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                                                                     Exhibit 10








                                  AMENDMENT TO
                              MANAGEMENT AGREEMENT

         THIS AMENDMENT TO MANAGEMENT AGREEMENT (this "Amendment") is dated as
of the 1st day of January, 1999, by and between CareMatrix of Massachusetts,
Inc., a Delaware corporation, with its principal place of business at 197 First
Avenue, Needham, Massachusetts 02494 (the "Manager"), and Cambridge House
Associates General Partnership, a New York general partnership, or its designee
or assignee, with its principal place of business at c/o Chancellor of Ossining,
Inc., 197 First Avenue, Needham, Massachusetts 02494 (the "Owner"), and amends
that certain Management Agreement dated as of August 14, 1996 between the
Manager and the Owner, as the same may have been previously amended to date.

         WHEREAS, the Owner is the operator of a 122 unit senior housing
facility located in Ossining, New York (the "Facility");

         WHEREAS, the Owner determined that the hiring of a management company
to provide day-to-day management of the Facility is necessary for the efficient
operation of the Facility;

         WHEREAS, the Owner and the Manager are parties to a certain Management
Agreement dated as of August 14, 1996 with respect the management of the
Facility (as previously amended to date, the "Original Agreement");

         WHEREAS, the Owner and the Manager desire to amend the Original
Agreement, as more particularly set forth herein;

         NOW, THEREFORE, in consideration of the mutual covenants set forth
herein, and for other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged, the parties hereto agree as
follows:

         1. Section 2.1 of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

                  "2.1 EMPLOYEES. The Manager shall recruit, evaluate, select,
         and hire a qualified and properly licensed Executive Director who shall
         be responsible for the functional operation of the Facility and
         supervision of personnel at the Facility on a day-to-day basis, as well
         as all resident assistance, custodial, food service, cleaning,
         maintenance, secretarial and bookkeeping personnel for the day-to-day
         operations of the Facility. Prior to the Conversion Date (hereinafter
         defined) all personnel, including, without limitation, the Executive
         Director, shall be employees of the Owner, and the Owner shall retain
         full responsibility for payment of wages, salaries and other
         compensation and benefits for the Executive Director and such other
         personnel. Effective as of the Conversion Date, all such personnel,
         including, without limitation, the Executive Director, shall be
         employees of the Manager, and the Manager shall have full
         responsibility for payment of wages, salaries and other compensation
         and benefits of the Executive Director and such other personnel. The
         Manager shall, subject to approval by the Owner, establish necessary
         and desirable personnel policies and procedures, wage structures and
         staff schedules. The Manager, subject to approval by Owner, shall have
         authority to hire, discipline, promote and discharge employees of the
         Owner


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         who participate in the day-to-day operation and administration of the
         Facility. Both the Manager and the Owner must approve the hiring and/or
         firing of the Executive Director, Assistant Administrator and the
         Director of Resident Services, which approval shall not be unreasonably
         withheld or delayed. The Manager shall: (a) maintain or cause to be
         maintained payroll records and prepare weekly and monthly payrolls,
         withholding taxes and Social Security taxes; (b) prepare and submit all
         required state and federal tax or benefit returns required with respect
         to employees, including, without limitation, the returns required by
         FICA, FUTA and all applicable unemployment compensation laws; (c)
         maintain in force all required levels of workers' compensation
         insurance; and (d) prepare and submit to the Owner any certificates of
         payroll expenses as may be reasonably requested. Prior to the
         Conversion Date, the Manager shall not be liable to any employee of the
         Facility for wages, salaries and other compensation and benefits, or to
         the Owner, unless the Manager was specifically required to obtain the
         approval of the Owner before committing to a salary or benefit and such
         approval was not obtained. The Manager shall not be liable to the Owner
         or others for any action or omission on the part of any employee of the
         Owner of the Facility, unless the employee was acting under the express
         direction of the Manager or unless such employee was following an
         express policy or procedure of the Manager and such direction, policy
         or procedure is subsequently determined to be the result of gross
         negligence. The Manager shall provide the Owner with quarterly reports
         of all hiring, disciplinary actions, promotions and firings at the
         Facility for the month."

         2. Subsection 2.5(c) of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

                  "(c) such other and further reports or calculations as may be
         required under any financing terms in accordance with the deadlines set
         forth in any financing agreements executed in connection with any
         Facility Financing (hereinafter defined) (any such financing agreement
         or agreements are collectively referred to herein as a "Financing
         Agreement")."

         3 Section 3 of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

                  "3. MANAGEMENT FEE. (a) As compensation for the services to be
         rendered by the Manager during the Term (as hereinafter defined), the
         Manager shall pay itself, at its principal office as set forth above
         (or at such other place as the Manager may from time to time designate
         in writing), and at the times hereinafter specified, a monthly base
         management fee (the "Base Management Fee") (i) for the period
         commencing on the beginning of the Term and continuing until the date
         (the "Conversion Date") which is the earlier of (x) the second
         anniversary of the date on which the Facility received its certificate
         of occupancy permitting operation of the Facility for its intended
         purpose, or (y) such date as is designated by the Manager in its sole
         discretion, equal to the greater of (I) Ten Thousand Dollars ($10,000)
         Dollars per month, or (II) five percent (5%) of Net Revenues
 
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         (as hereinafter defined), and (i) for the period commencing on the
         Conversion Date and continuing through the remainder of the Term, equal
         to the sum of (x) all Facility Expenses (hereinafter defined), and (y)
         the greater of (I) Ten Thousand Dollars ($10,000) per month, or (II)
         five percent (5%) of Net Revenues. In addition to the Base Management
         Fee, as additional compensation for the services to be rendered by the
         Manager during the Term, the Manager shall pay itself, at its principal
         office as set forth above (or at such other place as the Manager may
         from time to time designate in writing), and at the times hereinafter
         specified, a monthly incentive management fee (the "Incentive
         Management Fee") equal to eighty five percent (85%) of Net Cash Flow
         (as hereinafter defined). The Base Management Fee and the Incentive
         Management Fee are collectively referred to herein as the "Management
         Fee".

              (b) All Management Fees will be paid in arrears and shall be due
         and payable on or before the 15th day of each month following the month
         in which services were rendered. The Manager hereby acknowledges and
         agrees that any and all Management Fees due hereunder shall be
         subordinate to any Facility Financing, as well as to any preferred
         returns to equity investors of the Owner. The Owner hereby represents
         and warrants that as of the date hereof, there exists no Facility
         Financing except that certain $16,664,000 mortgage loan by Finova
         Capital Corporation, and that there are no preferred returns payable to
         equity investors of the Owner. The Owner hereby covenants and agrees
         with the Manager that at no time during the Term of this Agreement
         shall (i) the total Facility Financing exceed the sum of (x) all costs
         incurred by the Owner in connection with the acquisition, development,
         construction and fill-up of the Facility, plus (y) all costs incurred
         by the Owner in connection with any capital improvements to the
         Facility, and (ii) the preferred returns payable to equity investors of
         the Owner be increased beyond those set forth herein.

                  (c) "Net Revenues" as used herein shall mean Gross Revenues
         (defined below) less contractual adjustments for uncollectible
         accounts.

                  "Gross Revenues" as used herein shall mean and include all
         revenues received or receivable from or by reason of the operation of
         the Facility, including, without limitation, all revenue of the
         Facility for or on account of any and all goods provided and services
         rendered or activities during the period from the date of this
         Agreement and thereafter, the gross dollar amount of all such billings
         by the Facility to or on behalf of residents directly or indirectly
         connected with the Facility or the provision of all such goods and
         services.

                  "Facility Expenses" as used herein shall mean and include all
         personnel and other expenses incurred in connection with the operation
         of the Facility, including, without limitation, all expenses described
         in Section 4 below, but specifically excluding any Management Fees and
         all Facility Financing.

                  "Net Cash Flow" as used herein shall mean the excess of (i)
         all Net Revenue, over (ii) the sum of (x) all Facility Expenses, (y)
         all Base Management Fees, and (z) all Facility Financing."

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         4. Section 4 of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

            "4. EXPENSES.

                  4.1 MANAGER EXPENSES. The Manager shall bear the following
         expenses incurred by it in the management of the business and propertie
         s of the Facility:

                           (a) Salary and expenses (including, without
         limitation, payroll taxes, costs of employee benefit plans, travel,
         insurance, and fidelity bonds) of all personnel employed by the Manager
         to carry out all responsibilities detailed above.

                           (b) Salary and expenses (including, without
         limitation, payroll taxes, cost of employee benefit plans, travel,
         insurance and fidelity bonds) of all of the Manager's home office
         personnel and overhead.

                           (c) From and after the Conversion Date, all expenses
         described in Section 4.2 below, but specifically excluding any
         Management Fees and all Facility Financing.

                      4.2 OWNER EXPENSES. Except as otherwise expressly provided
         in this Agreement, the Owner shall bear all of the expenses of
         operating and financing the Facility and rendering resident services
         not expressly assumed by the Manager, including without limitation, the
         following:

                           (a) Fees and expenses of independent professional
         persons expressly retained by the Owner, or retained by the Manager for
         the account of the Owner with the prior permission of the Owner, for
         any purpose; salary, other compensation or benefits and expenses of all
         staff employed at the Facility by the Owner, including, without
         limitation, all administrative, medical, resident assistance and other
         health care personnel and the Executive Director; custodial, food
         service, cleaning, maintenance, operational, secretarial and
         bookkeeping personnel employed to administer the day-to-day operations
         of the Facility and to perform health care and related services in the
         day-to-day operations of the Facility's business.

                           (b) Principal, interest and discounts on indebtedness
         incurred or assumed by the Owner with respect to the acquisition,
         development, construction, and fill-up of Facility ("Facility
         Financing").

                           (c) Taxes, imposts, levies or other charges on the
         existence, operation, receipts, income or property of the Owner,
         provided, however, that all interest and penalties incurred as a result
         of the Manager's failure to timely file all returns which the Manager
         is required to file pursuant to this Agreement, or to make timely
         payment of all taxes, levies, imposts, or other charges, to the extent


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         that sufficient funds were available to the Manager as of the date such
         payments were due, shall be the responsibility of the Manager.

                           (d) Medical supplies and equipment, food, fuel,
         kitchen and food service equipment, linens, beds, furniture, clothing
         and all other supplies and equipment used in supplying services to
         residents.

                           (e) Expenses connected directly or indirectly with 
         the design, acquisition, disposition or ownership of real and personal 
         property devoted, used, or consumed in the business of the Facility, 
         including, without limitation, purchase and/or construction of the land
         and buildings used for such purpose, maintenance, repair and 
         improvement of property, all real estate and personal propertytaxes 
         assessed, premiums for property and liability insurance on property 
         owned by the Owner, brokerage commissions, and fees and expenses of 
         consultants, managers, or agents retained directly by the Owner.

                           (f) The Management Fee.

                           (g) Legal fees and related expenses pertaining to the
         Facility, and any other litigation or proceedings to which the Owner is
         a party. However, such fees shall not include those fees resulting from
         or arising out of the gross negligence by the Manager and the Owner
         shall provide such necessary funds to the Manager within 10 days after
         receipt of such notice.

         In the event that there are insufficient funds available to the Manager
         to pay expenses which the Manager is authorized to incur and pay
         hereunder, including, without limitation, any taxes to be paid on
         behalf of the Owner by the Manager, the Manager shall promptly notify
         the Owner of the amount necessary to cure and the reason for such
         deficit and the Owner shall provide such necessary funds to the Manager
         within 10 days after receipt of such notice."

         5. Section 7.1 of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

                      "7.1 TERM. (a) This Agreement shall continue for a term
         (as the same may be extended, the "Term") commencing on the date which
         is 12 months prior to the anticipated date (as mutually agreed to by
         the Owner and the Manager) for the opening of the Facility and
         continuing for a period of 15 years after the date on which the
         Facility receives its certificate of occupancy permitting the operation
         of the Facility for its intended use. The Owner and Manager agree to
         execute a certificate setting forth the date on which the Term
         commences promptly after such opening.

                           (b) On the conditions that (i) the Manager is not in
         default of its obligations hereunder beyond any applicable notice, cure
         or grace period at the time of exercise, and (ii) the Facility has had
         positive cash flow for each of the three years prior to the
         commencement of the Extension Exercise Period (hereinafter defined),
         the Manager shall have the option (each, an "Extension 



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         Option") to extend the Term for three additional periods of five years
         each on the same terms and conditions as set forth in this Agreement.
         Each Extension Option shall be exercised in writing by the Manager to
         the Owner during the six month period (the "Extension Exercise Period")
         commencing on the first day of the then last year of the Term."

         6. Sections 13 and 14 of the Original Agreement are hereby deleted in
their entirety, and replaced with the following:

                  "13. ASSIGNMENT; SUCCESSORS. Neither the Owner nor the Manager
         will assign its interests in this Agreement, without the prior written
         consent of the other; provided that (a) the Manager may assign (i) its
         interests hereunder to an affiliate, and (ii) its Management Fees to a
         lender as security for any financing arrangement of Manager, and (b)
         the Owner may assign its interests hereunder to a lender as security
         with respect to any Financing Agreement. Subject to the foreoging, this
         Agreement shall be binding upon and inure to the benefit of the parties
         and to their respective successors and assigns.

                  14. OWNER'S PURCHASE RIGHTS. In the event the Owner is not the
         fee title holder to the Facility, or the land on which the Facility is
         located, the Manager shall have the right to assume from the Owner any
         option to purchase, right of first offer or right of first refusal
         which the Owner may hold with respect to the Facility or the land on
         which the Facility is located."

         7. Section 16 of the Original Agreement is hereby deleted in its
entirety, and replaced with the following:

                  "16. NOTICES. Any notice, demand, consent, or other written
         instrument to be given or received under this Agreement ("Notice")
         required or permitted to be given shall be in writing signed by the
         party giving such Notice and/or consent and shall be hand delivered,
         sent by nationally recognized overnight carrier or sent, postage
         prepaid, by Certified or Registered Mail, Return Receipt Requested, to
         the other party at the addresses listed below:

         As to Manager:      CareMatrix of Massachusetts, Inc.
                             197 First Avenue
                             Needham, Massachusetts 02494
                             Attention: Chief Executive Officer

              cc:            CareMatrix of Massachusetts, Inc.
                             197 First Avenue
                             Needham, Massachusetts 02494
                             Attention: General Counsel

         As to Owner:        Cambridge House Associates General Partnership
                             197 First Avenue
                             Needham, Massachusetts 02494
                             Attention: President

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         Any party shall have the right to change the place to which such notice
         shall be sent or delivered by similar notice sent in like manner to all
         other parties hereto. All notices sent by certified mail or are hand
         delivered shall be deemed received upon delivery or when delivery is
         refused to the office or address of the addressee."

         8. Except as modified by this Amendment, the terms and conditions set
forth in the Original Agreement shall remain unchanged and in full force and
effect.



                         [signatures on following page]
                [remainder of this page intentionally left blank]


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         IN WITNESS WHEREOF, the parties have executed this Amendment, or caused
it to be executed by their respective duly authorized representatives, as an
instrument under seal as of the date first set forth above.



WITNESS:                                 CAREMATRIX OF MASSACHUSETTS, INC.


By:  /s/ Elizabeth Derrico               By: /s/ David B. Currie
     -----------------------                 -----------------------------
       Name: Elizabeth Derrico               Name:  David B. Currie
                                             Title: Vice President

                                         CAMBRIDGE HOUSE ASSOCIATES
                                         GENERAL PARTNERSHIP

WITNESS:                                 By: CHANCELLOR OF OSSINING, INC.,
                                             general partner



By:  /s/ Elizabeth Derrico                By: /s/ David B. Currie
     -----------------------                 -----------------------------
       Name: Elizabeth Derrico                Name:  David B. Currie
                                              Title: Vice President