Document:

OFFICE LEASE
                   Maintree Commons, Vineland, New Jersey

     This Lease is made on May 10, 1999, by MAINTREE OFFICE CENTER, L.L.C., a
New Jersey limited liability company, ("Landlord"), whose address is c/o
David Lerman, 1138 E. Chestnut Avenue, Building 2, Suite B, Vineland, New
Jersey  08360 and DCA OF VINELAND, L.L.C. a New Jersey limited liability
company ("Tenant"), whose address is 1450 E. Chestnut Avenue, Building Two,
Suite     , Vineland, NJ 08361.
      ----

     1.1  Premises.  The leased premises (the "Premises") consist of
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approximately 6,000 +/- square feet of space (Building Two , Suite     ) in
                                                                   ----
Maintree Commons (the "Complex"), located at 1450 E. Chestnut Avenue, Vineland,
NJ.  See Exhibit A attached. The Premises are measured from the exterior
surface of outside walls, and from the midline of interior walls separating
the Premises from adjoining space.  The space size (and corresponding rent)
shall be determined and adjusted in connection with final plan approval
pursuant to Exhibit B attached.

     2.1  Term.  The initial term of this Lease is five (5) year(s). Tenant's
          ----
renewal options are as described in Paragraph 18.16 below.

     2.2  Commencement Date.  The lease term (and Tenant's obligation to pay
          -----------------
rent) will begin on that date which  is the earlier of: (i) one hundred twenty
(120) days after Landlord delivers the Premises to Tenant with Landlord's Work
described in Exhibit B substantially complete ( the "Delivery Date"); or (ii)
the date on which Tenant opens for business from the Premises.  If, however,
Landlord is delayed in the delivery of the Premises because of Tenant's acts
or failure to act, the lease term and Tenant's obligation to pay rent shall
begin two hundred ten (210) days after this Lease is signed.  Regardless of
the aforementioned, lease payment will not begin sooner than two hundred ten
(210) days from Lease signing or, when Tenant opens for business, whichever
comes first.

     2.3  Delivery Date. The Delivery Date is estimated to occur within one
          -------------
hundred twenty (120) days after the later to occur of: (i) the date on which
this lease is fully signed; or (ii) the date on which the City of Vineland
has issued a building permit (the "Estimated Delivery Date"). Landlord has
the right to extend the Delivery Date for a period of up to ninety (90) days
beyond the Estimated Delivery Date (the "Extended Delivery Date"). If
Landlord does not deliver the Premises to Tenant by the Extended Delivery
Date, Tenant has the right to notify Landlord in writing that this lease
shall be terminated if the Premises are not delivered to Tenant within
thirty (30) days after Tenant's notice. If such a termination occurs,
Landlord shall return any deposits or advance rental payments to Tenant, and
the parties shall be relieved of any further obligations to one another under
this Lease. Tenant's sole remedy and right in the case of Landlord's failure
to deliver the Premises is for Tenant to terminate the Lease.

     Tenant shall not have the right to terminate this Lease if Landlord's
inability to deliver the Premises on time is due to delays attributable to
Tenant (for example, delays by Tenant in getting necessary permits or
approvals, or in submitting and getting Landlord's approval of Tenant's plans).

     3.1  Minimum Annual Rent.  Tenant will pay, as minimum annual rent
          -------------------
("Minimum Rent"), the sum of Sixty Nine Thousand Six Hundred and no/100
Dollars ($69,600), payable in monthly installments of Five Thousand Eight
Hundred and no/100 Dollars ($5,800) each. These amounts are subject to
adjustment once the actual square footage of the Premises is determined in
connection with final plan approval.  The Minimum Rent during the initial
lease term is based upon $11.60 per square foot.

     3.2  Initial Payments.  The first month's rent is to be paid when this
          ----------------
Lease is signed. All rent payments must be actually received by Landlord (or
Landlord's property manager, if applicable) on or before the first day of
each month. A late charge of up to five percent (5%) of the delinquent
payment may be assessed, at Landlord's option, if any, payment is not made
prior to  the fifth (5th) day after that payment is first due.  This late
charge is not a finance charge, but is intended to offset the additional
administrative burdens and costs incurred by Landlord in dealing with late
payments.

     3.3   Minimum Rental Adjustment  The Minimum Rent payment assumes that
           -------------------------
real estate taxes (and/or "payments in lieu of real estate taxes" or other
similar changes), insurance, and operating expenses (all of the preceding
items being referred to collectively as the "Operating Expenses") applicable
to the Complex do not exceed the base operating amounts (the "Base Operating
Amounts") next described:

                         RE Taxes (and/or other             Insurance & Other
Calendar Year               similar charges)                Operating Expenses
-------------            ----------------------             ------------------
    1999                       $0.20 PSF                         $1.30 PSF
    2000                       $0.40 PSF                         $1.30 PSF
    2001                       $0.60 PSF                         $1.30 PSF
    2002                       $0.80 PSF                         $1.30 PSF
    2003                       $1.00 PSF                         $1.30 PSF

<PAGE>  1

In any year when they do, Landlord may charge Tenant, as additional rent,
Tenant's prorata share of the additional Operating Expenses. Tenant's payment
of the additional amount shall be due within thirty (30) days after Landlord
bills Tenant. For any year in which Landlord anticipates that Operating
Expenses will exceed the Base Operating Amounts, Landlord may increase the
monthly Minimum Rent payment to cover the anticipated additional expenses,
and that increased amount will be paid monthly by Tenant. Within ninety (90)
days after the end of each such year, Landlord will provide Tenant a
reconciliation statement for that year detailing Operating Expenses in excess
of the Base Operating Amounts. Within thirty (30) days after that reconcili-
ation statement is issued, Tenant will pay Landlord any additional sums due
from Tenant, or Landlord will credit Tenant any unused amounts.

     3.4  Security Deposit. Tenant has paid Landlord a non-interest bearing
          ----------------
security deposit of   N/A   Dollars ($  N/A  ), to secure Tenant's performance
of all its obligations under this Lease.  Landlord may apply these funds to
the extent required for the payment of rent or other sums due from Tenant, or
for the payment of any amount which Landlord may be required to expend or for
any cost or loss which Landlord might incur because of Tenant's default. If
Tenant complies with all of the terms of this Lease, the security deposit not
applied pursuant to this paragraph shall be returned to Tenant within thirty
(30) days after the termination of this Lease.  If any portion of the deposit
is so used or applied, Tenant shall, within ten (10) days after demand,
deposit cash with Landlord in an amount sufficient to restore the security
deposit to its original amount.  If Landlord transfers its interest in the
Premises during the term of this lease, and if Landlord delivers to the new
owner the security deposit, Tenant shall look only to the new owner for the
return of its security deposit. The security deposit may not be used to pay
the last months' rent.

     4.1  Initial Improvements; Landlord's Work; Tenant's Work.  Landlord is
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delivering the Premises in the condition described in Exhibit B attached.  No
other representations have been made to Tenant regarding the condition of
the Premises, and no promises to alter, repair, improve or decorate the
Premises have been made to Tenant unless they are specifically described in
this Lease.  If a list of Landlord's Work and Tenant's Work is included on
Exhibit B, each of the parties shall perform and pay for the work designated
as its work.

     5.1  Possession and Use.  The Premises shall be delivered to Tenant free
          ------------------
and clear of all prior tenancies.  The Premises shall be used and occupied by
Tenant solely for the following type of Use [described]:
     Medical outpatient clinic, dialysis facility and related storage and
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support offices.
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Tenant is responsible to confirm with the applicable governmental authorities
that such Use is permitted at the Premises.  Tenant understands that certain
uses which otherwise might fall under the general category of "office use"
might not be uses which Landlord would want to include at the Complex. Tenant
also understands that Landlord is willing to permit the Use of the Premises by
this Tenant and for the limited and specific Use described above only.
Accordingly, Tenant shall not use, or permit the Premises to be used, for any
other purpose or purposes or under any other trade name whatsoever without the
prior written consent of Landlord, which may be granted or withheld by
Landlord in Landlord's sole, absolute discretion.  Tenant will not use (or
permit the use of) the Premises for any purpose which would increase the cost
of insurance of the Premises, Building or Complex, or which would result in a
cancellation of or any exclusion to coverage under such insurance. Tenant also
will not use (or permit the use of) the Premises for any illegal purpose, and
will not cause or permit any nuisance or waste.  Landlord has the right, from
time to time, to make reasonable rules and regulations regarding the Complex
and the Premises, and Tenant agrees to comply with those rules and regulations,
provided such does not materially interfere with the permitted Use.  Addition-
ally, Tenant shall comply with the requirements of any governmental authority
which shall impose any duty regarding the Premises and/or its condition, use
or occupancy.

     5.2  Quiet Enjoyment.  Tenant, upon paying the rent and performing the
          ---------------
covenants in the Lease, shall and may peaceably and quietly have and enjoy
the Premises and the Common Areas in accordance with the terms and conditions
of this Lease.

     5.3  Janitorial; Trash.
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     A.  Tenant is responsible to arrange and pay for cleaning and janitorial
     work at the Premises.
     B.  Tenant also shall be responsible to arrange and pay for the disposal
     of all of its trash and waste. All medical or other regulated waste shall
     be maintained and disposed of in accordance with all applicable laws.
     Paper and other trash and waste shall be placed in a dumpster to be
     maintained by Tenant in a specially designated area to be agreed upon by
     Tenant and Landlord as part of the final plan approval process described
     in Exhibit B. In this connection:
         (1) Tenant has indicated to Landlord that it would like to maintain
         an eight (8) cubic yard dumpster in the vicinity of the "garage
         option" portion of the Premises. Tenant understands that Tenant's
         building plans will need to reflect a concrete curb and pad and
         trash enclosure to be built and maintained by Tenant at Tenant's
         expense. The location, size, design, materials, and other aspects
         of the trash pad and enclosure, as well as the dumpster, are subject
         to Landlord's approval.  The trash enclosure shall conform as closely
         as possible to the currently existing trash enclosures built by
         Landlord at other locations in the Complex.
         (2) Ordinarily, Landlord would be handling trash container management.
         Because Tenant will be handling its own trash management, Tenant
         agrees to comply with the reasonable requirements of Landlord
         regarding housekeeping, frequency of removal, and such other matters
         as Landlord may require pertaining to trash management, failing which
         Landlord may take action on Tenant's behalf and at Tenant's expense.
         Additionally, Tenant shall use the same trash contractor as is being
         used by Landlord at the Complex (as the same may change from time to
         time).

<PAGE>  2

         (3) Tenant will receive from Landlord semi-annually a statement and
         a credit for the portion of Tenant's prorata share of trash removal
         expenses that otherwise would have been included as part of the
         Minimum Rent.

     6.1  Utilities.  Tenant is responsible for all charges (use, connection
          ---------
or otherwise) for water, sewer, gas, electricity, telephone service, cable
and any and all other utilities or services at or to the Premises.  See
Exhibit B (Landlord's and Tenant's Work) for description of utility
facilities.  Tenant will pay its own costs directly, if a utility service is
separately metered, or will pay Landlord, as additional rent, within ten (10)
days after Landlord's issuance of a bill, for Tenant's share of any utility
service that is not separately metered.

     7.1  Indemnity.  (a) Tenant shall indemnify, defend and hold harmless
          ---------
Landlord against all claims, costs, expenses (including but not limited to
attorneys' fees, court costs, and litigation expenses), losses, damages, obli-
gations and liabilities ("Claims") arising solely out of the acts or
negligence of Tenant, its employees, agents, patients and/or other invitees
for the death or any injury, loss or damage caused to any person or property
that occurs in or about the Premises (except to the extent such Claims arise
solely from the negligence or intentional misconduct of Landlord, its
employees, or agents); (b) Landlord shall indemnify, defend and hold
harmless Tenant from all Claims arising solely out of the acts of Landlord
or its employees or agents, for death or any injury, loss or damage caused
to any person or property that occurs in any part of the Complex or in or
about the Premises (except to the extent such Claims arise from the
negligence or intentional misconduct of Tenant and/or its employees, agents,
patients or other invitees).

     7.2  Tenant's Insurance. Before taking possession of the Premises, Tenant
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will provide Landlord proof that Tenant has obtained (and throughout the lease
term, Tenant will maintain) the following types of insurance in form, content
and reasonably satisfactory to Landlord:

     A. Public Liability and Property Damage.  Comprehensive public liability
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insurance with coverage including personal injury, bodily injury, broad form
property damage, operations hazard, owner's protective coverages, contractual
liability and products and completed operations liability, in limits of not
less than One Million Dollars ($1,000,000.00) inclusive.

     B. Property. Insurance covering all Tenant's improvements and all
        --------
personal property at the Premises, in an amount not less than their full
replacement value, providing protection against any peril included within the
classification "Fire and Extended Coverage", together with insurance against
sprinkler leakage (if the Premises are sprinklered), vandalism and malicious
mischief. All property at the Premises shall be there at Tenant's sole risk.

     C. Policy Forms. All policies shall name Landlord as an additional named
        ------------
insured. Executed copies of these policies shall be delivered to Landlord
prior to delivery of possession of the Premises to Tenant and thereafter
within thirty (30) days before the expiration of the term of each policy.
Tenant's property insurance shall waive subrogation by Tenant and its
insurer. All policies of insurance may not be canceled or amended except
upon thirty (30) days prior written notice from the insurance company to
Landlord.

     7.3  Landlord's Insurance.  At all times during the term of this Lease,
          --------------------
Landlord shall maintain in effect a policy of insurance covering the building
of which the Premises are a part (but not Tenant's trade fixtures, merchan-
dise, inventory, equipment, furniture, personal property, or other items used
in Tenant's business) in an amount at least equal to eighty percent (80%) of
the agreed value replacement cost (exclusive of the cost of excavations,
foundations and footings) from time to time during the term of this Lease,
providing protection against any peril generally included within the
classification "Fire and Extended Coverage."  Landlord also shall obtain
comprehensive public liability insurance pertaining to the Common Areas in
the amount of One Million dollars ($1,000,000).

     7.4  Waiver of Subrogation.  With respect to claims covered by the
          ---------------------
insurance which Tenant and Landlord are obligated by this Lease to maintain,
Landlord and Tenant waive the right each may have against the other on
account of any loss or damage occasioned to Landlord or Tenant, as the case
may be, their respective property, the Premises or its contents or to other
portions of the Complex, arising from any risk insured against by Landlord
or Tenant.  The parties, each on behalf of their respective insurance
companies insuring the property of either Landlord or Tenant against any
such loss, waive any right of subrogation that it may have against Landlord
or Tenant, as the case may be.  The release and waiver of subrogation rights
provided herein shall apply only if and to the extent that insurance
proceeds are in fact paid to or for the account of the party giving the
release.

     8.1  Common Areas.  This Lease includes the non-exclusive right to Tenant,
          ------------
its employees, and its guests, to use the common areas (e.g., driveways,
sidewalks, parking areas) provided for the general use of all tenants at the
Complex (the "Common Areas" ) as they exist from time to time. Landlord, in
Landlord's discretion, has the right to enlarge, reduce, modify and otherwise
make changes to the Common Areas, and to establish rules and regulations
regarding the use of the Common Areas.  Any changes to the Common Areas, and
any rules and regulations regarding the use of the Common Areas, may not
preclude access to the Premises or substantially deprive Tenant of the use and
enjoyment of the Premises.

     Landlord shall provide snow and ice management to the Common Areas
(including the sidewalks adjacent to Premises) and shall maintain lighting in
the Common Areas.

<PAGE>  3

     9.1  Signs.  Tenant shall have the right to add its name to the building
          -----
directory indicating the occupants of the Building in which the Premises are
located. Tenant also may install its premises identification near Tenant's
entrance. All signs must have Landlord's prior written approval (which
approval shall not be unreasonably withheld), and must conform to Landlord's
sign criteria.

     10.1  Alterations and Additions by Landlord.  Landlord has the right at
           -------------------------------------
any time to make expansions, additions, or alterations to all or any part of
the Complex.

     10.2  Alterations and Additions by Tenant.  No modifications, additions,
           -----------------------------------
or improvements to the Premises may be made without Landlord's prior written
consent  (including but not limited to the work, contractors, and materials),
Landlord's consent not to be unreasonably withheld. Additionally, all such
work shall be at Tenant's expense, shall not impair the safety or appearance
of the Premises or the Building, and shall be made according to all appli-
cable laws and regulations.

     11.1  Repairs and Maintenance.
           -----------------------
     A.  Landlord -- Except as otherwise provided in this Lease, Landlord
         --------
            is responsible to repair and maintain the roof, exterior
            (excluding glass doors and windows) and  structural components
            of the Building of which the Premises are a part.

     B.  Tenant -- Except as otherwise provided in this Lease, Tenant is
         ------
            responsible to repair and maintain:
            (1) the interior, non-structural portion of the Premises
            (including but not limited to wall surfaces and/or coverings,
            floor coverings, window treatments, equipment, fixtures, light
            bulbs, and other consumables);
            (2) HVAC (heating, ventilating, and air-conditioning) system,
            plumbing system, and electrical system pertaining to the Premises;
            and
            (3) everything pertaining to the Premises other than the items
            specifically described in Paragraph 11.1.A. above as Landlord's
            responsibility.

     C.  Tenant will not damage or injure the Premises, the Building, or the
Complex, and will pay the cost of repairing any damage or injury to the
Premises, Building, or the Complex by Tenant, its employees, agents, contrac-
tors or invitees.  Additionally, notwithstanding Paragraph A. above, if any
repair or maintenance work for which Landlord otherwise would be responsible
is made necessary because of the actions or omissions of Tenant, its
employees, agents, contractors, or invitees, Tenant shall pay for such work
upon Landlord's request for payment.

     D.  At the end of the Lease term, Tenant shall return the Premises in
good condition and repair, subject only to normal wear and tear. At the end
of the Lease, Landlord shall have the option: (1) to keep any improvements
or additions made by Tenant, without any obligation to compensate  Tenant;
and/or (2) to require that Tenant, at Tenant's expense, remove any  "unusual"
additions or improvements made by Tenant, and repair any related or resulting
damages.  For the purpose of this provision, "unusual additions or improve-
ments" means improvements not typically found in a business office or
typical medical office space.  It does not mean or include sheetrock
partition walls, plumbing or sinks.

     E.  The term "repair and maintain" shall include replacement when
required to restore the Premises or any component to good working order or
condition.

     11.2  Landlord's Entry Upon the Premises.  Landlord may enter the
           ----------------------------------
Premises at reasonable times during normal business hours for the purpose
of inspection, showing the Premises to prospective purchasers, tenants,
investors, lenders, or others, making repairs, and performing any work
necessary to comply with any laws, rules or regulations of any public
authority, fire rating bureau or Landlord's insurer or that Landlord may
deem necessary or appropriate. Landlord also may enter the Premises at
reasonable times to inspect, effect repairs, maintain or remodel adjacent
premises. Any such entry  shall be done with a minimum of two day prior
notice with the exception of emergencies and so as to cause minimum
inconvenience to Tenant, and Landlord shall cause any damage to the Premises
as a result of such entry, repairs, maintenance or remodeling to be repaired
promptly without cost to Tenant.

     12.1  Assignment, Sublet, or Other Transfer.
           -------------------------------------
     A.  Except as otherwise provided in Paragraph 12.1.B below, Tenant shall
not assign, sublet, or otherwise transfer the Lease or the Premises in whole
or in part without first obtaining the written consent of Landlord, which
consent shall not be unreasonably withheld.  In considering Tenant's request
for consent to assignment, sublease, etc., Landlord may take into account,
among other things, the following:
     (1) the financial strength and creditworthiness of the proposed trans-
     feree;
     (2) the business experience of the proposed transferee;
     (3) the prior history and/or reputation of the proposed transferee, its
     owners, officers, directors and shareholders;
     (4) the use which the proposed transferee intends to make to make of the
     Premises;
     (5) such other legitimate business considerations that Landlord
     reasonably deems appropriate.

Any attempted transfer, assignment or subletting without Landlord's written
prior consent shall be void and confer no rights upon any third party.

<PAGE>  4

     B.  So long as no change in scope, manner, or style of operation of the
Premises is involved, Tenant, without first having to obtain Landlord's
consent, may assign or sublet the Premises to (i) Tenant's medical director
and similar physician; (ii) any corporation or company which controls, is and
remains controlled by, or is and remains under common control with Tenant, or
to any corporation or company resulting from the merger or consolidation with
Tenant, or to any person or entity which acquires substantially all of the
assets of Tenant.

     C.  After any assignment, sublease, or other transfer permitted by
Landlord, Tenant nevertheless shall remain liable for all of its obligations
under this Lease.

     13.1  Damage or Destruction; Condemnation.  If the Premises or the
           -----------------------------------
Building are damaged or destroyed, or are the subject of condemnation, and:

     A.  if the Premises are so affected that they are rendered materially
unsuitable for Tenant's Use and cannot be repaired or restored within one
hundred eighty  (180) days, Tenant shall have the right to terminate this
Lease;

     B.  if the Premises and/or Building are not affected as described in A.
above, and Landlord elects to repair or restore, then and until Landlord's
repair/restoration work is substantially completed, Tenant's rent shall abate
in the same ratio that the square footage of the Premises rendered unusable
bears to the total square footage of the Premises;

     C.  if Landlord determines that it is infeasible, impractical, or
undesirable for Landlord to repair or restore, Landlord shall have the right
to terminate the Lease, in which case Tenant's obligations shall cease to
accrue under the Lease as of the date of the damage, destruction, or
condemnation taking.

     D.  All condemnation awards (other than that portion, if any, which may
be specifically awarded to Tenant for the loss of Tenant's improvements,
personal property, or relocation expenses) shall belong exclusively to
Landlord.

     14.1  Tenant's Default.  If Tenant defaults in the performance of any of
           ----------------
Tenant's obligations under the Lease, and Tenant's default is not cured
within the following notice and cure period: (a) failure to pay any sum due -
ten (10) days after written notice is sent by Landlord; (b) failure to
perform any other obligation - thirty (30) days after written notice is sent
by Landlord, Landlord shall have the right and option, in Landlord's sole
discretion, and without having to give further notice of any kind, to pursue
any one or more of the following remedies (as well as any other remedies
available to Landlord at law or equity):

     A.  Declare immediately due all accrued amounts as well as the entire
amount of all rent and other charges remaining to be paid for the balance of
the lease term, and sue to recover such amounts and to recover possession of
the Premises (together with such expenses as Landlord may incur in recovering
possession of the Premises, including but not limited to court costs,
litigation expenses, and attorneys' fees);

     B.  Enter upon and take possession of the Premises without terminating
this Lease, and without relieving Tenant of its obligation to pay the rent
and other payments required of Tenant under this Lease, and at Tenant's
expense:  expel or remove Tenant and any other person who may be occupying
the Premises or any part thereof and any personal property or trade fixtures
located therein, and change or alter the locks and other security devices,
and relet the Premises in the name of Landlord or Tenant, at any rental and
for any term readily obtainable, and receive the rent therefor.  In such
event, Tenant shall pay to Landlord on demand the expenses of such reletting
(include but not limited to all real estate commissions and all expenses
involved in readying the Premises for occupancy by the next tenant), and
any deficiency which may arise by reason of such reletting for the remainder
of the term of this Lease;

     C.  Declare this Lease and Tenant's right of occupancy terminated, in
which case Tenant shall peaceably surrender the Premises to Landlord;

     D.  Take action, on Tenant's behalf and at Tenant's expense, to perform
any obligation owing by Tenant under this Lease which Tenant has failed to
perform;

     E.  Landlord's rights and remedies shall be not mutually exclusive, and
Landlord may pursue one or more of its remedies simultaneously, in series,
and/or otherwise.

Landlord also shall have the right to pursue its default remedies if any of
the following occurs: (1) Tenant abandons or vacates the Premises for more
than ten (10) days; or (2) a receiver is appointed over Tenant's assets,
Tenant makes an assignment for the benefit of creditors, or Tenant takes or
suffers any action under any Bankruptcy Act.

Under no circumstances shall Landlord be deemed to have terminated this
Lease unless Landlord shall have given Tenant express written notice to that
effect.

<PAGE>  5

     14.2  Landlord's Default.  If Landlord fails to perform any of its
           ------------------
obligations under this Lease, Tenant (after first giving thirty (30) days
notice and opportunity to cure to (a) Landlord; and (b) if applicable,
Landlord's mortgagee(s) of whom Tenant has been given written notice) may
cure on Landlord's behalf and at Landlord's expense, and then offset the
reasonable costs of such cure against Tenant's next rent installment(s).
If Landlord's failure to perform involves an emergency repair, Tenant may
take action after first giving Landlord 24 hours notice and opportunity to
respond. Notwithstanding the right given above to Landlord's mortgagee(s)
to receive notice and opportunity to cure, such mortgagee(s) shall have
the option but not the obligation of curing on Landlord's behalf.

     15.1  Surrender of Premises; Holding Over.  If Tenant remains in
           -----------------------------------
possession of the Premises after the expiration of this Lease without
Landlord's express written consent, Tenant shall indemnify and hold harmless
Landlord from and against all claims, damages, losses, liabilities, costs and
expenses (including but not limited to court costs, litigation expenses, and
attorneys' fees) (collectively, "Losses") arising out of or pertaining to the
delay by Tenant in so surrendering the Premises; including, any Losses
pertaining to proposed successor tenants whose lease negotiation, lease
execution, and/or occupancy is delayed, interfered with or prevented by
Tenant's holdover.  Tenant's holding over shall be deemed to have created a
tenancy at will (terminable by Landlord at any time), and so long as Tenant
continues to occupy the Premises, Tenant shall be liable for the performance
of all of its obligations under this Lease, as well as a per diem rent based
on two (2) times the rate of the Minimum Rent and additional rent that had
been payable during the last month of the lease term.

     16.1  Subordination.  Tenant accepts this Lease subject and subordinate
           -------------
to any present or future mortgage, deed of trust or other lien at the
Premises, Building or Complex and to any renewals, refinancing, extensions,
modifications and replacements thereof.  This subordination shall be self-
operative and no further instrument of subordination shall be required.  In
confirmation of this subordination, Tenant shall execute and promptly deliver
any certificate that Landlord or any mortgagee may require.

     16.2  Attornment.  In the event of a sale, transfer or assignment of
           ----------
Landlord's interest in the Complex or any part thereof, including the
Premises, or in the event any proceedings are brought for the foreclosure
of or for the exercise of any power of sale under any mortgage made by
Landlord covering the Complex or any part thereof, including the Premises,
Tenant shall  attorn to and to recognize such transferee, purchaser, or
mortgagee as Landlord under this Lease, provided, however, that such
transferee, purchaser, or mortgagee recognizes Tenant's rights under this
Lease.

     17.1  Tenant's Estoppel Letter.  Within seven (7) days of Landlord's
           ------------------------
request, Tenant shall provide a true copy of Tenant's lease (and any modifi-
cations thereto), and a statement ("Tenant's Estoppel Letter") certifying:
(a) the lease term commencement and expiration dates; (b) that the Lease is
in full force and effect according to its original terms (or as modified,
stating the date and nature of such modification); (c) the date to which
the rental and other sums payable under this Lease have been paid; (d) the
fact that there are no current defaults under this Lease by either Landlord
or Tenant except as specified in Tenant's statement; (e) the amount of any
prepaid rents, charges, or security deposits claimed by Tenant; (f) whether
or not any "free rent" or other rent concessions have been granted to
Tenant; and (g) such other matters requested by Landlord.  Landlord and
Tenant intend that any statement delivered pursuant to this Paragraph may
be relied upon by any mortgagee, beneficiary, purchaser or prospective
purchaser of the Complex or any interest therein.  Tenant's failure to
deliver such statement within such time shall be conclusive upon Tenant,
(a) that this Lease is in full force and effect, without modification except
as may be represented by Landlord; (b) that there are no uncured defaults in
Landlord's performance; (c) that not more than one (1) month's rental has
been paid in advance; and (d) no free rent or other rent concessions have
been granted to Tenant.  Nothing in this Section 17.1 shall require Tenant
to sign any statement or certificate which is not accurate.

     18.1  Attorney's Fees.  In the event of legal action between Landlord
           ---------------
and Tenant, the prevailing party in such action shall be entitled to be
reimbursed by the other party in the amount of all reasonable attorney's
fees, litigation related expenses, and other costs incurred by the
prevailing party.

     18.2  Limitations on Landlord's Obligations.  If Landlord sells or
           -------------------------------------
transfers the Premises, Building and/or Complex, Landlord shall be released
from all liability and obligations under this Lease from and after the date
of such sale or transfer.  Thereafter, Tenant shall look solely to the
successor owner.  Additionally, all claims of Tenant, if any, against any
Landlord shall be limited to such Landlord's interest in the Complex.

     18.3  Notices.  Any notice under this Lease shall be in writing and shall
           -------
be deemed given if delivered personally, by Federal Express or other receipted
courier service, or mailed by registered or certified mail, addressed to
Landlord or Tenant, at the addresses indicated above, or to such other address
as either party shall give to the other from time to time on five (5) days
notice.

     18.4  Entire Agreement.  This Lease, including the exhibits, riders
           ----------------
and/or addenda, if any are attached , sets forth the entire agreement between
the parties.  All prior conversation or writings between the parties or their
representatives are merged herein and are extinguished.  This Lease shall not
be modified except by a signed written instrument.

     18.5  Provisions Binding.  Except as otherwise expressly provided in
           ------------------
this Lease, all covenants, conditions and provisions of this Lease shall be
binding upon and shall inure to the benefit of the parties hereto and their
respective heirs, legal representatives, successors and (to the extent
permitted) assigns.

<PAGE> 6

     18.6  Governing Law; Trial by Jury.  The laws of the State of New
           ----------------------------
Jersey shall govern this Lease.  If either party institutes legal action
pertaining to this Lease, the venue of the suit shall be in Cumberland
County, New Jersey.  The parties also expressly waive any right which
they otherwise may have to have any disputes between them resolved by
means of trial by jury.

     18.7  Brokerage Commissions.  Except for the involvement of ERA Pearce-
           ---------------------
Jannarone ("EP-J"), who is Tenant's broker, and/or  N/A  , who is Landlord's
broker, no brokers, real estate agents, or other similar persons were involved
in this transaction. The sole compensation to be paid to any brokers by
Landlord shall be in accordance with separate written commission agreement(s)
entered into between Landlord and such broker(s).  Landlord and EP-J have
entered such a written agreement, and Tenant has no liability to EP-J under
that agreement.  Accordingly, each of Tenant and Landlord shall indemnify,
defend, and hold the other harmless of and from all claims, liabilities,
obligations, costs and expenses (including but not limited to court costs,
attorneys fees, or litigation expenses) pertaining to broker's commissions or
other similar fee claims arising out of or relating to the actions or
omissions of the indemnifying party and not otherwise described herein.

     18.8  Authorship.  Neither party to this Lease shall be benefited or
           ----------
burdened by any rule of document interpretation that otherwise would interpret
a document against the interests of the author.

     18.9  Interest on Past Due Sums.  In addition to all other rights or
           -------------------------
remedies available to Landlord under this Lease, Landlord, at Landlord's sole
option, may require Tenant to pay interest on past due obligations at a rate
equal to the lesser of (i) fifteen percent (15%) per annum; or (ii) the
maximum rate of interest permitted to be charged to Tenant under state or
federal law (whichever allows the higher rate of interest).

     18.10  [Intentionally Deleted]

     18.11  Removal of Personal Property.  At the expiration or termination
            ----------------------------
of the Lease, at the request of Landlord, Tenant shall remove all of its
fixtures, furniture, equipment and other personal property from the Premises.
If Tenant does not do so within ten (10) days of Landlord's request, Landlord
may dispose of such property in any manner Landlord chooses, without any
liability or obligation to Tenant. Among other things, Landlord may treat such
property as abandoned by Tenant. Any costs or expenses incurred by Landlord in
dealing with or disposing of such property shall be reimbursed to Landlord by
Tenant upon demand.

     18.12  Mechanic's Liens.  Tenant will not cause or permit any mechanic's
            ----------------
or materialmen's liens to be filed against the Premises, Building or Complex.
If that occurs, Tenant shall cause the same to be removed immediately upon
Landlord's demand.

     18.13  Waiver by Landlord.  No failure by Landlord to take action upon
            ------------------
learning of Tenant's default under this Lease shall constitute a waiver by
Landlord. Landlord's waiver can only be granted in writing. Written waiver
by Landlord of a particular default shall apply to that particular
occurrence only, and not to any future such default or occurrence. Acceptance
by Landlord of any partial payment from Tenant will not waive Landlord's
right to pursue Tenant for any remaining balance. No endorsement or statement
on any check or letter which acknowledges a check or payment as rent shall be
deemed an accord and satisfaction.

     18.14  Condominium Rider.  This Lease is subject to the Condominium
Rider attached as Exhibit C.  Notwithstanding anything in Exhibit C to the
contrary, Exhibit C shall not be binding upon Tenant to the extent that it
modifies or otherwise limits the permitted Use of the Premises as described
in Paragraph 5.1 above, the terms of this Lease, and/or the Minimum Rent. It
is further understood that if the Premises are made part of a condominium
regime, Tenant shall not be responsible for any operating expenses in excess
of those that otherwise would have been chargeable to Tenant under this Lease
had the Complex not been made part of a condominium regime.

     18.15  Window Coverings.  Window coverings shall be provided at the
            ----------------
Tenant's expense.  All windows at the first floor level shall be covered
with horizontal members and shall be white to the exterior.

     18.16  Renewal Option.
            --------------

     A.  Tenant has two (2) renewal options for renewal terms of five (5)
years each.  To exercise its renewal options, Tenant must give Landlord
written notice one hundred eighty (180) days before the expiration of the
then current lease term that Tenant intends to renew.

     B.  The renewal terms(s) shall be on the same terms and conditions as
are described in the Lease, except as to Minimum Rent and Minimum Rental
Adjustment.  During the first renewal term, the Minimum Rent shall be the
greater of (1) $13.25 per square foot or (2) the Minimum Rent applicable in
year 5, multiplied by a fraction whose numerator is the CPI applicable in
month 60 of the initial lease term, and whose denominator is the CPI
applicable in Month 1 of the initial lease term.  During the second renewal
term, the Minimum Rent shall be the greater of (1) $15.15 per square foot or
(2) the Minimum Rent applicable in year 10, multiplied by a fraction whose
numerator is the CPI applicable in month 120 and whose dominator is the CPI
applicable in month 61.  If Tenant notifies Landlord that Tenant intends to
exercise a renewal option, Landlord shall provide Tenant, within thirty (30)
days thereafter, with the Minimum Rental Adjustment schedule to be appli-
cable during that renewal period.  Tenant then shall have seven (7) days
within which to notify Landlord in writing that (i) Tenant accepts that
Minimum Rental Adjustment schedule; or (ii) Tenant withdraws and terminates
its notice of intent to renew.

<PAGE>  7

     C.  The term CPI means the Consumer Price Index--All Urban Consumers
(Philadelphia Region), or the successor of that index.  If the CPI is no
longer available as a rent adjustment reference, the parties shall use such
other index or reference point as may then be in common use in determining
suburban office rent adjustments as reasonably may be selected by Landlord.

     D.  Landlord shall have no obligation to honor Tenant's exercise of
renewal option if:

         (1) Tenant is in default;
         (2) Tenant shall have been in default (whether or not that default
         was waived by Landlord or was cured    by Tenant after notice of
         default) more that three (3) times during the prior lease term; or
         (3) Landlord determines that Tenant (or the use of the Premises by
         Tenant) is creating problems which make the Tenant no longer
         desirable to Landlord as a Tenant at the Complex.

     18.17  Guarantee.  Tenant and the Guarantor identified in the Guarantee
            ---------
attached as Exhibit D shall be jointly and severally liable for all of the
obligations of Tenant under this lease.

     18.18  Cooperation with Landlord's Lender(s).  Landlord to this date has
            -------------------------------------
financed the project from Landlord's own resources, but Landlord contemplates
obtaining mortgage financing in the future. In this connection, Tenant agrees
to cooperate with Landlord's mortgage lender(s) to the extent that any
additional language is requested by them to be added to the Lease (provided,
however, that such language shall not limit Tenant's permitted Use of the
Premises, change the term of the lease, change the amount of rent payments
and other charges to be made by Tenant under the lease, or otherwise create
any material additional limitations or burdens upon Tenant. Tenant agrees to
execute a Subordination, Attornment, and Non-Disturbance Agreement and/or
such other instruments as are customary and reasonable in such circumstances.

                                       LANDLORD:

                                       MAINTREE OFFICE CENTER, L.L.C.

                                          /s/ David Lerman

                                       By:--------------------------------
                                       Name: DAVID LERMAN
                                       Title: Lerman Partners, L.P., Member

                                       TENANT:

                                       DCA OF VINELAND, L.L.C

                                          /s/ Bart Pelstring    5/10/99

                                       By:--------------------------------
                                       Name: BART PELSTRING
                                       Title: President

Index to Exhibits
-----------------
Exhibit A - Premises Location
Exhibit B - Landlord's and Tenant's Work
Exhibit C - Condominium Rider
Exhibit D - GuaranteeMEDICAL DIRECTOR AGREEMENT

THIS MEDICAL DIRECTOR AGREEMENT ("Agreement") made as of April 30, 1999

Between    Vineland Dialysis Professionals, LLC

           a ------------- professional limited liability company with offices
at         510 Jackson Avenue
           Northfield, N.J. 08225

           hereinafter referred to as the "P.A."

And        DCA of Vineland, LLC

           a New Jersey limited liability company with offices at
           c/o Dialysis Corporation of America
           27 Miller Street
           Lemoyne, PA 17043

           hereinafter referred to as the "Company."

The P.A. and the Company may hereafter be referred to individually as a "Party"
and collectively as the "Parties."

                                   WITNESSETH:

WHEREAS, the Company intends to develop, own and operate a renal dialysis
facility to be located within the vicinity of Vineland, State of New Jersey,
with such specific location as the Parties may select ("Facility");

WHEREAS, the P.A. is a limited liability company wholly owned by Dr. David
Blecker.

WHEREAS, the P.A. retains duly licensed physician(s) under the laws of the State
of New Jersey, specializing in the treatment of kidney disease and experienced
in the medical administration of a renal dialysis facility;

WHEREAS, the Company through the operation of the Facility seeks to operate a
free standing dialysis center to provide all levels of outpatient dialysis care,
including but not limited to chronic maintenance dialysis, home treatment
through hemodialysis or peritoneal dialysis, either continuous and insulatory
peritoneal dialysis or continuous cycling peritoneal dialysis, chronic dialysis,
and inpatient dialysis services and related services to hospitals, nursing
homes, healthcare facilities, and similar institutions, as well as ancillary
services to End Stage Renal Disease ("ESRD") patients ("Dialysis Treatments");
to provide to persons having ESRD and other forms of renal failure the care they
need; to encourage proper distribution and effective utilization of ESRD
treatment while maintaining or improving the quality of care; and to promote the
efficient delivery of ESRD care;

<PAGE>

WHEREAS, the Company desires to contract with the P.A. to provide certain
services as defined herein and the P.A. desires to render such services to the
Company; and

WHEREAS, the Parties desire to enter into this Agreement in order to provide a
full statement of their respective responsibilities as they exist in connection
with the provision of services during the term of this Agreement;

NOW THEREFORE, in consideration of the mutual covenants and promises contained
in and intending to be legally bound by this Agreement the Parties agree as
follows:

1.       CONTRACT FOR SERVICES

         The Company hereby contracts with the P.A. to assist in the Facility's
Dialysis Treatments and provide services at the Facility as required by 42 CFR
405.2100 et seq., or any successor regulations, including those services as
provided in Section 3 of this Agreement. P.A. represents, warrants and agrees
that there will be available to the Facility during its operations, the services
of a qualified, licensed Medical Director as per Section 2. P.A., subject to the
terms of this Agreement and, in particular, Section 8 hereof, shall be
responsible for planning, organizing, conducting and directing the professional
ESRD services at the Facility. All services to be provided by the P.A. in this
Agreement are hereinafter sometimes collectively referred to as "Services." The
P.A. hereby agrees to provide such Services under and subject to the terms and
conditions as provided in this Agreement.

2.       MEDICAL STAFF AND COVERAGE

         2.1 PHYSICIANS. The Services of the P.A. shall be coordinated by Dr.
David Blecker, who is hereby appointed by the Company to serve as the Medical
Director of the Facility throughout the term of this Agreement, unless the P.A.
shall designate some other qualified physician to assume the duties of Medical
Director. Any candidate recommended or designated by the P.A. to serve as
Medical Director will be subject to the approval of Company which approval will
not be unreasonably withheld. The Medical Director may hereinafter also be
referred to as the "Physician."

         2.2 COVERAGE. The P.A. or the Medical Director need not devote
full-time to the Dialysis Treatments or the provision of Services but shall
devote sufficient time as necessary to fulfill its and his or her
responsibilities as required in this Agreement. The P.A. shall provide for
Physician coverage for all hours of Facility's operation and 24 hour emergency
on-call coverage.

         The Company acknowledges that P.A. and Medical Director are engaged in
the practice of medicine in the Vineland, New Jersey area, in particular, the
private practice of nephrology and/or internal medicine, and that each such
persons may continue to be so engaged during the term of this Agreement and may
perform services for and on behalf of their respective patients in addition to
but non-competitive with those Dialysis Treatments of and those Services which
are required of him to be performed for the Facility as provided for in this
Agreement, provided, the same does not unreasonably interfere with the
performance of their respective obligations hereunder. Services deemed
non-competitive include and are limited to treatment of patients other than for
Dialysis Treatments and other than acute dialysis treatments which the Facility
may perform.

                                       2
<PAGE>

         2.3      MEDICAL DIRECTOR.

                  2.3.1 LICENSE AND CERTIFICATION. Each Medical Director (i)
represents to and shall be licensed to practice medicine and to dispense
narcotics and other pharmaceuticals in accordance with the laws of the State of
New Jersey; (ii) represents to and shall be Board certified in internal medicine
or in nephrology; (iii) represents to and shall have at least 12 months of
experience or training in the care of patients at ESRD facilities; (iv)
represents to and shall have experience in medical administration of a renal
dialysis facility; and (v) represents that he or she is not subject to any
pending or threatened litigation or professional discipline relating to his or
her medical practice or licensure for the prescribing and/or dispensing of
narcotics and pharmaceuticals, for the last five years has not been subject to
any such litigation or professional discipline except as disclosed in EXHIBIT
2.3.1, nor has any knowledge of facts or circumstances that could give use to
any such litigation or professional discipline other than as disclosed in
EXHIBIT 2.3.1.

                  2.3.2 MEDICAL STAFF APPOINTMENT. Each Medical Director shall
apply for, be awarded and maintain appointment in good standing on the medical
staff of the Facility in accordance with Facility's policies as well as
applicable Facility and medical staff bylaws, rules and regulations.

                  2.3.3 PROGRAM ELIGIBILITY. Each Medical Director shall be and
remain eligible to participate in the Medicare program and the state medical
assistance program.

                  2.3.4 AGREEMENT TO BE BOUND. The P.A. and the Medical Director
represent and warrant that they shall use their best efforts and skills in
fulfilling their responsibilities and duties as provided in this Agreement. The
P.A. shall not utilize any Physician to provide Services under this Agreement
unless such Physician has been appointed Medical Director as provided in Section
2.1, and has executed a document, legally obligating such Physician individually
to abide by the terms and conditions of this Agreement in form as provided in
EXHIBIT 2.3.4 or as otherwise reasonably requested by Company.

                  2.3.5 NO CONFLICT. The P.A. and each Medical Director
represent and warrant that it, he and/or she has no affiliation, contract,
agreement or other arrangement with any other person or entity that would
prohibit the P.A. or Physician from performing under this Agreement or otherwise
conflict with the terms and provisions of this Agreement. The P.A. and each
Medical Director hereby indemnify and hold the Company, the Facility and their
respective shareholders, officers, directors, successors and assigns
(collectively "Representatives") harmless from any and all claims, suits,
obligations restrictions, liabilities and other causes of action (collectively
"Claims") which may arise from a breach of this representation as set forth in
this Section 2.3.5, which indemnification includes but is not limited to any and
all costs and fees incurred by the Company, Facility and/or Representatives in
defending any such Claims as indemnified herein, including reasonably counsel
fees.

3.       SERVICES

The Services of the P.A. and Medical Director shall include:

         3.1 Being in charge of and responsible for all medical aspects of the
Facility's operation to provide high quality medical treatment, providing the
proper coordination and functioning of all medical services, and being
responsible for adequate supervision of dialysis

                                       3
<PAGE>

treatments in accordance with federal regulation and/or any and all other
applicable state and/or local regulations now in existence or hereafter passed
applicable to the operation of the Facility;

         3.2 Consulting with and advising the executive management of the
Facility on matters including, but not limited to, the hiring and firing of
medical, para-medical and technical personnel employed by the Facility and the
type of equipment and supplies to be used in the Facility for patient care;

         3.3 Assuring adequate monitoring of the patient and the dialysis
process (minimum in-center rounds once per week), including for self-dialysis
patients, assuring periodic assessment of patient performance of dialysis tasks;

         3.4 Assuring the development and availability of a patient care policy
and procedures manual and its implementation; at a minimum, the manual shall
describe the types of dialysis used in the Facility and the procedures followed
in performance of such dialysis; hepatitis prevention and procedures for
handling an individual with hepatitis; and a disaster preparedness plan (e.g.,
patient emergency, fire, flood);

         3.5 Assuring that patient teaching materials are available for the use
of all trainees during training and at times other than during the dialysis
procedure when self-dialysis training or home dialysis training is offered;

         3.6 Supervising in the development and implementation of a system of
patient care evaluation (quality assurance) including peer review and audit;

         3.7 Aiding in the recruitment of qualified doctors and nurses to be
associated with and/or employed by and as required by the executive management
of the Facility;

         3.8 Supervising the nursing, technical and medical staff;

         3.9 Establishing and supervising a training program in dialysis
techniques for medical, nursing and technical employees of the Facility;

         3.10 Serving as the chairman of the Medical Review Board of the
Facility;

         3.11 Consulting with other medical and governmental agencies and
facilities needed to further the interests, operating and progress of the
Facility;

         3.12 Supervising the maintenance of all appropriate medical records
relating to medical services rendered at the Facility;

         3.13 Developing and supervising a preventative maintenance training
program for staff personnel pertaining to the maintenance of all equipment;

         3.14 Using its, his and her best efforts to be available and present at
the Facility during times of inspection by regulatory agencies;

         3.15 Acting as spokesperson and coordinator for the Facility during any
Certificate of Need process in connection with the establishment and approval
processes for the Facility and any future expansion thereof and assisting the
Facility in obtaining all necessary approvals and consents for additional
dialysis stations;

                                       4
<PAGE>

         3.16 Establishing review and monitoring of water quality for dialysis;

         3.17 Instituting and supervising a dialyzer re-use program in
compliance with recognized medical standards;

         3.18 Evaluating laboratory procedures and services;

         3.19 Establishing, maintaining and monitoring infection control
policies;

         3.20 Assuring and warranting that the Medical Director, any Assistant
Medical Director(s) and Physician(s) have the proper credentials and maintain
the necessary licenses and/or approvals to participate in all federal, state and
local kidney disease programs governing the operation and/or reimbursement for
the Facility in which the Facility participates; and

         3.21 Helping to establish hospital inpatient dialysis agreements and
other affiliation agreements with acute-care hospitals, nursing homes and
similar healthcare facilities and transplant centers; assuring that the Facility
meets all licensing and other requirements for any hospital or other entity in
which the Facility has an affiliated inpatient agreement, and promote the goals
of the Company and the Facility in maintaining such agreements.

4.       COMPENSATION

         4.1 AMOUNT OF COMPENSATION. For the P.A.'s services as provided in this
Agreement, which are and include the services of the Medical Director, the
Company will pay the P.A. and the P.A. accepts as full and sufficient
compensation the amounts set forth in EXHIBIT 4.1 ("Compensation"), incorporated
herein by reference.

         4.2 PAYMENT. The Company shall pay Compensation under this Agreement to
P.A. on the last day of each month in each Agreement Year (incremental periods
of 12 months starting from the Commencement Date), allowing for ten business
days check processing time, an amount equal to one twelfth (1/12th) of the
Compensation required to be paid to P.A. pursuant to this Article 4 in such
Agreement Year, by check drawn to the order of P.A. and mailed to the address
specified for P.A. set forth on EXHIBIT 12.8 attached hereto, or such other
address as designated in writing.

         4.3 PHYSICIAN'S FEES. It is agreed and understood that P.A., the
Medical Director and all other Physicians involved in patient care at the
Facility shall do their own billing of fees for Physician's services to the
appropriate party, which services and fees shall not be billed to or be the
responsibility of the Company or the Facility.

         4.4 ECONOMICAL SERVICES. The P.A. and Medical Director represent and
warrant that the Services shall be performed in an economical and professional
manner, and that each of them shall use their best efforts to maintain the costs
of Dialysis Treatments at reasonable and efficient levels subject to the
exercise of good medical judgment. This representation and warranty is a
material inducement to the Company in entering into this Agreement.

                                       5
<PAGE>

5.       INSURANCE

         5.1 REQUIRED COVERAGE. The P.A. shall maintain for itself and shall
require any Physician who provides Services pursuant to this Agreement to
maintain basic limits professional malpractice liability insurance during the
term of this Agreement and thereafter covering all Services provided pursuant to
this Agreement in amounts not less than $1,000,000 per occurrence and $3,000,000
per annual aggregate. The P.A.'s and Medical Director's obligations under this
Section 5.1 shall survive for three (3) years following termination of this
Agreement. Upon failure of P.A. or any Physician to obtain such professional
malpractice liability insurance, in addition to being a breach of the Agreement,
the Company shall have the option, not the obligation, to obtain the same for
the P.A. and any such Physician(s), to pay the premiums and charge the same
together with any administrative and service fees and charges to the P.A. and/or
Physician and P.A. and/or Physician shall immediately pay such sum to the
Company.

         5.2 CERTIFICATE OF INSURANCE. The P.A. and/or Physician shall provide
to the Company prior to commencing or continuing Services hereunder certificates
of insurance evidencing the professional malpractice liability insurance
coverage required in Section 5.1 as well as a certificate of insurance
evidencing the P.A.'s workmen's compensation coverage and to notify the Company
immediately of any modifications or cancellation or termination of such
insurance coverage.

         5.3 COMPANY INSURANCE. The Company shall provide and maintain liability
insurance for itself and its employees who perform services at or in connection
with the Facility.

         5.4 INDEMNIFICATION. Each Party (including any Physician providing
Services) shall hold harmless and indemnify the other and their Representatives,
and any person or entity that directly or indirectly, through one or more
intermediaries, controls or is controlled by, or is under common control with,
it, including their officers, directors and shareholders, hereinafter
"Affiliates," from and against any and all Claims, expenses and attorney's fees
resulting from or attributable to any and all acts and omissions of such
Indemnifying Party.

6.       RULES AND REGULATIONS

         6.1 LAWS, RULES AND REGULATIONS. The P.A. and each Physician shall at
all times render Services in compliance with all applicable federal, state and
local laws, rules and regulations and in compliance in all material respects
with the Facility's bylaws, rules and regulations.

         6.2 REQUIREMENTS AND STANDARDS. The P.A. and all Physicians shall
maintain such standards and meet such requirements as will, at all times,
continue certification of the Facility as an ESRD dialysis facility under the
federal Medicare program and continuance of any license or operating certificate
of the Facility.

7.       RESTRICTIVE COVENANT

         7.1      GENERAL AND DEFINITIONS

                  7.1.1 PURPOSE. The Parties acknowledge that the Dialysis
Treatments and Services are of a special and unique character and that the P.A.
and each Physician has and will

                                       6
<PAGE>

receive substantial economic benefit and valuable business information as a
result of association with the Company and the Facility; that the Company will
incur expense in the development and promotion of the Facility; and that if the
P.A. or a Physician is permitted to engage in Restricted Activity during the
Restricted Period (as hereinafter defined) the Company will suffer substantial
economic injury.

                  7.1.2 RESTRICTED ACTIVITY. As used in this Agreement
"Restricted Activity" shall mean participation or involvement, direct or
indirect, either as principal, agent, proprietor, shareholder, P.A., creditor,
subcontractor, administrator, physician, medical director, officer, employee,
consultant or otherwise, in any entity, trade or business (other than for the
Company) providing Dialysis Treatments and/or Services within the "Restricted
Area" as defined in Section 7.1.4; and "Restricted Activity" also includes the
restriction and prohibition of advising, assisting, consulting with, leasing or
selling real property to, provide financing for or aid in the establishment or
operation of any competing business or Restricted Activity in the Restricted
Area during the Restricted Period; provided however such Restricted Activity
shall not include: (i) a Physician's direct patient care services to ESRD, other
dialysis patients or any other patients as otherwise provided for in Section 2.2
of this Agreement; (ii) the ownership of less than five percent (5%) of the
issued and outstanding stock of a public company; or (iii) those activities
listed on EXHIBIT 7.1.2.

                  7.1.3 SERVICES. The terms "Dialysis Treatments" and "Services"
shall be as defined in this Agreement, as well as generally including the
providing of dialysis equipment and supplies; provided the terms "Dialysis
Treatments" and "Services" do not include dialysis involving a medical problem
which the Facility is unable to handle which requires hospitalization, but
inclusive of those acute and chronic dialysis patients requiring hospitalization
and other patients of an institution or hospital who may require dialysis
treatment if the Facility or the Company has an affiliation agreement to provide
such inpatient dialysis services with such local institution or hospital,
including but not limited to staff assisted hemodialysis, continuous ambulatory
peritoneal dialysis and home training staff assisted dialysis treatments,
exclusive of those facilities listed on EXHIBIT 7.1.3.

                  7.1.4 RESTRICTED AREA. As used in this Agreement, "Restricted
Area" shall mean any location within a radius of 20 miles of the Facility.

                  7.1.5 RESTRICTED PERIOD. As used in this Agreement "Restricted
Period" shall mean the Term of this Agreement and one (1) year thereafter,
provided however, in the event of any violation of this Article 7 the Restricted
Period shall be extended by a period of time equal to that period beginning when
the violation commenced and ending when the violation terminated; provided
further that if this Agreement is terminated pursuant to Section 11.3 and the
cause was not due to the P.A. or Medical Director, then the Restrictive Period
shall mean the Term of this Agreement and nothing more.

         7.2 COMPETITION. During the Restricted Period the P.A. and/or any
Physician shall not engage in any Restricted Activity.

         7.3 EMPLOYEES AND CONTRACTORS. During the Restricted Period, P.A. or
any Physician shall not induce, solicit or attempt to influence, any employee,
contractor, reimbursement sources, providers, suppliers, insurors and other
third-party payors of the Company or the Facility to terminate a relationship
with the Company or the Facility or to enter into any employment or other
business relationship or affiliation or Restricted Activity with any other
person, firm, or corporation, including the P.A. or any Physician.

                                       7
<PAGE>

         7.4 SCOPE OF COVENANTS. It is expressly understood and agreed that the
scope of the various covenants in this Article 7 are reasonable both in time and
area and are fair and necessary to protect the legitimate interests of Company
and the Facility against the material adverse effects which would result from
the violation of any of these covenants.

         7.5 DIVISIBILITY OF COVENANTS. The covenants of this Article 7 shall be
regarded as divisible and shall be given the greatest operative effect possible.
If any part of them is declared invalid or unenforceable in any respect, the
validity and enforceability of the remainder shall not be affected. If the
Restricted Activity, Restricted Area and/or Restricted Period, as provided
herein, should be adjudged unreasonable in any judicial proceeding, then the
Restricted Activity, Restricted Area and/or Restricted Period shall be reduced
as is deemed necessary to allow this Article 7 to be enforced.

         7.6 REMEDIES. It is understood that in the event of any violation of
the covenants of this Article 7, the Company and/or the Facility shall suffer
irreparable injury not compensable by monetary damages and the Company, the
Facility and their Affiliates shall be entitled to seek preliminary and
permanent injunctive relief from any court of competent jurisdiction in addition
to any other remedies available under this Agreement or at law or in equity. The
Company, the Facility and/or the Affiliates shall be entitled to reasonable
attorney's fees and other costs it or they may incur in connection with
protecting their rights in the event of a breach as contemplated and provided
herein.

         7.7 BANKRUPTCY. The covenants and restrictions contained in this
Section 7 shall not be applicable upon a final declaration of bankruptcy of the
Company or the abandonment of the Facility by the Company which means the
intentional giving up of the Facility by the Company and not the termination of
operations or this Agreement as otherwise provided herein.

         7.8 INDEPENDENT COVENANT. The restrictive covenants, particularly the
covenant not to compete on the part of the P.A. and Physicians, shall be
construed as an agreement independent of any other provision of this Agreement,
and the existence of any claims or cause of action of the P.A. or Physician
against the Company or the Facility, whether based upon this Agreement or
otherwise, shall not constitute a defense to or a repeal or cancellation of the
enforcement by the Company, the Facility or the Affiliates of this covenant not
to compete.

8.       CONFIDENTIALITY

         8.1 CONFIDENTIAL INFORMATION. In the operation and development of
existing renal dialysis facilities and implementing Dialysis Treatments and
Services by the Company and its parent, Dialysis Corporation of America ("DCA")
and the planning and development of the Company's and DCA's proposed businesses,
the Company and DCA generate information and data which is and will be
proprietary and confidential ("Confidential Information"), the disclosure of
which would be extremely detrimental to the business of the Company and DCA and
of great assistance to its competitors. The Confidential Information includes,
but is not limited to:

                  (a) DEVELOPMENT. Data, plans and projections regarding the
location, development and expansion of existing and proposed facilities;

                  (b) MARKETING. Market surveys, studies and analyses;

                                       8
<PAGE>

                  (c) SERVICES. Information concerning the identities, locations
and qualifications of professionals and other persons presently, or
prospectively to be, retained or employed by the Company or DCA;

                  (d) SUPPLIERS, ETC. Information concerning the identities,
locations, prices, costs and other terms of dealings with referral and
reimbursement sources, suppliers, providers and supplier and provider
organizations and entities; administrative and accounting procedures and
policies and information about contractual and other arrangements and
affiliations with any of the foregoing;

                  (e) REGULATORY MATTERS. Information concerning legislative,
administrative, regulatory and zoning requirements, bodies and officials;

                  (f) RECORDS. Medical, patient and personnel records;

                  (g) DATA. Statistical, financial, cost and accounting data;

                  (h) PATIENTS. Existing and prospective patient lists, names
and addresses; and

                  (i) MANUALS. Administrative, accounting, operations and
procedures manuals.

         8.2 NON-DISCLOSURE. The P.A. and Medical Director understand and agree
that due to the highly competitive nature of the healthcare industry and the
business of the Facility, the Company and DCA, disclosure of any of the
Confidential Information would be extremely damaging to any and all of them. The
P.A. and Medical Director agree that its, he and/or she will not use or divulge
such Confidential Information without the prior written consent of the Company.
The restrictions set forth in this Article 8 shall not apply to any part of the
Confidential Information which (i) is or becomes generally available to the
public or publicly known other than as a result of disclosure by the P.A. or
Medical Director; (ii) becomes available to the P.A. or Medical Director on a
nonconfidential basis from a source which is not itself breaching any
non-disclosure or similar restrictive covenant; (iii) is disclosed pursuant to
the requirement of a governmental agency or court of competent jurisdiction or
as otherwise required under applicable law; or (iv) was known or available to
the P.A. or Medical Director prior to the date of this Agreement without any
obligation of confidentiality; provided as to this subparagraph (iv) such can be
proved through written evidence.

         8.3 REMEDIES. It is understood that any violation or breach of the
covenants and provisions of this Article 8 could cause the Company, the Facility
and/or DCA irreparable injury not compensable by monetary damages, and the
Company, the Facility and/or DCA and their Affiliates are entitled to such
injunctive relief and any and all other remedies as provided in Section 7.6 of
this Agreement.

9.       TERM

         9.1 TERM. The term of this Agreement shall commence on the Commencement
Date as provided in Section 9.2 and continue thereafter (unless sooner
terminated as provided for in this Agreement) for an initial term of ten (10)
years from such date ("Term").

                                       9
<PAGE>

         9.2 COMMENCEMENT DATE. The Term of this Agreement shall commence
("Commencement Date") on the effective date of certification of the Facility as
a Medicare-certified end-stage renal disease facility ("Certification"). If the
Certification does not occur on or before 12 months following the date of this
Agreement, then this Agreement shall be void and of no force and effect and
neither party shall have any right or obligation hereunder.

         9.3 RENEWAL. Provided the P.A. and the Medical Director have fulfilled
their obligations and responsibilities under this Agreement and have not
defaulted or breached under the terms and conditions of the Agreement, then this
Agreement is automatically renewed for five additional five year renewals
provided P.A. does not give the Company less than one (1) year written
notification prior to the end of the Term or any particular renewal period, of
its intent to terminate at the expiration of the Term or such renewal period.

10.      CONTRACTUAL RELATIONSHIP

         10.1 INDEPENDENT CONTRACTOR. The P.A. and any Medical Director shall,
at all times, be independent contractors and not employees of the Company or the
Facility, and the P.A. and any Medical Director shall not hold itself or the
Physicians out as employees of the Company or the Facility. In furtherance
thereof, the Company and Facility and P.A. covenant and agree that one is
neither the employee, employer, principal or agent of the other, except that
each of the P.A. and Medical Director is an independent contractor to the
Company and the Facility. However, it is understood that nothing in this section
or elsewhere in this Agreement shall be deemed not to subject the P.A. and
Medical Director to the supervision of the executive management or the board of
directors of the Company and the administrator of the Facility and to their
directions and control, except such Physicians and professional employees shall
have independent control over the medical practice, unless as to the latter, the
same is determined to be improper and violative of federal, state, local rules,
codes, or regulations, or such medical practices are otherwise unethical.

         P.A. and all other Physicians understand and agree that personnel
employed at the Facility are employees of the Company and are not to be
considered or viewed as employees or servants of P.A. No demands or requests
will be made or placed upon such employees for secretarial duties, patient
scheduling, etc., other than for Dialysis Treatment as to be provided by the
Facility.

         10.2 OBLIGATIONS. The P.A. and each Physician shall be liable for the
payment or provision for payment of all their required withholding, social
security and other taxes or benefits. It is further understood and agreed that
there is no obligation on behalf of the Company or the Facility to provide to
any Physician benefits such as but not limited to group health insurance, dental
benefits, life insurance, etc.

         10.3 WITHHOLDING. Neither the Company nor the Facility shall withhold,
on behalf of the P.A. or any Physician, any sums for income tax, unemployment
insurance, social security or any other withholding or benefit, all of which
shall be the respective obligations of the P.A. or any Physician.

         10.4 CONTROL. Nothing in the Agreement is intended, and shall not be
construed, to create an employer/employee relationship, a partnership or a joint
venture relationship. The interest of the Parties is to ensure that the Dialysis
Treatments of and the Services to be performed for the Facility by the P.A. and
the Physicians are rendered and performed in a

                                       10
<PAGE>

competent, efficient and satisfactory manner and in accordance with this
Agreement and all rules and regulations of the Facility.

         10.5 GOVERNMENTAL REVIEW. In the event the Internal Revenue Service or
any other governmental agency shall, at any time, question or challenge the
independent contractor relationship between the Company and the P.A. or the
Physicians, the Company, the P.A. and the Physician, upon receipt by either of
them of notice from the Internal Revenue Service or any other governmental
agency, shall promptly notify the other Parties and afford the other Parties the
opportunity to participate in any discussion or negotiation with the Internal
Revenue Service or other governmental agency, irrespective of whom or by whom
such discussions or negotiations are initiated. The other Parties shall
participate in any such discussions or negotiations to the extent permitted by
the Internal Revenue Service or other governmental agency. The provisions of
this Section 10.5 shall apply only to issues arising from the independent
contractor relationship described herein and not to any other tax matter
involving the Parties.

11.      TERMINATION

         11.1     TERMINATION WITHOUT FAULT

                  11.1.1 DEATH. This Agreement shall terminate upon the death of
the Medical Director unless within thirty (30) days of the death of Medical
Director, P.A. has appointed a substitute Medical Director, which is the
obligation of P.A., approved by the Company, and such substitute Medical
Director agrees to be bound by this Agreement and executes EXHIBIT 2.3.4.

                  11.1.2 DISABILITY. If the Medical Director becomes mentally or
physically unable to perform the Services required under this Agreement for a
continuous period of thirty (30) days, or if the P.A. or Medical Director is
professionally disqualified so that it, he or she cannot adequately perform its,
his or her duties and responsibilities as Medical Director, or is absent other
than for a short illness or vacation or similar reason, and the P.A. fails to
promptly appoint a substitute Medical Director, but no later than thirty (30)
days from such occurrence, which is the obligation of P.A., approved by the
Company, which substitute Medical Director agrees to be bound by this Agreement,
such shall be deemed a breach of this Agreement, other than due to failure to
perform based on mental or physical disability due to natural causes, which will
not be deemed a breach but rather a basis for termination, and the Company may
terminate this Agreement on thirty (30) days written notice. Any professional
disqualification of the P.A. or the Medical Director or non-short term absence
of the Medical Director hereby leaving the Facility without a qualified Medical
Director acceptable to the Company, except due to disability or incompetence due
to natural causes as opposed to conditions caused by the Medical Director, such
as but not limited to drug abuse or alcoholism, and any conduct or omission to
act by the P.A. or the Medical Director, that may be deemed unethical or subject
the P.A. or the Medical Director to discipline or to professional
disqualification by standards published from time to time by the Judicial
Council of the American Medical Association, whether or not disciplinary action
is taken, is a basis for the Company in its sole discretion to terminate the
Agreement and shall be deemed a breach of this Agreement.

         11.2 RIGHT TO TERMINATE UPON DEFAULT. Except as otherwise provided in
Section 11.1, a Party shall have the right as provided in this Section 11.2, to
terminate this Agreement at any time upon the occurrence of any of the following
events:

                                       11
<PAGE>

                  11.2.1 In the event the P.A. or any of its appointed
Physicians violates Sections 2.3.1, 2.3.3, 2.3.5, 7.2 or Article 8, the Company
may terminate this Agreement immediately; and

                  11.2.2 In the event a Party materially violates any other term
or condition of this Agreement which violation is not cured within thirty (30)
days after written notice to the breaching Party of such violation or if the
violation cannot reasonable be cured within such thirty (30) days, the breaching
party has not commenced within such thirty (30) days and thereafter diligently
pursued action reasonably necessary to cure such violation, the other Party may
terminate this Agreement.

         11.3 LOSS OF LICENSE; FORCE MAJEURE. Either Party may terminate this
Agreement if:

                  11.3.1 The license for the Facility or its certification to
participate in the ESRD program is lost or suspended for ninety (90) days or
longer not due to nor the fault of that Party seeking to terminate, after
exhaustion of all hearings and appeal rights; or

                  11.3.2 The Facility is not usable or reasonably relocatable
within one hundred twenty (120) days due to fire, natural disaster, change of
laws or Force Majeure or other cause beyond the Parties' control, and not due to
nor the fault of that Party seeking to terminate.

         11.4 CUMULATIVE REMEDIES. The specific remedies provided in this
Agreement shall be in addition to and not in substitution for the rights and
remedies which would otherwise be vested in the Parties under the Agreement, at
law or in equity, all of which rights and remedies are specifically reserved by
the Parties. Failure of a Party to exercise any remedy shall not constitute a
waiver of the Party's rights for that default nor of any further or future
default.

12.      GENERAL PROVISIONS

         12.1 ASSIGNMENT. The P.A. shall not assign, sell or transfer this
Agreement, its obligations hereunder or any interest herein. This Agreement may
be assigned in whole or in part by the Company.

         12.2 GOVERNING LAW. This Agreement shall be deemed to have been made
and shall be construed and interpreted in accordance with the laws of the State
of New Jersey, conflicts of law provisions notwithstanding.

         12.3 SEVERABILITY. If any term or provision of this Agreement or in the
application thereof to any person or circumstances shall to any extent be
invalid or unenforceable, the remainder of this Agreement on the application of
such term or provision to persons or circumstances other than those to which it
is held invalid or unenforceable shall not be affected thereby, and each term
and provision of the Agreement shall be valid and enforceable to the fullest
extent permitted by law.

         12.4 INTEGRATED AGREEMENT. This Agreement constitutes the entire
understanding and agreement between the Parties concerning the subject matter
hereof. This Agreement supersedes all prior written or oral agreements or
understanding existing between the Parties concerning the subject matter hereof.

         12.5 CAPTIONS. Captions contained in this Agreement are inserted only
as a matter of convenience and in no way define, limit, or extend the scope or
intent of this Agreement or any provision hereof.

                                       12
<PAGE>

         12.6 GENDER. Any noun or pronoun used in this Agreement shall be
construed in masculine, feminine or neuter as its sense and use may require.

         12.7 WAIVERS AND AMENDMENTS. No waiver of any term, provision, or
condition of this Agreement, whether by conduct or otherwise in any one or more
instances, shall be deemed to be or construed as a further and continuing waiver
of any such term, provision or condition of this Agreement. No amendment to any
provision of this Agreement shall be effective unless in writing and signed by
each Party.

         12.8 NOTICES. All notices pursuant to this Agreement shall be in
writing and shall be given by hand delivery or by depositing said notices in the
United States registered or certified mails, return receipt requested, addressed
to a party at the addresses as provided in attached EXHIBIT 12.8, or to such
other address as may hereafter be specified in writing by one Party notifying
all other Parties in the manner set forth herein. All notices given in the
manner prescribed in this Section shall be deemed properly served upon receipt.

         12.9 ACCESS TO BOOKS AND RECORDS. This Section is included herein
because of the possible application of Section 1861 (v) (1) (I) of the Social
Security Act to this Agreement; if that section should not be found applicable
to this Agreement under the terms of such section then this Section shall be
deemed not to be a part of this Agreement and shall be null and void.

                  12.9.1 P.A. Until the expiration of four (4) years after the
furnishing of Services pursuant to this Agreement, the P.A. shall make available
upon written request of the Secretary of Health and Human Services or the United
States Controller General or any of their duly authorized representatives, this
Agreement, and any books, documents and records of the P.A. that are necessary
to certify the nature and extent of costs incurred by the Company under this
Agreement.

                  12.9.2 SUBCONTRACTORS. If the P.A. carries out any of the
duties of this Agreement with a value of Ten Thousand Dollars ($10,000) or more
over a twelve (12) month period through a subcontract with a related
organization or person, such subcontract must be approved by the Company and
must contain a clause similar to that set forth in Section 12.9.1 above.

         12.10 NO DISCRIMINATION. Each Party agrees that, in the performance of
this Agreement, services will be provided without discrimination toward any
patients, employees, or other persons regardless of their race, creed, color or
ethnic background. Both the Company and P.A. are equal opportunity employers.
All Parties shall comply with all requirements and provisions of the Civil
Rights Act of 1964, 42 U.S.C.A. Section 2000 ET SEQ. and other applicable
federal and state law.

         12.11 RECOVERY OF LITIGATION COSTS. Subject to Articles 7 and 8 of this
Agreement, if any legal action or other proceeding is brought for the
enforcement of this Agreement, or because of an alleged dispute, breach,
default, or misrepresentation in connection with any of the provisions of this
Agreement, the successful or prevailing party or parties shall be entitled to
recover reasonable attorneys fees and other costs incurred in that action or
proceeding, in addition to any other relief to which it or they may be entitled.

                                       13
<PAGE>

         12.12 CONFIDENTIALITY. This Agreement and its terms and provisions
shall be kept confidential and shall not be disclosed to any other party, nor
shall this Agreement or any part thereof be reproduced or summarized, except to
the extent as required by law.

         12.13 BINDING AGREEMENT. All of the terms and provisions of this
Agreement shall be binding upon, inure to the benefit of and be enforceable by
each of the Parties hereto, their respective legal representatives and their
permitted successors and assigns.

         IN WITNESS WHEREOF the Parties hereto have executed this Agreement as
of the day and year first above written.

VINELAND DIALYSIS PROFESSIONALS, LLC

By:  /s/ DAVID BLECKER, M.D.
     -----------------------------------------
     Name:  DAVID BLECKER, M.D.
     Title: President

DCA OF VINELAND, LLC

By:  /s/ DIALYSIS CORPORATION OF AMERICA
     -----------------------------------------
     Member: DIALYSIS CORPORATION OF AMERICA
     Name:  BART PELSTRING
     Title: President

                                       14
<PAGE>

                                  EXHIBIT 2.3.1

                     LITIGATION AND PROFESSIONAL DISCIPLINE

                                       15
<PAGE>

                                  EXHIBIT 2.3.4

                                MEDICAL DIRECTOR

I, David Blecker, M.D., Medical Director

         of DCA of Vineland, LLC
================================================================================

In order to induce the Company to execute this Agreement, to appoint the
undersigned as Medical Director and to permit the undersigned to assist in
providing Dialysis Treatments and Services; in consideration of the amounts to
be paid as provided in this Agreement to P.A.; and intending to be legally bound
hereby, the undersigned agrees to be bound personally by the Agreement,
including the restrictions set forth in Article 7 of this Agreement.

Date:---------------------, 1999                     /s/ DAVID BLECKER
                                            -----------------------------------
                                                     DAVID BLECKER, M.D.

ACKNOWLEDGED and AGREED
this 13 day of SEPT., 1999

/s/ STEPHEN W. EVERETT
------------------------------

By:
    --------------------------

                                       16
<PAGE>

                                   EXHIBIT 4.1

                                  COMPENSATION

         For P.A.'s services under this Medical Director Agreement, the Company
will pay the P.A. Thirty Five Thousand and 00/100 ($35,000.00) Dollars per
Agreement Year; or Two Thousand Nine Hundred Sixteen and 67/100 ($2,916.67)
Dollars per month.

         The P.A.'s Compensation shall be renegotiated in good faith on or about
the end of each Agreement Year and shall be competitive with the national
standard in the industry. Failure to reach an acceptable renegotiated
Compensation shall not be deemed a breach of nor a basis for termination of this
Medical Director Agreement.

                                       17
<PAGE>

                                  EXHIBIT 7.1.2

                       EXCLUSIONS FROM RESTRICTED ACTIVITY

1.      David Blecker, M.D., as Medical Director of the dialysis unit ("Unit")
at Kessler Memorial Hospital ("KMH").

2.      Should KMH offer to P.A., Dr. Blecker or any of their Affiliates
(collectively "P.A.") all or a percent of its Unit, P.A. shall be entitled to
purchase such interest in the Unit, provided P.A. uses its best efforts to
obtain for Dialysis Corporation of America, the parent of the Company ("DCA") an
equal percentage ownership interest in the KMH Unit as may be offered to the
P.A. If DCA declines any such interest or KMH declines to sell any ownership
interest in the Unit to DCA, then P.A. is entitled to acquire the entire
ownership interest in the Unit as offered.

                                       18
<PAGE>

                                  EXHIBIT 7.1.3

Facilities Excluded From Restricted Area:

                                See Exhibit 7.1.2

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