EXHIBIT 10.9 AMENDMENT TO TERMS OF EMPLOYMENT AGREEMENT THIS AMENDMENT, is made the 1st day of September 1998, by and between TOTAL RENAL CARE HOLDINGS, INC., a Delaware Corporation ("Company"), and STANLEY M. LINDENFELD, M.D. ("Employee")....

 
                                                                    EXHIBIT 10.9
 
                                  AMENDMENT TO
                         TERMS OF EMPLOYMENT AGREEMENT
 
  THIS AMENDMENT, is made the 1st day of September 1998, by and between TOTAL
RENAL CARE HOLDINGS, INC., a Delaware Corporation ("Company"), and XXXXXXX X.
XXXXXXXXXX, M.D. ("Employee").
 
                                  WITNESSETH:
 
  WHEREAS, Parties entered into a Employment Agreement effective as of March 2,
1998, ("Agreement"); and
 
  WHEREAS, parties desire to amend the Agreement.
 
  NOW, THEREFORE, in consideration of the foregoing premises and for other good
and valuable consideration, receipt and sufficiency of which is hereby
acknowledged, the parties hereto agree as follows:
 
    1. Title. Section 1 is deleted in its entirety and replaced with the
  following new Section 1:
 
    Employment and Duties. The Company shall employ Executive, and Executive
  accepts such employment, for the Term set forth in Section 3 hereof on the
  terms and conditions set forth in this Agreement. During the Term,
  Executive shall serve as Vice President, Quality Management and Chief
  Medical Officer of the Company and shall perform the duties of such office,
  as well as such other duties as may be assigned to Executive from time to
  time during the Term by the Chief Executive Officer of the Company or his
  designee. Executive shall devote Executive's best efforts and skills to the
  business and interests of the Company on a full-time basis. For the
  purposes hereof, full time shall mean ninety percent (90%) of Executive's
  time. Executive shall not engage in any other business activity during the
  Term to the extent that such activities adversely affect the performance of
  Executive's responsibilities to the Company hereunder. Executive shall at
  all times observe and abide by the Company's policies and procedures as in
  effect from time to time.
 
    2. No Conflicts. In the event of a conflict between the terms of the
  Agreement and the Amendment, the terms of this Amendment shall control.
 
  IN WITNESS WHEREOF, the parties hereto have executed this Amendment effective
as of the date first above written.
 
TOTAL RENAL CARE HOLDINGS, INC.           EMPLOYEE
 
 
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By: Xxxxx X. Xxxxxxxx                     Xxxxxxx X. Xxxxxxxxxx, M.D.
Its: Vice President, General Counsel