The  closing of the
         purchase  and  sale of the  Purchased  Securities  shall be made at the
         office of Fulbright & Jaworski L.L.P., New York, New York.

                  3.  Compensation.  As  compensation  for the commitment of the
Purchaser  hereunder,  the Company will pay to the  Purchaser an amount equal to
the sum of (a)  $1,828,213  plus (b) an  additional  $1.36  per  share  for each
Purchased Security and Compensible  Conversion Security,  but no amount shall be
payable  pursuant to this clause (b) unless the number of  Purchased  Securities
and Compensible  Conversion  Securities in the aggregate  exceeds 178,988 shares
(the "Take-up Threshold") and then only with respect to that number of Purchased
Securities and Compensible  Conversion  Securities that in the aggregate  exceed
the Take-up Threshold.  "Compensible  Conversion  Security" means any Conversion
Security that is acquired by the  Purchaser or that the  Purchaser  obtained the
right to acquire on a date when the last reported sale price of the Common Stock
on the New York Stock Exchange was less than or equal to $34.05.

                  Such  compensation  shall  be  paid to the  Purchaser  by wire
transfer payable in same-day funds to an account specified by the Purchaser,  on
(A) if the  Purchaser  is required to purchase  any  Purchased  Securities,  the
Closing Date, or (B) otherwise, as soon as practicable after the Redemption Date
(but in no event later than two Business Days thereafter).

                  4.   Additional   Purchases.   The   Purchaser   may  purchase
Debentures,  in the open market or otherwise, in such amounts and at such prices
as the  Purchaser  may deem  advisable.  All  Debentures  so  purchased  will be
converted by the  Purchaser  into Common Stock in  accordance  with Section 2(a)
hereof.  The Common  Stock  acquired by the  Purchaser  upon  conversion  of any
Debentures  acquired  pursuant to this Section 4 may be sold at any time or from
time to  time by the  Purchaser.  It is  understood  that,  for the  purpose  of
stabilizing  the price of the Common Stock or otherwise,  the Purchaser may make
purchases and sales of Common Stock,  in the open market or otherwise,  for long
or short account, on such terms as it may deem advisable and it may overallot in
arranging sales.

                  5. Agreements. The Company agrees with the Purchaser that:

                                       11


                     (a) The  Company  will use its best  efforts  to cause  the
         Registration Statement, if not effective at the Execution Time, and any
         amendment thereof, to become effective. Prior to the termination of the
         offering of the Securities,  the Company will not file any amendment of
         the Registration  Statement or supplement to the Prospectus  unless the
         Company has  furnished  you a copy for your review  prior to filing and
         will not file any such  proposed  amendment or  supplement to which you
         reasonably  object in writing;  provided,  however,  that the preceding
         clause  shall not apply to the filing of any  document  required  to be
         filed by the Company  under the Exchange Act that upon filing is deemed
         to be incorporated by reference in the Registration  Statement,  except
         that  the  Company  shall  furnish  you a copy of any such  document  a
         reasonable time prior to filing.  Subject to the foregoing sentence, if
         filing of the  Prospectus  is required  under Rule 424(b),  the Company
         will  cause the  Prospectus,  properly  completed,  and any  supplement
         thereto  to be filed with the  Commission  pursuant  to the  applicable
         paragraph  of Rule 424(b)  within the time period  prescribed  and will
         provide  evidence  satisfactory to the Purchaser of such timely filing.
         The  Company  will   promptly   advise  the   Purchaser  (1)  when  the
         Registration Statement (and any amendment thereto), if not effective at
         the  Execution  Time,  shall  have  become  effective,   (2)  when  the
         Prospectus,  and any  supplement  thereto,  shall  have been  filed (if
         required) with the Commission  pursuant to Rule 424(b), (3) when, prior
         to termination of the offering of the Securities,  any amendment to the
         Registration  Statement shall have been filed or become effective,  (4)
         of any request by the  Commission or its staff for any amendment of the
         Registration  Statement or for any  supplement to the Prospectus or for
         any  additional  information,  (5) of the issuance by the Commission of
         any  stop  order  suspending  the  effectiveness  of  the  Registration
         Statement or the  institution or threatening of any proceeding for that
         purpose and (6) of the receipt by the Company of any notification  with
         respect to the  suspension of the  qualification  of the Securities for
         sale in any  jurisdiction  or the  institution  or  threatening  of any
         proceeding  for such purpose.  The Company will use its best efforts to
         prevent the  issuance of any such stop order or the  suspension  of any
         such  qualification  and, if issued,  to obtain as soon as possible the
         withdrawal thereof.

                     (b) If,  at any  time  when a  prospectus  relating  to the
         Securities is required to be delivered  under the Act, any event occurs
         as a result of which the Prospectus as then supplemented  would include
         any untrue  statement of a material  fact or omit to state any material
         fact  necessary  to make the  statements  therein  in the  light of the
         circumstances under which they were made not misleading, or if it shall
         be necessary to amend the  Registration  Statement  or  supplement  the
         Prospectus to comply with the Act or the Exchange Act or the respective
         rules thereunder, the Company promptly will (1) notify the Purchaser of
         such event,  (2) prepare and file with the  Commission,  subject to the
         second  sentence of  paragraph  (a) of this  Section 5, an amendment or
         supplement which will correct such statement or omission or effect such
         compliance  and (3) supply any  supplemented  Prospectus to you in such
         quantities as you may reasonably request.



                                       12


                     (c) As soon as practicable, the Company will make generally
         available to its security  holders an earnings  statement or statements
         of the Company and its  subsidiaries  which will satisfy the provisions
         of Section 11(a) of the Act and Rule 158 under the Act.

                     (d) The Company will furnish to each of the  Purchaser  and
         counsel for the Purchaser,  without charge, copies of manually executed
         signature pages to the Registration Statement, it being understood that
         the originals of such pages will be retained in the Company's  files as
         required by the rules of the Commission, and copies of the Registration
         Statement  (including  exhibits  thereto) and, so long as delivery of a
         prospectus  by the  Purchaser  or dealer may be required by the Act, as
         many copies of each  Preliminary  Prospectus and the Prospectus and any
         supplement thereto as the Purchaser may reasonably request. The Company
         will pay the expenses of printing or other  production of all documents
         relating to the transactions  contemplated hereby. The Company will pay
         all transfer  taxes as may be imposed on the  Purchaser  in  connection
         with its purchase of Purchased Securities pursuant hereto.

                     (e) The  Company  will use its best  efforts to qualify the
         Securities  for  sale  under  the  laws  of such  jurisdictions  as the
         Purchaser may designate and will maintain such qualifications in effect
         so long as required for the  distribution of the  Securities;  provided
         that in no event  shall the  Company  be  obligated  to  qualify  to do
         business in any  jurisdiction  where it is not now so  qualified  or to
         execute a general  consent  to  service  of  process in any state or to
         otherwise  subject itself to taxation (other than stock transfer taxes)
         in connection with any such qualification.

                     (f) The  Company  will mail or cause to be mailed not later
         than the Business Day following the date of execution hereof the Notice
         of  Redemption  by first  class mail to the  registered  holders of the
         Debentures as of the close of business on the date of execution hereof,
         which mailing will conform to the  requirements  of the Indenture.  The
         Company will not withdraw or revoke the Notice of Redemption or attempt
         to do so.

                     (g) The  Company  will  advise the  Purchaser  daily of the
         amount of Debentures  surrendered in the previous day for redemption or
         for conversion.

                     (h) The  Company  will not take any  action  the  effect of
         which would be to require an adjustment in the conversion  price of the
         Debentures.

                     (i) The Company will not, prior to the Redemption Date and,
         if the aggregate number of the Securities  exceeds 450,000 shares,  for
         an  additional  period of 90 days  following the  Redemption  Date (the
         "Lock-up  Period"),  without the prior written  consent of Smith Barney
         Inc.,  offer,  sell or contract to sell,  or  otherwise  dispose of (or
         enter into any transaction which is designed to, or might reasonably be
         expected to, result in the disposition (whether by actual disposition




                                       13


         or effective economic  disposition due to cash settlement or otherwise)
         by the Company)  directly or  indirectly,  or announce the offering of,
         any other  shares of Common Stock  (other than the  Securities)  or any
         securities convertible into, or exercisable or exchangeable for, shares
         of Common  Stock,  except for (i) grants of options to employees of and
         consultants to the Company  pursuant to the Company's  option plans and
         stock  purchase  plans,  (ii)  issuances of shares of Common Stock upon
         exercise of outstanding options and warrants, (iii) issuances of Common
         Stock  (or  any   securities   convertible   into  or   exercisable  or
         exchangeable  for Common Stock) in connection  with the  acquisition of
         any related business or geriatric care facility  (including a leasehold
         interest therein or a management agreement therefor), (iv) issuances of
         securities  pursuant  to the  Company's  Rights Plan (as defined in the
         Registration  Statement)  and (v)  issuances  of shares of Common Stock
         upon conversion of the Debentures;  provided, however, that in the case
         of any securities  issued pursuant to the foregoing clause (iii),  such
         securities and the underlying  Common Stock shall,  until expiration of
         the Lock-up Period, not be registered under the Act unless registration
         under the Act within the  Lock-up  Period is  required  pursuant to the
         terms of any  written  agreement  to which the  Company  is a party and
         which  written  agreement  was in  existence  prior to the date of this
         Agreement

                           (j) The Company will apply the net proceeds  from the
         sale of Securities substantially in accordance with the description set
         forth in the Prospectus.

                           (k) The  Company  will  have the  Securities  listed,
         subject to notice of  issuance,  on the New York Stock  Exchange  on or
         before the Closing Date.

                  6.  Conditions  to  the  Obligations  of  the  Purchaser.  The
obligations of the Purchaser to convert Debentures and to purchase any Purchased
Securities  shall  be  subject  to  the  accuracy  of  the  representations  and
warranties on the part of the Company contained herein as of the Execution Time,
each Effective Date occurring after the Execution Time, the Redemption Date and,
as to the  purchase  of the  Purchased  Securities,  the  Closing  Date,  to the
accuracy of the statements of the Company made in any  certificates  pursuant to
the provisions  hereof,  to the  performance  by the Company of its  obligations
hereunder and to the following additional conditions:

                           (a) If the  Registration  Statement  has  not  become
         effective prior to the Execution Time,  unless the Purchaser  agrees in
         writing to a later time, the  Registration  Statement shall have become
         effective not later than 6:00 P.M.,  New York City time, on the date of
         execution  hereof;  if  filing  of the  Prospectus,  or any  supplement
         thereto,  is required pursuant to Rule 424(b), the Prospectus,  and any



                                       14


         such  supplement,  shall  have been  filed in the manner and within the
         time period required by Rule 424(b);  and no stop order  suspending the
         effectiveness of the Registration  Statement shall have been issued and
         no  proceedings   for  that  purpose  shall  have  been  instituted  or
         threatened.

                           (b)  On  the  date  of  this  Agreement   (after  the
         Effective  Time and prior to the  mailing of the Notice of  Redemption)
         and on the  Closing  Date,  the  Company  shall have  furnished  to the
         Purchaser the opinion of Fulbright & Jaworski  L.L.P.,  counsel for the
         Company,  dated  the  date of this  Agreement  and  the  Closing  Date,
         respectively, to the effect that:

                           (i) The Company is a  corporation  duly  incorporated
                  and validly  existing in good  standing  under the laws of the
                  State of Delaware with full  corporate  power and authority to
                  own,  lease and  operate  its  properties  and to conduct  its
                  business as described in the  Registration  Statement  and the
                  Prospectus (and any amendment or supplement thereto);

                           (ii)  Each  Significant  Subsidiary  (as  defined  in
                  Section 1.02(w) of Regulation S-X  promulgated  under the Act)
                  is a corporation  validly  existing and in good standing under
                  the laws of the  jurisdiction of its  organization,  with full
                  corporate power and authority to own,  lease,  and operate its
                  properties  and to conduct its  business as  described  in the
                  Registration  Statement and the Prospectus  (and any amendment
                  or  supplement  thereto);  and all the  outstanding  shares of
                  capital  stock of each of the  Significant  Subsidiaries  have
                  been duly  authorized and validly  issued,  are fully paid and
                  nonassessable,  and to the  knowledge  of  such  counsel,  are
                  wholly owned by the Company  directly,  or indirectly  through
                  one of the other Subsidiaries,  free and clear of any security
                  interest,  lien,  adverse claim,  equity or other encumbrance,
                  except as  described  in the  Prospectus  and  except  for the
                  shares of capital  stock of certain  Significant  Subsidiaries
                  pledged to  Citibank  as agent in  connection  with the Credit
                  Agreement and/or to Meditrust;

                           (iii) The authorized  capital stock of the Company is
                  as  set  forth  under  the  caption  "Capitalization"  in  the
                  Prospectus;  and the  authorized  capital stock of the Company
                  conforms in all material  respects as to legal  matters to the
                  description  thereof  contained  in the  Prospectus  under the
                  caption "Description of Capital Stock";

                           (iv) The Company has corporate power and authority to
                  enter into this  Agreement,  and this  Agreement has been duly
                  authorized, executed and delivered by the Company;

                           (v)  The  Debentures   have  been  duly  and  validly
                  authorized  by the  Company and  constitute  valid and binding
                  obligations  of the Company  entitled  to the  benefits of the
                  Indenture,    subject   to   the   qualification    that   the



                                       15


                  enforceability of the Company's obligations  thereunder may be
                  limited  by  bankruptcy,  fraudulent  conveyance,  insolvency,
                  reorganization,  moratorium,  and other  laws  relating  to or
                  affecting creditors' rights generally and by general equitable
                  principles;

                           (vi) Assuming the mailing of the Notice of Redemption
                  in  accordance  with Section 1(c) hereof,  all the  Debentures
                  will have  been duly  called  for  redemption  by the close of
                  business on the Business Day  following  the date of execution
                  hereof and the right to convert the Debentures  into shares of
                  Common Stock will expire at 5:00 P.M.,  New York City time, on
                  June 29,  1998;  the  shares of  Common  Stock  issuable  upon
                  conversion  of the  Debentures  have  been  duly  and  validly
                  authorized  and, when issued and delivered upon  conversion of
                  any Debentures pursuant to this Agreement,  will be fully paid
                  and nonassessable; the Purchased Securities have been duly and
                  validly  authorized and, when issued and delivered to and paid
                  for by the Purchaser pursuant to this Agreement, will be fully
                  paid and  nonassessable;  the Conversion  Securities (and, for
                  the  opinion to be  delivered  on the Closing  Date only,  the
                  Purchased  Securities)  are  duly  listed,  and  admitted  and
                  authorized  for  trading,   subject  to  official   notice  of
                  issuance, on the New York Stock Exchange; the certificates for
                  the  Securities  conform  in  all  material  respects  to  the
                  requirements  of the  Delaware  General  Corporation  Law (the
                  "DGCL");  and the  holders  of  outstanding  shares of capital
                  stock of the Company are not  entitled  to  preemptive  rights
                  under the Company's  Certificate of  Incorporation or the DGCL
                  or,  to  the  knowledge  of  such  counsel,  other  rights  to
                  subscribe  for the  Securities  or the shares of Common  Stock
                  issuable upon conversion of the Debentures;

                           (vii)  None  of  the  call  of  the   Debentures  for
                  redemption,  the conversion or redemption  thereof,  the issue
                  and sale of the  Securities  or the  execution,  delivery  and
                  performance   by  the  Company  of  this   Agreement  and  the
                  consummation by the Company of the  transactions  contemplated
                  herein  constitutes  or will  constitute a breach or violation
                  of,  or  a  default  under,  in  any  material  respect,   the
                  certificate  or articles of  incorporation  or bylaws or other
                  organizational   documents  of  the  Company  or  any  of  the
                  Significant Subsidiaries or any material agreement, indenture,
                  lease or other  instrument  to which the Company or any of the
                  Significant Subsidiaries is a party or by which any of them or
                  any of their respective properties is bound that is an exhibit
                  to the




                                       16


                  Registration   Statement  or  any  document   incorporated  by
                  reference  therein or is otherwise  known to such counsel,  or
                  will result in the creation or imposition of any lien,  charge
                  or  encumbrance  upon any property or assets of the Company or
                  any of the Significant  Subsidiaries  pursuant to the terms of
                  any material agreement or instrument to which any of them is a
                  party or by which  any of them may be bound or to which any of
                  the  property  or assets of any of them is subject  that is an
                  exhibit  to  the   Registration   Statement  or  any  document
                  incorporated  by reference  therein or is  otherwise  known to
                  such counsel, nor will any such action result in any violation
                  (assuming  compliance with all applicable state securities and
                  Blue Sky laws),  in any material  respect of any existing law,
                  or any  regulation,  ruling,  judgment,  injunction,  order or
                  decree known to such counsel to be  applicable  to the Company
                  or the  Significant  Subsidiaries  or any of their  respective
                  properties;

                           (viii) No consent,  approval,  authorization or other
                  order  of,  or   registration   or  filing  with,  any  court,
                  regulatory body,  administrative  agency or other governmental
                  body,  agency,  or  official  is  required  on the part of the
                  Company  (except  as have been  obtained  under  the Act,  the
                  listing  of the  Purchased  Securities  on the New York  Stock
                  Exchange or such as may be required under state  securities or
                  Blue Sky laws governing the purchase and  distribution  of the
                  Securities,  as to which  such  counsel  need not  express  an
                  opinion) for the  redemption by the Company of the  Debentures
                  and the valid  issuance and sale of the  Securities  to you as
                  contemplated by this Agreement;

                           (ix) Such  counsel  has been  advised by the staff of
                  the  Commission  that  the  Registration   Statement  and  all
                  post-effective amendments, if any, have become effective under
                  the Act and, to the knowledge of such  counsel,  no stop order
                  suspending the effectiveness of the Registration Statement has
                  been issued and no  proceedings  for that  purpose are pending
                  before or  contemplated  by the  Commission;  and any required
                  filing of the Prospectus pursuant to Rule 424(b) has been made
                  in accordance with Rule 424(b);

                           (x) The Registration Statement and the Prospectus and
                  any   supplements  or  amendments   thereto  (except  for  the
                  financial  statements  and the notes thereto and the schedules
                  and  other   financial  and   statistical   data  included  or
                  incorporated  by reference  therein,  as to which such counsel
                  need not express any  opinion)  appear on their face to comply
                  as to form in all material  respects with the  requirements of
                  the Act;

                           (xi) The documents  incorporated  by reference in the
                  Registration  Statement  (except for the financial  statements
                  and the notes thereto and the  schedules  and other  financial
                  and  statistical  data included or  incorporated  by reference
                  therein,  as to  which  such  counsel  need  not  express  any
                  opinion),  at the time they were filed, appeared on their face
                  to have complied as to form in all material  respects with the
                  requirements of the Exchange Act;

                           (xii) To the knowledge of such counsel, (A) there are
                  no legal or  governmental  proceedings  pending or  threatened
                  against  the Company or any of the  Subsidiaries,  or to which
                  the  Company  or  any  of the




                                       17

                  Subsidiaries, or any of their property, are subject, which are
                  not  disclosed  in the  Prospectus  and  which,  if  adversely
                  decided,  are  reasonably  likely to cause a Material  Adverse
                  Effect  or   materially   affect  the   consummation   of  the
                  transactions contemplated hereby and (B) there are no material
                  agreements, contracts, indentures, leases or other instruments
                  of a character  required to be described  in the  Registration
                  Statement and the  Prospectus  (or any amendment or supplement
                  thereto) or that are required to be filed as an exhibit to the
                  Registration   Statement  or  any  document   incorporated  by
                  reference therein that are not described or filed as required;

                           (xiii) The statements in the  Registration  Statement
                  and the  Prospectus,  insofar  as  they  are  descriptions  of
                  contracts,  agreements or other legal  documents,  or refer to
                  statements  of law or legal  conclusions,  are accurate in all
                  material respects and present fairly the information described
                  therein;

                           (xiv) The Company is not and,  after giving effect to
                  the issue and sale of the  Securities  and the  application of
                  the proceeds thereof as described in the Prospectus,  will not
                  be, an  "investment  company"  as  defined  in the  Investment
                  Company Act of 1940, as amended;

                           (xv) To the  knowledge  of such  counsel,  except  as
                  disclosed  in the  Prospectus  or as could  not be  reasonably
                  expected to materially and adversely  affect  consummation  of
                  the transactions contemplated by this Agreement, no holders of
                  securities of the Company have rights to the  registration  of
                  such securities under the Registration Statement;

                           (xvi)  The  statements  in the  Prospectus  under the
                  caption "Certain Federal Income Tax Considerations" and in the
                  Notice of  Redemption  under the caption  "Federal  Income Tax
                  Considerations,"  in each  case  insofar  as  such  statements
                  constitute summaries of the legal matters referred to therein,
                  fairly present the information called for with respect to such
                  legal  matters and fairly  summarize  the matters  referred to
                  therein; and

                           (xvii)  Although  such  counsel  has not  undertaken,
                  except as otherwise  indicated  in its  opinion,  to determine
                  independently, and does not assume any responsibility for, the
                  accuracy,  completeness  or fairness of the  statements in the
                  Registration  Statement and the  Prospectus,  such counsel has
                  participated in the preparation of the Registration  Statement
                  and the  Prospectus,  including  review and  discussion of the
                  contents thereof, and has reviewed the documents  incorporated
                  by reference  therein,  and,  relying as to  materiality  to a
                  large   extent  upon  the   opinions  of  officers  and  other
                  representatives  of  the  Company,  nothing  has  come  to the
                  attention  of such  counsel  that has caused  such  counsel to
                  believe that the Registration  Statement on the Effective Date
                  contained an untrue




                                       18
 

                  statement  of a  material  fact or omitted to state a material
                  fact  required to be stated  therein or  necessary to make the
                  statements  therein not misleading or that the Prospectus,  as
                  of its date and as of the Closing  Date,  contained  an untrue
                  statement  of a  material  fact or omitted to state a material
                  fact  required to be stated  therein or  necessary in order to
                  make the  statements  therein,  in light of the  circumstances
                  under  which  they  were  made,   not   misleading  (it  being
                  understood  that such  counsel  need  express no opinion  with
                  respect to the financial  statements and the notes thereto and
                  the  schedules  and  other  financial  and  statistical   data
                  included or  incorporated  by  reference  in the  Registration
                  Statement or the Prospectus and information furnished by or on
                  behalf of the Purchaser).

                  The  opinion of such  counsel  shall be limited to the laws of
         the United States,  the State of New York and the internal  corporation
         law of the State of Delaware.  In delivering  their opinion pursuant to
         clause (ii) above and clause (vii) above with respect to organizational
         documents such counsel may rely on the opinion of Florida  councel with
         respect to RoTech Medical Corporation, a Florida Corporation, provided,
         that (A) each such local counsel is acceptable  to the  Purchaser,  (B)
         such  reliance is expressly  authorized  by each opinion so relied upon
         and a copy of each such opinion is delivered to the  Purchaser  and is,
         in form and substance,  reasonably  satisfactory to it and its counsel,
         and (C) counsel  shall state in their  opinion that they have no reason
         to believe that such  counsel and the  Purchaser  are not  justified in
         relying thereon.

                           (c)  On  the  date  of  this  Agreement   (after  the
         Effective  Time and prior to the  mailing of the Notice of  Redemption)
         and on the  Closing  Date,  the  Company  shall have  furnished  to the
         Purchaser the opinion of Marshall A. Elkins,  Esq.,  General Counsel of
         the Company,  dated the date of this  Agreement  and the Closing  Date,
         respectively, to the effect that:

                           (i) The Company is duly  registered  and qualified to
                  conduct  its  business  and is in good  standing  as a foreign
                  corporation in each  jurisdiction or place where the nature of
                  its  properties  or the conduct of its business  requires such
                  registration or qualification,  except where the failure so to
                  register or qualify or to be in good standing would not have a
                  Material Adverse Effect;

                           (ii) All the  outstanding  shares of capital stock of
                  the Company have been duly authorized and validly issued,  are
                  fully paid and nonassessable;

                           (iii)  Each   Subsidiary  is  duly   registered   and
                  qualified to conduct its business and is in good standing as a
                  foreign   corporation   or   limited   partnership   in   each
                  jurisdiction  or place where the nature of its  properties  or
                  the conduct of its  business  requires  such  registration  or
                  qualification,


                                       19


                  except where the failure so to register or qualify or to be in
                  good standing would not have a Material Adverse Effect;

                           (iv) Neither the Company nor any of the  Subsidiaries
                  is in  violation  in any  material  respect of its  respective
                  certificate or articles of incorporation  or bylaws,  or other
                  organizational  documents,  or to the best  knowledge  of such
                  counsel  after  reasonable  inquiry,  is  in  default  in  any
                  material   respect  in  the   performance   of  any   material
                  obligation,  agreement  or  condition  contained  in any bond,
                  debenture,  note or other evidence of  indebtedness  or in any
                  material  agreement,  indenture,  lease or other instrument to
                  which the Company or any of the  Subsidiaries is a party or by
                  which any of them or any of their respective properties may be
                  bound, except as disclosed in the Prospectus and except to the
                  extent  that any such  violation  or default  would not have a
                  Material Adverse Effect;

                           (v) Such  counsel  has no reason to believe  that the
                  Company  and  its   Subsidiaries   do  not  have  all  Permits
                  (including,  without limitation, such Permits as are necessary
                  under such  federal and state  health care laws and under such
                  HMO and similar  licensure  laws and such  insurance  laws and
                  regulations   as  are   applicable  to  the  Company  and  its
                  Subsidiaries)  as are necessary to own,  lease and operate its
                  properties and conduct its business, except to the extent that
                  the  failure  to have such  Permits  would not have a Material
                  Adverse  Effect;  and to the best  knowledge  of such  counsel
                  after reasonable  inquiry there are no proceedings  pending or
                  threatened against the Company or any of its Subsidiaries that
                  may cause any such  Permit  that is material to the conduct of
                  the business of the Company or any of its  Subsidiaries  to be
                  revoked, withdrawn, cancelled, suspended or not renewed;

                           (vi) Such  counsel has no reason to believe  that (a)
                  the   business   practices  of  the  Company  or  any  of  its
                  Subsidiaries  violate in any material  respect any  applicable
                  provisions of federal or state law  governing  Medicare or any
                  state Medicaid program, including without limitation, Sections
                  1320a-7a and  1320a-7b of Title 42 of the United  States Code,
                  or that any individual with an ownership or control  interest,
                  as defined in 42 U.S.C.  ss.1320a-3(a)(3),  in the  Company or
                  any of its  Subsidiaries  or who is an officer,  director,  or
                  managing  employee as defined in 42 U.S.C.  ss.1320a-5(b),  of
                  the Company or any of its  Subsidiaries is a person  described
                  in 42 U.S.C. ss.1320a-7(b)(8)(B), or that (b) the Company's or
                  any Subsidiary's  business  practices  violate in any material
                  respect  any  applicable  provisions  of  federal or state law
                  regarding  physician  ownership of, or financial  relationship
                  with,  or referral to entities  providing  health care related
                  goods or services,  or laws requiring  disclosure of financial
                  interests  held by  physicians  in  entities to which they may
                  refer  patients for the provision of health care related goods
                  or services;  and to the best  knowledge of such counsel after
                  reasonable  inquiry,  neither  the  Company




                                       20

                  nor any of its  Subsidiaries is in violation of any other law,
                  ordinance,  administrative  or governmental rule or regulation
                  applicable to the Company or any of its Subsidiaries or of any
                  decree of any  court or  governmental  agency  or body  having
                  jurisdiction  over  the  Company  or any of its  Subsidiaries,
                  except to the extent that any such violation  would not have a
                  Material Adverse Effect; and

                           (vii)  Although  such  counsel  has  not  undertaken,
                  except as otherwise  indicated in such counsel's  opinion,  to
                  determine    independently,    and   does   not   assume   any
                  responsibility for, the accuracy,  completeness or fairness of
                  the   statements  in  the   Registration   Statement  and  the
                  Prospectus,  such counsel has  participated in the preparation
                  of the  Registration  Statement  and  the  Prospectus  and the
                  documents  incorporated by reference therein,  and nothing has
                  come to the  attention  of such  counsel  that has caused such
                  counsel to believe  that the  Registration  Statement,  on the
                  Effective Date or at the Execution  Time,  contained an untrue
                  statement of material fact or omitted to state a material fact
                  required  to be  stated  therein  or  necessary  to  make  the
                  statements  therein not misleading or that the Prospectus,  as
                  of its date and as of the Closing  Date,  contained any untrue
                  statement  of a  material  fact or omitted to state a material
                  fact  required to be stated  therein or  necessary in order to
                  make the  statements  therein,  in light of the  circumstances
                  under  which  they  were  made,   not   misleading  (it  being
                  understood  that such  counsel  need  express no opinion  with
                  respect to the financial  statements and the notes thereto and
                  the  schedules  and  other  financial  and  statistical   data
                  included or  incorporated  by  reference  in the  Registration
                  Statement or the Prospectus and information furnished by or on
                  behalf of the Purchaser).

                           (d)  On  the  date  of  this  Agreement   (after  the
         Effective  Time and prior to the  mailing of the Notice of  Redemption)
         and on the Closing Date,  the Purchaser  shall have received from Dewey
         Ballantine  LLP,  counsel for the Purchaser,  such opinion or opinions,
         dated the date of this  Agreement and the Closing  Date,  respectively,
         and addressed to the  Purchaser,  with respect to this  Agreement,  the
         Registration  Statement,  the Prospectus and such other related matters
         as the Purchaser  may  reasonably  require,  and the Company shall have
         furnished  to such  counsel  such  documents  as they  request  for the
         purpose of enabling them to pass upon such matters.

         (e) On the date of this  Agreement  (after the Effective Time and prior
         to the mailing of the Notice of  Redemption),  on each  Effective  Date
         occurring after the Execution Time and on the Closing Date, the Company
         shall have  furnished to the  Purchaser a  certificate  of the Company,
         signed by the Chief Executive Officer (or the Chief Operating  Officer)
         and Chief  Financial  Officer of the Company (or such other officers as
         are acceptable to the  Purchaser),  dated the date of delivery,  to the
         effect that the signers of such certificate have carefully




                                       21


         examined the Registration Statement, the Prospectus, any supplements to
         the Prospectus and this Agreement and to the effect that:

                           (i) the representations and warranties of the Company
                  in  this  Agreement  are  true  and  correct  in all  material
                  respects on and as of the date of such  certificate as if made
                  on the date of such  certificate  and the Company has complied
                  with all the  agreements  and satisfied all the  conditions on
                  its part to be  performed or satisfied at or prior to the date
                  of such certificate;

                           (ii) no stop order  suspending the  effectiveness  of
                  the Registration  Statement has been issued and no proceedings
                  for that purpose  have been  instituted  or, to the  Company's
                  knowledge, threatened; and

                           (iii)  since  the date of the most  recent  financial
                  statements  included  in  the  Prospectus  (exclusive  of  any
                  supplement thereto), there has been no material adverse change
                  or development involving a prospective material adverse change
                  in the  condition  (financial  or other),  business,  business
                  prospects,  properties,  net worth or results of operations of
                  the Company and the Subsidiaries, taken as a whole, whether or
                  not  arising  from  transactions  in the  ordinary  course  of
                  business,  except  as  set  forth  in or  contemplated  in the
                  Prospectus (exclusive of any supplement thereto).

                           (f)  On  the  date  of  this  Agreement   (after  the
         Effective  Time and prior to the mailing of the Notice of  Redemption),
         on each  Effective  Date  occurring  after the Execution  Time on which
         financial  information is included or incorporated in the  Registration
         Statement or the Prospectus and on the Closing Date,  each of KPMG Peat
         Marwick LLP,  Deloitte & Touche LLP and Arthur  Andersen LLP shall have
         furnished  to the  Purchaser  a letter,  dated  respectively  as of the
         Execution Time, each such Effective Date and as of the Closing Date, in
         form and substance satisfactory to the Purchaser,  confirming that they
         are  independent  accountants  within  the  meaning  of the Act and the
         Exchange  Act  and  the  respective   applicable  published  rules  and
         regulations thereunder and containing statements and information of the
         type  ordinarily   included  in  accountants'   "comfort   letters"  to
         underwriters  with  respect to the  financial  statements  and  certain
         financial  information contained in or incorporated by reference in the
         Registration Statement and Prospectus.

                  (g) Subsequent to the Execution Time or, if earlier, the dates
         as  of  which  information  is  given  in  the  Registration  Statement
         (exclusive of any amendment  thereof) and the Prospectus  (exclusive of
         any  supplement  thereto),  there shall not have been (i) any change in
         the capital  stock,  increase in  long-term  debt or any  decreases  in
         consolidated net current assets or stockholders'  equity of the Company
         and its  subsidiaries on a consolidated  basis as compared with amounts
         shown in the most recent balance sheet incorporated by




                                       22


         reference in the Prospectus  or, for the period  commencing on the date
         following  the end of the most recent  period for which a  consolidated
         income  statement  of the Company is  incorporated  by reference in the
         Prospectus, any decreases, as compared with the corresponding period in
         the  preceding  year, in  consolidated  net revenues or in the total or
         per-share  consolidated  amounts of earnings before extraordinary items
         or of net earnings  specified  in the letters  referred to in paragraph
         (f) of this Section 6 or (ii) any change, or any development  involving
         a  prospective  change,  in or affecting  the  condition  (financial or
         other), business, business prospects,  properties, net worth or results
         of  operations of the Company and its  subsidiaries,  taken as a whole,
         whether or not arising  from  transactions  in the  ordinary  course of
         business,  except as set  forth in or  contemplated  in the  Prospectus
         (exclusive of any supplement thereto), the effect of which, in any case
         referred  to in clause (i) or (ii) above,  is, in the sole  judgment of
         the  Purchaser,  so material and adverse as to make it  impractical  or
         inadvisable  to proceed with the offering or delivery of the Securities
         as  contemplated  by  the  Registration  Statement  (exclusive  of  any
         amendment  thereof) and the  Prospectus  (exclusive  of any  supplement
         thereto).

                           (h) Subsequent to the Execution Time, there shall not
         have  been any  decrease  in the  rating of any of the  Company's  debt
         securities   by   any   "nationally   recognized   statistical   rating
         organization" (as defined for purposes of Rule 436(g) under the Act) or
         any notice  given of any  intended  or  potential  decrease in any such
         rating  or of a  possible  change  in any  such  rating  that  does not
         indicate the direction of the possible change.

                           (i) The  Securities  shall  have  been  approved  for
         listing on the New York Stock  Exchange,  subject to official notice of
         issuance,  and  satisfactory  evidence of such  action  shall have been
         provided to the Purchaser.

                           (j) At the  Execution  Time,  the Company  shall have
         furnished  to the  Purchaser  a  letter  substantially  in the  form of
         Exhibit A hereto  addressed to the Purchaser from each of the executive
         officers of the Company.

                           (k)  On  the  date  of  this  Agreement   (after  the
         Effective  Time and prior to the mailing of the Notice of  Redemption),
         on each Effective  Date  occurring  after the Execution Time and on the
         Closing Date, the Purchaser shall have received a certificate signed by
         the Chief Accounting  Officer of the Company  substantially in the form
         heretofore   approved  by  the  Purchaser,   respecting  the  Company's
         compliance  with  the  financial  covenants  set  forth  in each of the
         Company's indentures, the Credit Agreement and certain other agreements
         of the Company.

                           (l) The Company shall have furnished to the Purchaser
         such further  information,  certificates and documents as the Purchaser
         may reasonably request.




                                       23


                  If any of the conditions specified in this Section 6 shall not
have been  fulfilled  in all  material  respects  when and as  provided  in this
Agreement,  or if any of the opinions,  letters and certificates mentioned above
or elsewhere in this Agreement shall not be in all material respects  reasonably
satisfactory  in  form  and  substance  to the  Purchaser  and  counsel  for the
Purchaser,  this Agreement and all obligations of the Purchaser hereunder may be
canceled at, or at any time prior to, the Closing Date by the Purchaser.  Notice
of such cancellation shall be given to the Company in writing or by telephone or
facsimile confirmed in writing.

                  The documents required to be delivered by this Section 6 shall
be  delivered  at the office of  Fulbright  & Jaworski  L.L.P.,  counsel for the
Company,  at 666 Fifth Avenue,  New York, New York, on the due date for delivery
thereof.

                  7. Reimbursement of Purchaser's  Expenses.  If the sale of the
Securities  provided for herein is not consummated  because any condition to the
obligations  of the  Purchaser  set forth in  Section 6 hereof is not  satisfied
other than by reason of a breach by the  Purchaser,  because of any  termination
pursuant to Section 10 hereof or because of any refusal, inability or failure on
the part of the  Company  to perform  any  agreement  herein or comply  with any
provision hereof other than by reason of a default by the Purchaser, the Company
will reimburse the Purchaser on demand for all out-of-pocket expenses (including
reasonable fees and  disbursements  of counsel) that shall have been incurred by
it in connection with the proposed purchase and sale of the Securities.

                  8.       Indemnification and Contribution.

                           (a) The Company agrees to indemnify and hold harmless
         the  Purchaser,  the directors,  officers,  employees and agents of the
         Purchaser and each person who controls the Purchaser within the meaning
         of either  the Act or the  Exchange  Act  against  any and all  losses,
         claims, damages or liabilities,  joint or several, to which they or any
         of them may become  subject  under the Act,  the  Exchange Act or other
         Federal  or  state  statutory  law  or  regulation,  at  common  law or
         otherwise,  insofar as such losses,  claims, damages or liabilities (or
         actions in respect  thereof)  arise out of or are based upon any untrue
         statement or alleged  untrue  statement of a material fact contained in
         the  registration  statement for the  registration of the Securities as
         originally  filed or in any amendment  thereof,  or in any  Preliminary
         Prospectus or the Prospectus, or in any amendment thereof or supplement
         thereto,  or arise out of or are based  upon 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,  and agrees
         to reimburse each such indemnified party, as incurred, for 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 Company will not be liable in any
         such case to the extent that any such loss, claim,  damage or liability
         arises out of or is based  upon any such  untrue  statement  or alleged
         untrue  statement  or  omission  or alleged  omission  made  therein in
         reliance upon and in conformity




                                       24


         with  written  information  furnished to the Company by or on behalf of
         the Purchaser  specifically for inclusion therein;  provided,  further,
         that with respect to any untrue  statement or omission of material fact
         made in any Preliminary  Prospectus,  the indemnity agreement contained
         in this Section 8(a) shall not inure to the benefit of the Purchaser to
         the extent that any such loss, claim,  damage or liability occurs under
         the  circumstance  where it shall  have been  determined  by a court of
         competent jurisdiction by final and nonappealable judgment that (w) the
         Company  had  previously  furnished  copies  of the  Prospectus  to the
         Purchaser, (x) delivery of the Prospectus was required by the Act to be
         made to the person asserting the loss, claim, damage or liability,  (y)
         the untrue  statement or omission of a material  fact  contained in the
         Preliminary  Prospectus  was corrected in the  Prospectus and (z) there
         was not  sent or  given to such  person,  at or  prior  to the  written
         confirmation of the sale of such  securities to such person,  a copy of
         the  Prospectus.  This  indemnity  agreement will be in addition to any
         liability which the Company may otherwise have.

                           (b)  The  Purchaser  agrees  to  indemnify  and  hold
         harmless the Company,  each of its directors,  each of its officers who
         signs the  Registration  Statement  and each  person who  controls  the
         Company  within the meaning of either the Act or the  Exchange  Act, to
         the same  extent as the  foregoing  indemnity  from the  Company to the
         Purchaser,  but only to the extent that any such loss, claim, damage or
         liability  arises out of or is based upon any such untrue  statement or
         omission,  or alleged untrue  statement or omission or alleged omission
         made  in the  documents  referred  to in  the  foregoing  indemnity  in
         reliance upon and in conformity  with written  information  relating to
         the Purchaser furnished to the Company by or on behalf of the Purchaser
         specifically  for  inclusion  in  the  documents  referred  to  in  the
         foregoing  indemnity,  and agrees to  reimburse  each such  indemnified
         party, as incurred, for any legal or other expenses reasonably incurred
         by them in connection  with  investigating  or defending any such loss,
         claim, damage, liability or action. This indemnity agreement will be in
         addition to any liability  which the Purchaser may otherwise  have. The
         Company  acknowledges  that (i) the legend in block capital  letters on
         the cover  page  related to  stabilization  and (ii) the third and last
         paragraphs under the heading "Standby  Arrangements" in any Preliminary
         Prospectus and the Prospectus constitute the only information furnished
         in  writing  by or on  behalf of the  Purchaser  for  inclusion  in any
         Preliminary  Prospectus  or the  Prospectus,  and you confirm that such
         statements are correct in all material respects.

                           (c) Promptly  after receipt by an  indemnified  party
         under this Section 8 of notice of the commencement of any action,  such
         indemnified  party  will,  if a claim in respect  thereof is to be made
         against  the  indemnifying  party  under  this  Section  8,  notify the
         indemnifying  party in writing  of the  commencement  thereof;  but the
         failure so to notify  the  indemnifying  party (i) will not  relieve it
         from  liability  under  paragraph  (a) or (b) above  unless  and to the
         extent  it did not  otherwise  learn of such  action  and such  failure
         results in the  forfeiture  by the  indemnifying  party of  substantial
         rights  and  defenses  and (ii) will




                                       25


         not, in any event,  relieve the indemnifying party from any obligations
         to any  indemnified  party  other than the  indemnification  obligation
         provided in paragraph (a) or (b) above. The indemnifying party shall be
         entitled to appoint counsel of the  indemnifying  party's choice at the
         indemnifying  party's expense to represent the indemnified party in any
         action  for  which   indemnification  is  sought  (in  which  case  the
         indemnifying party shall not thereafter be responsible for the fees and
         expenses of any separate counsel  retained by the indemnified  party or
         parties  except  as set  forth  below);  provided,  however,  that such
         counsel  shall be reasonably  satisfactory  to the  indemnified  party.
         Notwithstanding the indemnifying party's election to appoint counsel to
         represent the indemnified  party in an action,  the  indemnified  party
         shall  have the  right to  employ  separate  counsel  (including  local
         counsel),  and the  indemnifying  party shall bear the reasonable fees,
         costs and expenses of such  separate  counsel if (i) the use of counsel
         chosen by the  indemnifying  party to represent the  indemnified  party
         would present such counsel with a conflict of interest, (ii) the actual
         or potential defendants in, or targets of, any such action include both
         the indemnified  party and the  indemnifying  party and the indemnified
         party shall have been  advised by its counsel  that  representation  of
         such indemnified  party and any indemnifying  party by the same counsel
         would be  inappropriate  under  applicable  standards  of  professional
         conduct  (whether or not such  representation  by the same  counsel has
         been proposed) due to actual or potential  differing  interests between
         them,  (iii) the  indemnifying  party shall not have  employed  counsel
         satisfactory  to the  indemnified  party to represent  the  indemnified
         party within a reasonable  time after notice of the institution of such
         action or (iv) the  indemnifying  party shall authorize the indemnified
         party to employ  separate  counsel at the  expense of the  indemnifying
         party. It is understood, however, that the Company shall, in connection
         with any one such  action or  separate  but  substantially  similar  or
         related  actions  in the  same  jurisdiction  arising  out of the  same
         general allegations or circumstances, be liable for the reasonable fees
         and expenses of only one separate firm of local counsel at any time for
         the  Purchaser  and  all  controlling  persons,  which  firm  shall  be
         designated in writing by Smith Barney Inc. An  indemnifying  party will
         not,  without the prior  written  consent of the  indemnified  parties,
         settle or  compromise  or  consent  to the entry of any  judgment  with
         respect to any pending or threatened claim,  action, suit or proceeding
         in  respect  of which  indemnification  or  contribution  may be sought
         hereunder  (whether  or not  the  indemnified  parties  are  actual  or
         potential  parties  to




                                       26


         such claim or action)  unless such  settlement,  compromise  or consent
         includes an unconditional  release of each  indemnified  party from all
         liability  arising out of such claim,  action,  suit or proceeding  and
         does  not  include  a  statement  as  to  or  an  admission  of  fault,
         culpability  or a failure  to act by or on  behalf  of any  indemnified
         party. An  indemnifying  party shall not be liable under this Section 8
         to any  indemnified  party  regarding  any  settlement or compromise or
         consent to the entry of any  judgment  with  respect to any  pending or
         threatened  claim,  action,  suit or  proceeding  in  respect  of which
         indemnification or contribution may be sought hereunder (whether or not
         the indemnified  parties are actual or potential  parties to such claim
         or action) unless such  settlement,  compromise or consent is consented
         to by such indemnifying  party, which consent shall not be unreasonably
         withheld.

                           (d) In the  event  that  the  indemnity  provided  in
         paragraph  (a)  or  (b)  of  this  Section  8  is   unavailable  to  or
         insufficient to hold harmless an indemnified party for any reason,  the
         Company and the Purchaser agree to contribute to the aggregate  losses,
         claims,  damages and  liabilities  (including  legal or other  expenses
         reasonably incurred in connection with investigating or defending same)
         (collectively  "Losses") to which the Company and the  Purchaser may be
         subject in such  proportion as is  appropriate  to reflect the relative
         benefits  received by the Company on the one hand and by the  Purchaser
         on the other from the offering of the  Securities;  provided,  however,
         that in no case shall the  Purchaser be  responsible  for any amount in
         excess of the fees payable by the Company to the Purchaser  pursuant to
         Section  3  hereof.  If the  allocation  provided  by  the  immediately
         preceding  sentence is unavailable for any reason,  the Company and the
         Purchaser  shall  contribute in such  proportion as is  appropriate  to
         reflect not only such relative  benefits but also the relative fault of
         the  Company  on the one  hand  and of the  Purchaser  on the  other in
         connection  with the  statements  or omissions  which  resulted in such
         Losses as well as any other relevant equitable considerations. Benefits
         received by the  Company  shall be deemed to be equal to the sum of (i)
         the  aggregate  Redemption  Price for the  Debentures  converted by the
         Purchaser  pursuant to Section  2(a) hereof and (ii) the amount paid by
         the Purchaser to the Company  pursuant to Section 2(b) hereof (less the
         total fees payable by the Company to the Purchaser  pursuant to Section
         3 hereof), and benefits received by the Purchaser shall be deemed to be
         equal  to the  total  fees  payable  by the  Company  to the  Purchaser
         pursuant to Section 3 hereof.  Relative  fault shall be  determined  by
         reference  to,  among other  things,  whether any untrue or any alleged
         untrue statement of a material fact or the omission or alleged omission
         to state a material fact relates to information provided by the Company
         on the one  hand or the  Purchaser  on the  other,  the  intent  of the
         parties  and  their  relative  knowledge,  access  to  information  and
         opportunity  to correct or prevent  such untrue  statement or omission.
         The  Company  and the  Purchaser  agree  that it would  not be just and
         equitable if contribution were determined by pro rata allocation or any
         other method of allocation which does not take account of the equitable
         considerations  referred to above.  Promptly  after  receipt by a party
         entitled  to  contribution  under  this  Section  8 of  notice  of  the
         commencement   of  any  action,   such  party  will,  if  a  claim  for
         contribution  in respect thereof is to be made against another party or
         parties  under  this  paragraph  (d),  notify  such party or parties in
         writing of the commencement  thereof; but the failure so to notify such
         party or  parties  (i) will not  relieve  such  party or  parties  from
         liability  under this paragraph (d) unless and to the extent it or they
         did not otherwise  learn of such action and such failure results in the
         forfeiture by such party or parties of substantial  rights and defenses
         and (ii) will not, in any event, relieve such party or parties from any
         obligations  to any  party  entitled  to  contribution  other  than the
         contribution obligation provided in this paragraph (d). Notwithstanding
         the




                                       27


         provisions  of this  paragraph  (d),  no person  guilty  of  fraudulent
         misrepresentation  (within  the  meaning of  Section  11(f) of the Act)
         shall be entitled to contribution from any person who was not guilty of
         such fraudulent misrepresentation. For purposes of this Section 8, each
         person who controls the Purchaser  within the meaning of either the Act
         or the Exchange Act and each director,  officer,  employee and agent of
         the  Purchaser  shall  have  the same  rights  to  contribution  as the
         Purchaser,  and each person who controls the Company within the meaning
         of either the Act or the Exchange  Act, each officer of the Company who
         shall have signed the  Registration  Statement and each director of the
         Company  shall have the same  rights to  contribution  as the  Company,
         subject in each case to the  applicable  terms and  conditions  of this
         paragraph (d).

                  9.  Soliciting  Conversions.  The  Purchaser  may  assist  the
Company in soliciting  conversion of the  Debentures by the holders  thereof but
shall not be entitled to compensation by the Company for any such assistance.

                  10.   Termination.   This   Agreement   shall  be  subject  to
termination in the absolute discretion of the Purchaser,  by notice given to the
Company at any time prior to the Closing Date, if at any time prior to such time
(i) trading in the  Company's  Common  Stock or the  Debentures  shall have been
suspended  by the  Commission  or the New York  Stock  Exchange  or  trading  in
securities generally on the New York Stock Exchange shall have been suspended or
limited or minimum prices shall have been  established on such Exchange,  (ii) a
banking  moratorium shall have been declared either by Federal or New York State
authorities  or (iii) there shall have  occurred any outbreak or  escalation  of
hostilities,  declaration by the United States of a national emergency or war or
other calamity or crisis the effect of which on financial  markets is such as to
make it, in the sole judgment of the Purchaser,  impracticable or inadvisable to
proceed with the offering or delivery of the Securities as  contemplated  by the
Prospectus (exclusive of any supplement thereto).

                  11. Representations and Indemnities to Survive. The respective
agreements, representations, warranties, indemnities and other statements of the
Company or its officers and of the  Purchaser  set forth in or made  pursuant to
this  Agreement  will  remain  in  full  force  and  effect,  regardless  of any
investigation made by or on behalf of the Purchaser or the Company or any of the
officers,  directors or controlling persons referred to in Section 8 hereof, and
will survive the  conversion of any  Debentures  and the delivery of and payment
for any Securities.  The provisions of Sections 7 and 8 hereof shall survive the
termination or cancellation of this Agreement.

                  12. Notices.  All communications  hereunder will be in writing
and effective only on receipt,  and, if sent to the  Purchaser,  will be mailed,
delivered or telefaxed to the Smith Barney Inc.  General Counsel (fax no.: (212)
816-7912)  and  confirmed to the General  Counsel,  Smith  Barney  Inc.,  at 388
Greenwich  Street,  32nd Floor,  New York,  New York  10013,  or, if sent to the
Company,  will be mailed,  delivered or telefaxed to Integrated Health Services,
Inc.,  10065 Red Run  Boulevard,  Owings Mills,  Maryland  21117 (fax no.: (410)
998-8700), attention of the General Counsel.



                                       28


                  13.  Successors.  This  Agreement will inure to the benefit of
and be binding upon the parties hereto and their  respective  successors and the
officers and directors and controlling  persons referred to in Section 8 hereof,
and no other person will have any right or obligation hereunder.

                  14.  Applicable  Law. This  Agreement  will be governed by and
construed in accordance with the laws of the State of New York.

                  15. Counterparts.  This Agreement may be signed in one or more
counterparts,  each of  which  shall  constitute  an  original  and all of which
together shall constitute one and the same agreement.

                  16.  Headings.  The  section  headings  used  herein  are  for
convenience only and shall not affect the construction hereof.

                  17.  Definitions.  The terms which  follow,  when used in this
Agreement, shall have the meanings indicated.

                  "Act" shall mean the Securities  Act of 1933, as amended,  and
         the rules and regulations of the Commission promulgated thereunder.

                  "Business  Day" shall mean any day other  than a  Saturday,  a
         Sunday or a legal  holiday or a day on which  banking  institutions  or
         trust companies are authorized or obligated by law to close in New York
         City.

                  "Commission"   shall   mean  the   Securities   and   Exchange
         Commission.

                  "Effective  Date"  shall  mean  each  date and  time  that the
         Registration  Statement and any post-effective  amendment or amendments
         thereto  became or become  effective  under the Act and each date after
         the date hereof on which a document  incorporated  by  reference in the
         Registration Statement is filed under the Exchange Act.

                  "Effective   Time"  shall  mean  the  time  the   Registration
         Statement is initially declared effective by the Commission.

                  "Exchange Act" shall mean the Securities Exchange Act of 1934,
         as amended, and the rules and regulations of the Commission promulgated
         thereunder.

                  "Execution  Time"  shall  mean the date  and  time  that  this
         Agreement is executed and delivered by the parties hereto.

                  "Preliminary Prospectus" shall mean any preliminary prospectus
         referred to in paragraph 1(a) above.




                                       29


                  "Prospectus"  shall  mean  the  prospectus   relating  to  the
         Securities  that is first  filed  pursuant  to Rule  424(b)  after  the
         Execution  Time or, if no filing  pursuant to Rule 424(b) is  required,
         shall  mean the form of final  prospectus  relating  to the  Securities
         included in the Registration Statement at the Effective Date.

                  "Registration Statement" shall mean the registration statement
         referred to in paragraph 1(a) above,  including  exhibits and financial
         statements,  as amended at the Execution  Time (or, if not effective at
         the  Execution  Time,  in the form in which it shall become  effective)
         and,  in  the  event  any  post-effective   amendment  thereto  becomes
         effective prior to the Closing Date, shall also mean such  registration
         statement as so amended.

                  "Rule 415" and "Rule 424" refer to such rules under the Act.











                                       30



                  If the foregoing is in accordance with your  understanding  of
our  agreement,  please  sign and return to us the  enclosed  duplicate  hereof,
whereupon this letter and your acceptance  shall  represent a binding  agreement
between the Company and the Purchaser.

                                                Very truly yours,

                                                Integrated Health Services, Inc.

                                                By:
                                                  ------------------------------
                                                Name:
                                                Title:

The  foregoing  Agreement is hereby
confirmed and accepted as of the
date first above written.

Smith Barney Inc.

By:
  ------------------------------
  Name:
  Title:



                                       31




                                                                       EXHIBIT A

                        Integrated Health Services, Inc.
                      Standby Underwriting of Common Stock


                                            , 1998

Smith Barney Inc.
388 Greenwich Street
New York, New York 10013

Ladies and Gentlemen:

                  This letter is being  delivered to you in connection  with the
proposed Standby Agreement (the "Standby  Agreement")  between Integrated Health
Services,   Inc.,  a  Delaware   corporation  (the  "Company"),   and  you  (the
"Purchaser"),  relating  to a call for  redemption  by the Company of all of its
outstanding 6% Convertible Subordinated Debentures due 2003. Such Debentures are
convertible  into shares of the Common  Stock,  $.001 par value,  of the Company
("Common  Stock"),  at any time prior to 5:00 P.M.,  New York City time,  on the
Redemption Date (as defined in the Standby Agreement).

                  In order to induce the  Purchaser  to enter  into the  Standby
Agreement, the undersigned hereby agrees that, without the prior written consent
of Smith Barney Inc. (which will not be unreasonably withheld),  the undersigned
will not,  prior to or on the Redemption  Date (and, if the aggregate  number of
the Securities (as defined in the Standby Agreement) exceeds 450,000 shares, for
an additional  period of 90 days following the Redemption  Date),  offer,  sell,
contract to sell, pledge or otherwise dispose of, or file (or participate in the
filing of) a registration  statement with the Securities and Exchange Commission
which the Company has agreed not to file  pursuant to the Standby  Agreement  in
respect of, or establish or increase a put  equivalent  position or liquidate or
decrease a call  equivalent  position  within  the  meaning of Section 16 of the
Securities  Exchange Act of 1934, as amended,  and the rules and  regulations of
the Securities and Exchange Commission  promulgated  thereunder with respect to,
any shares of capital stock of the Company or any securities convertible into or
exercisable  or  exchangeable  for such capital stock,  or publicly  announce an
intention  to effect any such  transaction,  other than  shares of Common  Stock
disposed of as bona fide gifts  approved by Smith  Barney Inc.,  which  approval
will not be unreasonably withheld.




                                      A-1


                  If for any reason the Standby  Agreement  shall be  terminated
prior to the Closing Date (as defined in the Standby  Agreement),  the agreement
set forth above shall likewise be terminated.

                                                     Yours very truly,

                                                     ---------------------------
                                                     [Name]