<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2020v4.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-11-11T07:45:40-06:00</ReturnTs>
    <TaxPeriodEndDt>2020-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>390859910</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>BAKER TILLY US LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>20 STANWIX STREET</AddressLine1Txt>
        <CityNm>PITTSBURGH</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>15222</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>232771024</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SENIOR CHOICE INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SENI</BusinessNameControlTxt>
      <PhoneNum>7244631010</PhoneNum>
      <USAddress>
        <AddressLine1Txt>942 PHILADELPHIA STREET</AddressLine1Txt>
        <CityNm>INDIANA</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>15701</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DENISE MCQUOWN-HATTER</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>7244631010</PhoneNum>
      <SignatureDt>2021-11-05</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>DENISE</PersonFirstNm>
        <PersonLastNm>MCQUOWN-HATTER</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRIAN R LENART EA</PreparerPersonNm>
      <PTIN>P00289136</PTIN>
      <PhoneNum>4126976400</PhoneNum>
      <PreparationDt>2021-11-05</PreparationDt>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>DENISE MCQUOWN-HATTER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>942 PHILADELPHIA STREET</AddressLine1Txt>
        <CityNm>INDIANA</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>15701</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>21035911</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>AFFINITYHEALTHSERVICES.NET</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1994</FormationYr>
      <LegalDomicileStateCd>PA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROVIDE PERSONAL AND SKILLED NURSING CARE IN THREE FACILITIES LOCATED IN THE STATE OF PA.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>5</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>5</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>422</TotalEmployeeCnt>
      <TotalVolunteersCnt>35</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>5560</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1916726</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>19036315</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>17468074</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>291996</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>104842</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>1440278</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>1546269</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>20774149</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>21035911</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>10719806</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>10649085</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11396753</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>12054792</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>22116559</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>22703877</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-1342410</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1667966</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>14740057</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>14770289</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>20097067</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>21519995</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>-5357010</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-6749706</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE CORPORATION PROVIDES PERSONAL AND SKILLED NURSING CARE IN THREE FACILITIES LOCATED IN THE STATE OF PENNSYLVANIA.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>20257377</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>19007201</RevenueAmt>
      <Desc>THE CORPORATION PROVIDES PERSONAL AND SKILLED NURSING CARE IN THREE FACILITIES LOCATED IN THE STATE OF PENNSYLVANIA. THE CORPORATION PROVIDED 60,178 DAYS OF SKILLED NURSING CARE AND 35,656 DAYS OF PERSONAL CARE DURING 2020.</Desc>
      <TotalProgramServiceExpensesAmt>20257377</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">1</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>1</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>14</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>422</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>5</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>5</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>PA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>AFFINITY HEALTH SERVICES INC</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>7244631010</PhoneNum>
        <USAddress>
          <AddressLine1Txt>942 PHILADELPHIA STREET</AddressLine1Txt>
          <CityNm>INDIANA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15701</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>EILEEN GRAHAM</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JODIE BABICH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC T LAWLOR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CRAIG SAYLOR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER AURANDT</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENISE MCQUOWN-HATTER</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CULINARY SERVICES GROUP LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1135 BUSINESS PARKWAY SOUTH</AddressLine1Txt>
            <CityNm>WESTMINSTER</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21157</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DIETARY</ServicesDesc>
        <CompensationAmt>1629175</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FUNCTIONAL PATHWAYS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10133 SHERRIL BLVD SUITE 200</AddressLine1Txt>
            <CityNm>KNOXVILLE</CityNm>
            <StateAbbreviationCd>TN</StateAbbreviationCd>
            <ZIPCd>37932</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY</ServicesDesc>
        <CompensationAmt>998825</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTHCARE SERVICES GROUP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3220 TILLMAN DRIVE SUITE 300</AddressLine1Txt>
            <CityNm>BENSALEM</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19020</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HOUSEKEEPING &amp; LAUNDRY</ServicesDesc>
        <CompensationAmt>830441</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AFFINITY HEALTH SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>942 PHILADELPHIA STREET</AddressLine1Txt>
            <CityNm>INDIANA</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGEMENT</ServicesDesc>
        <CompensationAmt>719264</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DIAMOND DRUGS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>645 KOLTER DRIVE</AddressLine1Txt>
            <CityNm>INDIANA</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHARMACY SUPPLIES</ServicesDesc>
        <CompensationAmt>360034</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>11</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>1890580</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>26146</AllOtherContributionsAmt>
      <TotalContributionsAmt>1916726</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PROGRAM SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>17468074</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17468074</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>17468074</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>68237</TotalRevenueColumnAmt>
        <ExclusionAmt>68237</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>36605</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>36605</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>36605</TotalRevenueColumnAmt>
        <ExclusionAmt>36605</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>NURSING HOME ASSESSMENT</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>1539127</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1539127</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>7142</TotalRevenueColumnAmt>
        <ExclusionAmt>7142</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>1546269</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>21035911</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>19007201</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>111984</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>8739868</TotalAmt>
        <ProgramServicesAmt>8256174</ProgramServicesAmt>
        <ManagementAndGeneralAmt>483694</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1170389</TotalAmt>
        <ProgramServicesAmt>1124960</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45429</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>738828</TotalAmt>
        <ProgramServicesAmt>695872</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42956</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>393652</TotalAmt>
        <ManagementAndGeneralAmt>393652</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>16728</TotalAmt>
        <ManagementAndGeneralAmt>16728</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3302488</TotalAmt>
        <ProgramServicesAmt>3085197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>217291</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>20302</TotalAmt>
        <ManagementAndGeneralAmt>20302</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>260537</TotalAmt>
        <ProgramServicesAmt>144145</ProgramServicesAmt>
        <ManagementAndGeneralAmt>116392</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>43058</TotalAmt>
        <ManagementAndGeneralAmt>43058</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>494968</TotalAmt>
        <ProgramServicesAmt>494968</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>8639</TotalAmt>
        <ProgramServicesAmt>4848</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3791</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>38642</TotalAmt>
        <ProgramServicesAmt>22387</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16255</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>816480</TotalAmt>
        <ProgramServicesAmt>816480</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1047379</TotalAmt>
        <ProgramServicesAmt>1047379</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>316230</TotalAmt>
        <ManagementAndGeneralAmt>316230</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>NURSING SUPPLIES</Desc>
        <TotalAmt>1291951</TotalAmt>
        <ProgramServicesAmt>1291951</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>NURSING HOME ASSESSMENT</Desc>
        <TotalAmt>1124754</TotalAmt>
        <ProgramServicesAmt>1124754</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RAW FOOD</Desc>
        <TotalAmt>793721</TotalAmt>
        <ProgramServicesAmt>793721</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
        <TotalAmt>463748</TotalAmt>
        <ProgramServicesAmt>463748</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1621515</TotalAmt>
        <ProgramServicesAmt>890793</ProgramServicesAmt>
        <ManagementAndGeneralAmt>730722</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>22703877</TotalAmt>
        <ProgramServicesAmt>20257377</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2446500</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2287</BOYAmt>
        <EOYAmt>2030</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>517648</BOYAmt>
        <EOYAmt>2187234</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2822977</BOYAmt>
        <EOYAmt>1808285</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>148905</BOYAmt>
        <EOYAmt>148948</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>24828777</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>19068953</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>6422736</BOYAmt>
        <EOYAmt>5759824</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>4242462</BOYAmt>
        <EOYAmt>4331507</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>583042</BOYAmt>
        <EOYAmt>532461</EOYAmt>
      </IntangibleAssetsGrp>
      <TotalAssetsGrp>
        <BOYAmt>14740057</BOYAmt>
        <EOYAmt>14770289</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2390313</BOYAmt>
        <EOYAmt>2290669</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>97493</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>17493916</BOYAmt>
        <EOYAmt>16990280</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>83184</BOYAmt>
        <EOYAmt>97378</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>32161</BOYAmt>
        <EOYAmt>2141668</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>20097067</BOYAmt>
        <EOYAmt>21519995</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>-5357010</BOYAmt>
        <EOYAmt>-6749706</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-5357010</BOYAmt>
        <EOYAmt>-6749706</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>14740057</BOYAmt>
        <EOYAmt>14770289</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1667966</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>275270</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1490</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>697</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5560</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1916726</CurrentTaxYearAmt>
        <TotalAmt>1924473</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>20216313</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19944482</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>19529534</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>19036315</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17468074</CurrentTaxYearAmt>
        <TotalAmt>96194718</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>20217803</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19945179</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>19529534</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>19041875</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>19384800</CurrentTaxYearAmt>
        <TotalAmt>98119191</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>98119191</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>98367</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>95147</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>99538</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91833</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>68237</CurrentTaxYearAmt>
        <TotalAmt>453122</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>98367</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>95147</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>99538</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91833</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>68237</CurrentTaxYearAmt>
        <TotalAmt>453122</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1403088</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1367830</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1433034</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1440278</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1546269</CurrentTaxYearAmt>
        <TotalAmt>7190499</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>21719258</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>21408156</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21062106</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>20573986</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>20999306</CurrentTaxYearAmt>
        <TotalAmt>105762812</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.92770</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.93040</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00430</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00450</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>494000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>494000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>17703114</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>13872321</DepreciationAmt>
        <BookValueAmt>3830793</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6311608</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4945833</DepreciationAmt>
        <BookValueAmt>1365775</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>320055</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>250799</DepreciationAmt>
        <BookValueAmt>69256</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>5759824</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>VEHICLE LOAN</Desc>
        <Amt>21649</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PPP LOAN</Desc>
        <Amt>2021500</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>CAPITAL LEASE</Desc>
        <Amt>98519</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>2141668</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>21309181</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>275270</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>275270</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>21033911</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>2000</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>2000</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>21035911</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>22701877</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>22701877</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>2000</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>2000</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>22703877</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS THE CUSTODIAN FOR RESIDENT TRUST FUNDS FOR SOME OF THE FACILITIES' RESIDENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CAMBRIA COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>251334277</BondIssuerEIN>
        <CUSIPNum>132047BX8</CUSIPNum>
        <BondIssuedDt>2006-07-01</BondIssuedDt>
        <IssuePriceAmt>22455000</IssuePriceAmt>
        <PurposeDesc>EXCHANGE OF 1996 BONDS</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>22455000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>132480</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>22455000</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2006</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>DENISE MCQUOWN-HATTER</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>PRESIDENT OF AFFINITY HEALTH SERVICES, INC.</RelationshipDescriptionTxt>
        <TransactionAmt>719264</TransactionAmt>
        <TransactionDesc>MANAGEMENT FEES &amp; CONSULTING SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS MANAGED BY AFFINITY HEALTH SERVICES, INC., WHICH PROVIDES EXECUTIVE, FINANCIAL AND GENERAL OVERSIGHT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S PROCESS TO REVIEW FORM 990 CONSISTENTS OF COPIES OF FORM 990 BEING PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS AND HIGH LEVEL POSITIONS SIGN AND UPDATE CONFLICT OF INTEREST FORMS ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,700,150. MANAGEMENT AND GENERAL EXPENSES 181,049. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,881,199. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 278,715. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 278,715. CONSULTANTS: PROGRAM SERVICE EXPENSES 90,315. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,315. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 16,017. MANAGEMENT AND GENERAL EXPENSES 36,242. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,259.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
