﻿<?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="2024v5.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-17T07:06:17-06:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>872525370</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CITRIN COOPERMAN ADVISORS LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>28601 CHAGRIN BLVD SUITE 210</AddressLine1Txt>
        <CityNm>WOODMERE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>44122</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>340726068</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>WEST SIDE DEUTSCHER FRAUEN VEREIN</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>WEST</BusinessNameControlTxt>
      <PhoneNum>4402383361</PhoneNum>
      <USAddress>
        <AddressLine1Txt>18627 SHURMER ROAD</AddressLine1Txt>
        <CityNm>STRONGSVILLE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>441366150</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>PAUL PSOTA</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>4402383361</PhoneNum>
      <SignatureDt>2025-11-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>DAVID REAPE</PreparerPersonNm>
      <PTIN>P00068117</PTIN>
      <PhoneNum>2168311200</PhoneNum>
      <PreparationDt>2025-11-14</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>PAUL PSOTA</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>18627 SHURMER ROAD</AddressLine1Txt>
        <CityNm>STRONGSVILLE</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>441366150</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>24187485</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.ALTENHEIM.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1887</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>OPERATE A NURSING HOME, RESIDENTIAL CARE FACILITY IN A MANNER DESIGNED TO SATISFY THE PRIMARY NEEDS OF AGED PERSONS INCLUDING HOUSING, HEALTH CARE AND FINANCIAL SECURITY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>15</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>509</TotalEmployeeCnt>
      <TotalVolunteersCnt>75</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>318060</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>20060</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>23517748</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>23578504</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>125814</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>183744</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>43895</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>7796</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>24005517</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>23790104</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>13323280</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>13837063</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>9264782</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>8740921</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>22588062</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>22577984</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1417455</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>1212120</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>56143246</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>57021874</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3147762</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2764926</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>52995484</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>54256948</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO ACHIEVE THE OPTIMAL LEVEL OF MENTAL, PHYSICAL, AND SPIRITUAL WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITY BEING SERVED THROUGH THE PROVISION OF HIGH QUALITY RESIDENTIAL LIVING, SKILLEDNURSING CARE, AND SPECIALIZED SERVICES OFFERED IN A FAMILY-LIKE ATMOSPHERE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>12936002</ExpenseAmt>
      <RevenueAmt>16075509</RevenueAmt>
      <Desc>PROVIDED NURSING CARE TO AGED PATIENTS &amp; OTHERS WHO REQUIRE SUCHSERVICES. 42,530 DAYS OF NURSING WERE PROVIDED IN 2024.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>7537465</ExpenseAmt>
        <RevenueAmt>7510791</RevenueAmt>
        <Desc>PROVIDED RESIDENTIAL CARE TO AGED PATIENTS &amp; OTHERS WHO REQUIRESUCH SERVICES.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>20473467</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</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">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</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 referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>50</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>509</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>1</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>1</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>15</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</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>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>OH</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>PAUL PSOTA CEO</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>4402383361</PhoneNum>
        <USAddress>
          <AddressLine1Txt>18627 SHURMER ROAD</AddressLine1Txt>
          <CityNm>STRONGSVILLE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>441366150</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN KEDZIOR</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.40</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID KNOWLES</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVE SARTSCHEV</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>0.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NORBERT MANZ</PersonNm>
        <TitleTxt>2ND VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANNA WARD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARRY ZIMMERMAN</PersonNm>
        <TitleTxt>1ST VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.30</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ED OLIVEROS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.30</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KARL HELFRICH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TAMMY HASELEY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUE RIEDTHALER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JIM KAMINSKI</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.30</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RENATE ELBER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBBIE BRASSEL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REINER MUELLER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY WIEMKEN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL PSOTA</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>30.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>247492</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34261</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELODIE ROACH</PersonNm>
        <TitleTxt>ADMINISTRATOR THROUGH NOVE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>110214</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>88</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELLE KENNEDY</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>126333</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5103</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT SOINGER</PersonNm>
        <TitleTxt>DIRECTOR OF FACILITIES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>105506</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10588</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>589545</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>50040</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>4</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AUGERE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>115 EXECUTIVE PKWY 200</AddressLine1Txt>
            <CityNm>HUDSON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44236</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>1765429</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RENEWAL REHAB DBA BLUE SKY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 75563</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606755563</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY SERVICES</ServicesDesc>
        <CompensationAmt>1221200</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INTELYCARE INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 787317</AddressLine1Txt>
            <CityNm>PHILADELPHIA</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>191787317</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT LABOR</ServicesDesc>
        <CompensationAmt>1090224</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRECISION MECHANICAL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5441 STATE TD</AddressLine1Txt>
            <CityNm>PARMA</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44134</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MECHANICAL CONTRACTOR</ServicesDesc>
        <CompensationAmt>141118</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HW&amp;CO</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>28601 CHAGRIN BLVD SUITE 210</AddressLine1Txt>
            <CityNm>WOODMERE</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44122</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ACCOUNTING SERVICES</ServicesDesc>
        <CompensationAmt>129922</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>20060</GovernmentGrantsAmt>
      <TotalContributionsAmt>20060</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NURSING CARE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>16070196</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16070196</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RESIDENTIAL CARE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>7508308</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7508308</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>23578504</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>188164</TotalRevenueColumnAmt>
        <ExclusionAmt>188164</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>392961</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>397381</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-4420</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-4420</TotalRevenueColumnAmt>
        <ExclusionAmt>-4420</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>HANDS ON LEASE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>6285</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6285</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1511</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1511</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>7796</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>23790104</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>23586300</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>183744</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>639586</TotalAmt>
        <ManagementAndGeneralAmt>639586</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>10757970</TotalAmt>
        <ProgramServicesAmt>10267318</ProgramServicesAmt>
        <ManagementAndGeneralAmt>490652</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>154218</TotalAmt>
        <ProgramServicesAmt>126422</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27796</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1315795</TotalAmt>
        <ProgramServicesAmt>1151690</ProgramServicesAmt>
        <ManagementAndGeneralAmt>164105</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>969494</TotalAmt>
        <ProgramServicesAmt>840608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>128886</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>103869</TotalAmt>
        <ProgramServicesAmt>103869</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>23325</TotalAmt>
        <ProgramServicesAmt>23325</ProgramServicesAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>903721</TotalAmt>
        <ProgramServicesAmt>903721</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>95128</TotalAmt>
        <ProgramServicesAmt>58142</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36986</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>229431</TotalAmt>
        <ProgramServicesAmt>229431</ProgramServicesAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>832536</TotalAmt>
        <ProgramServicesAmt>830422</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2114</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>53180</TotalAmt>
        <ProgramServicesAmt>53180</ProgramServicesAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>211001</TotalAmt>
        <ProgramServicesAmt>208043</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2958</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>348432</TotalAmt>
        <ProgramServicesAmt>348432</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SERVICES</Desc>
        <TotalAmt>2075872</TotalAmt>
        <ProgramServicesAmt>1775755</ProgramServicesAmt>
        <ManagementAndGeneralAmt>300117</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER EXPENSES</Desc>
        <TotalAmt>1453469</TotalAmt>
        <ProgramServicesAmt>1453469</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD &amp; SUPPLY</Desc>
        <TotalAmt>1021252</TotalAmt>
        <ProgramServicesAmt>1021252</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FRANCHISE PERMIT FEE</Desc>
        <TotalAmt>728023</TotalAmt>
        <ProgramServicesAmt>728023</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>661682</TotalAmt>
        <ProgramServicesAmt>350365</ProgramServicesAmt>
        <ManagementAndGeneralAmt>311317</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>22577984</TotalAmt>
        <ProgramServicesAmt>20473467</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2104517</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2876415</BOYAmt>
        <EOYAmt>1231710</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <EOYAmt>61531</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1617676</BOYAmt>
        <EOYAmt>752735</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>48832</BOYAmt>
        <EOYAmt>50062</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>71770</BOYAmt>
        <EOYAmt>98202</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>6332127</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4250546</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1578160</BOYAmt>
        <EOYAmt>2081581</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>6123283</BOYAmt>
        <EOYAmt>6561403</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>546128</BOYAmt>
        <EOYAmt>541862</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>43280982</BOYAmt>
        <EOYAmt>45642788</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>56143246</BOYAmt>
        <EOYAmt>57021874</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2809931</BOYAmt>
        <EOYAmt>2391504</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>4767</BOYAmt>
        <EOYAmt>10358</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>333064</BOYAmt>
        <EOYAmt>363064</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3147762</BOYAmt>
        <EOYAmt>2764926</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>51874056</BOYAmt>
        <EOYAmt>53143725</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1121428</BOYAmt>
        <EOYAmt>1113223</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>52995484</BOYAmt>
        <EOYAmt>54256948</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>56143246</BOYAmt>
        <EOYAmt>57021874</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1212120</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>49344</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>2742168</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4410620</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>295713</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>644782</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>20060</CurrentTaxYearAmt>
        <TotalAmt>8113343</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>24949628</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19744971</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21623760</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>23517748</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>23578504</CurrentTaxYearAmt>
        <TotalAmt>113414611</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>27691796</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>24155591</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21919473</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24162530</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>23598564</CurrentTaxYearAmt>
        <TotalAmt>121527954</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>121527954</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>11289</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>72090</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>203318</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>190234</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>188164</CurrentTaxYearAmt>
        <TotalAmt>665095</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>11289</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>72090</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>203318</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>190234</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>188164</CurrentTaxYearAmt>
        <TotalAmt>665095</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>813095</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>33085</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16241</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>43895</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7796</CurrentTaxYearAmt>
        <TotalAmt>914112</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>28516180</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>24260766</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22139032</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24396659</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>23794524</CurrentTaxYearAmt>
        <TotalAmt>123107161</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98720</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98740</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00540</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00380</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS INCOME - 2020 AMOUNT: $ 2,746. 2021 AMOUNT: $ 33,085. 2022 AMOUNT: $ 16,241. 2023 AMOUNT: $ 9,327. 2024 AMOUNT: $ 1,511. WORKERS COMP REFUND - 2020 AMOUNT: $ 809,449. INSURANCE PROCEEDS - 2020 AMOUNT: $ 900. HANDS ON LEASE - 2023 AMOUNT: $ 34,568. 2024 AMOUNT: $ 6,285.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6332127</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4250546</DepreciationAmt>
        <BookValueAmt>2081581</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>2081581</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>RELATED PARTY RECEIVABLE</Desc>
        <BookValueAmt>45642788</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>45642788</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEPOSITS</Desc>
        <Amt>363064</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>363064</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAID RESIDENTS CAN REQUEST, AND IN CERTAIN CASES, WEST SIDE DEUTSCHER FRAUEN VEREIN IS REQUIRED TO MAINTAIN THEIR PERSONAL FUNDS IN A CUSTODIAN ACCOUNT. THESE CUSTODIAL ACCOUNTS ARE ACCOUNTED FOR SEPARATELY AND ARE MAINTAINED BY THE NURSING FACILITY ON THE RESIDENTS BEHALF. THE CUSTODIAL ACCOUNTS ARE LISTED ON THE BALANCE SHEET OF FORM 990, PART X, LINE 21 AS CUSTODIAL ACCOUNT LIABILITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL PSOTA</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>228884</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13608</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10332</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23929</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>281753</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REIMBURSES CEO FOR DISABILITY INSURANCE PREMIUM AS W-2 WAGES AND GROSSES UP THE WAGE PAYMENT TO INCLUDE TAXES. THE ORGANIZATION PAYS THE DUES FOR THE CEO TO BE A MEMBER OF THE LOCAL ROTARY CLUB BECAUSE OF THE BUSINESS CONTACTS GENERATED THEREFROM.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER CLASSES THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS. THE BOARD OF DIRECTORS, IN ITS DISCRETION MAY, FROM TIME TO TIME, DETERMINE THE QUALIFICATION OF THE MEMBERS IN ACCORDANCE WITH THE CODE OF REGULATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS WHO MAY ELECT MEMBERS THE ORGANIZATION HAS ONE CLASS OF VOTING MEMBERS. THEY HAVE THE RIGHT TO VOTE TO ELECT THE GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING BODY DECISION APPROVAL THE VOTING MEMBERS HAVE APPROVAL RIGHTS OVER ANY AMENDMENT MADE TO THE ORGANIZATION'S GOVERNING DOCUMENTS AND CHANGING OF THE INDEPENDENT AUDITOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO REVIEW AND COMMENT ON THE FORM 990 PRIOR TO FILING</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY THE BOARD DISCUSSES THE MATTER WHEN A POTENTIAL CONFLICT ARISES. THE INDIVIDUAL WITH THE CONFLICT IS NOT PERMITTED TO PARTICIPATE IN THE DISCUSSION OR APPROVAL OF THE TRANSACTION. THE DECISION OF ENGAGING IN THE TRANSACTION IS MADE BY BOARD MEMBERS WHO ARE INDEPENDENT OF THE INDIVIDUAL WITH THE CONFLICT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR DETERMINING COMPENSATION THE EXECUTIVE COMMITTEE OF THE ALTENHEIM BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE CEO'S PERFORMANCE AND COMPENSATION. A PART OF THE EXECUTIVE COMMITTEE'S PROCESS IS THE REVIEW OF INDUSTRY SALARY AND BENEFITS BENCHMARKING REPORTS FOR THE CEO POSITION. THE EXECUTIVE COMMITTEE THEN ESTABLISHES THE CEO'S COMPENSATION. THE CEO CONDUCTS AN ANNUAL PERFORMANCE AND COMPENSATION REVIEW OF OTHER ALTENHEIM EMPLOYEES AND SETS THEIR COMPENSATION WITH THE ADVICE AND COUNSEL OF THE BOARD'S EXECUTIVE COMMITTEE. ALL COMPENSATION DECISIONS ARE DOCUMENTED CONTEMPORANEOUSLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS AVAILABLE TO PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST AFTER THE APPROVAL OF THE GOVERNING MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALTENHEIM PROPERTIES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18627 SHURMER ROAD</AddressLine1Txt>
          <CityNm>STRONGSVILLE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44136</ZIPCd>
        </USAddress>
        <EIN>341968851</EIN>
        <PrimaryActivitiesTxt>PROPERTY MGMT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WSDFV</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE ALTENHEIM FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18627 SHURMER ROAD</AddressLine1Txt>
          <CityNm>STRONGSVILLE</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44136</ZIPCd>
        </USAddress>
        <EIN>341647102</EIN>
        <PrimaryActivitiesTxt>SUPPORT SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WSDFV</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ALTENHEIM PROPERTIES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>18744073</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THE ALTENHEIM FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>18744073</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>