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      <Desc>Luthercare provides long term care and short-term rehabilitation along with occupational, speech and physical therapy in our health care centers located in Lititz and Lebanon, Pennsylvania. Memory support services are provided in a specialized care unit. An innovative approach and philosophy is embraced, with a focus on the overall wellness of the individual - physical, psychological and spiritual. Strong support is provided by volunteers, 697 individuals in 2016 who donated 24,620 hours, extending compassion and caring beyond the limitations of staff capacity. In 2016 Luthercare provided skilled nursing care services for 714 older adults, for a total of 73,788 census days and an average 95.55% occupancy rate.</Desc>
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        <Desc>LUTHERCARE'S SENIOR LIVING COMMUNITIES OFFER AN INDEPENDENT LIVING EXPERIENCE TO OLDER ADULTS, ENRICHED WITH OPPORTUNITIES TO ENGAGE IN MANY SOCIAL AND LEARNING ACTIVITIES ON AND OF CAMPUS. EXTENSIVE RENOVATIONS HAVE TAKEN PLACE AT BOTH LUTHERCARE INDEPENDENT LIVING CAMPUSES OVER THE PAST SEVERAL YEARS WHICH HAVE TRANSFORMED THE RESIDENT EXPERIENCE. 675 OLDER ADULTS WERE PART OF THE INDEPENDENT LIVING PROGRAM IN 2016, FOR A TOTAL OF 166,024 CENSUS DAYS AND AN AVERAGE OF 95.70% OCCUPANCY RATE. IN ADDITION, VALUABLE SUPPORT IS OFFERED THROUGH OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY, AND PERSONAL CARE SERVICES INCLUDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND SPECIALIZED MEMORY SUPPORT IS ALSO OFFERED. PERSONAL CARE WAS PROVIDED TO 185 INDIVIDUALS IN 2016, FOR 42,643 CENSUS DAYS AND AN AVERAGE 92.47% OCCUPANCY RATE.</Desc>
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        <Desc>Luthercare is deeply committed to supporting children and families in a variety of ways. We offer child care and early learning opportunities through five child care centers in Lancaster and Lebanon Counties. 1,038 infants and children through age 12 were served by our programs in 2016. Support was provided through public funding, private payment and scholarship subsidy. We also operate a mentoring program for Home child Care Providers, and worked with 5 centers in 2016. In addition, Luthercare manages the Child Care Information Services program in Lebanon County, which assists families in identifying affordable child care options and other support services.</Desc>
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        <PersonNm>Mark Kandrysawtz</PersonNm>
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        <PersonNm>Rev David R Fisher</PersonNm>
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        <PersonNm>Dr Joan Harrold</PersonNm>
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        <EOYAmt>73321405</EOYAmt>
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        <EOYAmt>29374383</EOYAmt>
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        <EOYAmt>1865348</EOYAmt>
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        <EOYAmt>115146239</EOYAmt>
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        <EOYAmt>5106664</EOYAmt>
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        <EOYAmt>20494840</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>50513291</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>12864745</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>1344486</EOYAmt>
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        <EOYAmt>4130668</EOYAmt>
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        <BOYAmt>88329890</BOYAmt>
        <EOYAmt>94454694</EOYAmt>
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      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
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        <EOYAmt>4016064</EOYAmt>
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        <BOYAmt>21602021</BOYAmt>
        <EOYAmt>20691545</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>115146239</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-2631995</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1089089</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>632430</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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      <ChurchInd>X</ChurchInd>
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      <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>
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      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>1</MailingsMembersInd>
      <MailingsMembersAmt>100</MailingsMembersAmt>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>1</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>100</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>937</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>1137</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>Luthercare occasionally sends out mailings to legislators and our constituents regarding issues that affect our community and its residents. Luthercare will also reach out to state legislators on issues surrounding senior health care and child care. LUTHERCARE PAYS DUES TO THE ORGANIZATIONS LEADINGAGE AND LEADINGAGE PA. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID BY LUTHERCARE THAT IS ALLOCABLE TO LOBBYING IS $937.</ExplanationTxt>
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      <ExplanationProvidedInd>X</ExplanationProvidedInd>
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        <ContributionsAmt>14584</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>539360</InvestmentEarningsOrLossesAmt>
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        <EndYearBalanceAmt>6481378</EndYearBalanceAmt>
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        <OtherExpendituresAmt>131974</OtherExpendituresAmt>
        <EndYearBalanceAmt>9038523</EndYearBalanceAmt>
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        <EndYearBalanceAmt>8978011</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>7229475</BeginningYearBalanceAmt>
        <ContributionsAmt>24942</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1248159</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>27306</OtherExpendituresAmt>
        <EndYearBalanceAmt>8475270</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6575726</BeginningYearBalanceAmt>
        <ContributionsAmt>18140</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>678920</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>43311</OtherExpendituresAmt>
        <EndYearBalanceAmt>7229475</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.73770</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.26230</PrmnntEndowmentBalanceEOYPct>
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        <BookValueAmt>2191392</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>68206077</DepreciationAmt>
        <BookValueAmt>58927049</BookValueAmt>
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      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>764123</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>504437</DepreciationAmt>
        <BookValueAmt>259686</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>15090287</DepreciationAmt>
        <BookValueAmt>4263822</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>7679456</OtherCostOrOtherBasisAmt>
        <BookValueAmt>7679456</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>73321405</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Unearned income</Desc>
        <Amt>370363</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Deposits held</Desc>
        <Amt>712</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Gift certificates payable</Desc>
        <Amt>3400</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>LT Capital Lease</Desc>
        <Amt>612852</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Swap Termination Fees</Desc>
        <Amt>3143341</Amt>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>51894917</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1089089</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>609783</OtherRevenueAmt>
      <RevenueNotReportedAmt>1698872</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>50196045</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-70192</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-70192</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>50125853</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>52805393</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>70192</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>70192</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>52735201</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>22647</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>22647</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>52757848</TotalExpensesPerForm990Amt>
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        <FormAndLineReferenceDesc>Part IV, Line 2b:</FormAndLineReferenceDesc>
        <ExplanationTxt>LUTHERCARE OCCASIONALLY MANAGES THE FINANCES OF RESIDENTS who have no other options from whom to obtain assistance. IN this role, luthercare COLLECTS FUNDS FROM RESIDENTS AND DEPOSITS THEM INTO A SEPARATE ACCOUNT BY FACILITY. THE FUNDS FOR managING THE FINANCES ARE CONTAINED IN THE RESIDENT FUND ACCOUNTS, which are reported on Line 21 of the Form 990 balance sheet. TYPICALLY, luthercare DEPOSITS CHECKS RELATED TO SOCIAL SECURITY AND PENSION PAYMENTS FOR THE RESIDENTS. AS THE RESIDENTS HAVE EXPENSES THAT ARE DUE, luthercare PAYS FOR THE EXPENSES OUT OF luthercare'S OPERATING CHECKING ACCOUNT. luthercare THEN TRANSFERS THE TOTAL AMOUNT OF EXPENSES FROM THE RESIDENT BANK ACCOUNT BY FACILITY TO THE OPERATING ACCOUNT TO REIMBURSE THOSE FUNDS. INTEREST IS EARNED AND CREDITED TO EACH ACCOUNT. AT all times luthercare knows the balance of THE RESIDENT FUNDS account. IN ADDITION, WHEN Prospective RESIDENTS Place A DEPOSIT TO HOLD An apartment or cottage, a portion OF THIS DEPOSIT IS REFUNDABLE. THESE FUNDS ARE HELD IN ESCROW BY LUTHERCARE ON BEHALF OF THE RESIDENTS UNTIL THE DEPOSIT IS REFUNDED, IF NECESSARY, BASED ON THE TERMS OF THEIR CONTRACT.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ENDOWMENTS, AS FUNDED BY THE ORGANIZATION AND ITS DONORS, HAVE BEEN ESTABLISHED FOR A VARIETY OF REASONS RELATED TO THE charitable PURPOSE OF luthercare AND ITS residents' NEEDS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Agency accounts for uncertainty in income taxes by using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. Management has determined that there were no tax uncertainties that met this recognition threshold in 2016 or 2015.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in value of deferred gifts 26,348. INVESTMENT FEES -22,647. Change in fair value of interest rate swap agreements 5,157,334. Loss on Refinancing -1,257,052. Loss on termination of interest rate swap -3,294,200.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Rental Expenses -43,709. Store Expenses -10,450. Fundraising Events Direct Expenses -21,880. Bad Debt Recovery 5,847.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fundraising Events Direct Expenses 21,880. Store Expense 10,450. Rental Expenses 43,709. Bad Debt REcovery -5,847.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT EXPENSES 22,647.</ExplanationTxt>
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        <Event1Nm>ANNUAL GOLF TOURNAMENT</Event1Nm>
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        <GrossRevenueEvent1Amt>10784</GrossRevenueEvent1Amt>
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        <GrossReceiptsTotalAmt>87002</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>76218</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>10784</GrossRevenueTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>3943</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>13736</RentFcltyCostsTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>4201</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>21880</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-11096</NetIncomeSummaryAmt>
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      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The president reviews all requests for gifts and selects THE organizations TO WHICH Luthercare will contribute. DONEE organizationS ARE monitored by management to ensure that THEY MEET the standards of a charitable organization. THE ORGANIZATION DOES NOT, HOWEVER, REQUIRE ADDITIONAL DOCUMENTATION ONCE THE EXEMPT STATUS OF DONEES HAS BEEN ESTABLISHED GIVEN THE LOW RISK ASSOCIATED WITH THE AMOUNTS GIVEN.</ExplanationTxt>
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      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>0</SubstantiationRequiredInd>
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      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
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      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
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      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CARL MCALOOSE</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
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        <BonusFilingOrganizationAmount>9750</BonusFilingOrganizationAmount>
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        <TotalCompensationFilingOrgAmt>414989</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>elizabeth brennan</PersonNm>
        <TitleTxt>CFO/treasurer</TitleTxt>
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        <PersonNm>BLAKE S DAUB</PersonNm>
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        <TotalCompensationFilingOrgAmt>231883</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>curtis b evans</PersonNm>
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        <TotalCompensationFilingOrgAmt>220229</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <PersonNm>SALLY GROOME</PersonNm>
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        <BonusFilingOrganizationAmount>5232</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7185</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15988</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>199680</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM SNYDER</PersonNm>
        <TitleTxt>VP, PHILANTHROPY &amp; COMM. ENG.</TitleTxt>
        <BaseCompensationFilingOrgAmt>135006</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5430</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7457</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>67434</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>215327</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>William Snyder, the Vice President for Philanthropy and community engagement for the organization AND AN ORDAINED MINISTER, received a $35,000 housing allowance in 2016. This amount was not included in his taxable income UNDER RULES ASSOCIATED WITH MINISTERS' PARSONAGE ALLOWANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>CARL MCALOOSE PARTICIPATES IN A NONQUALIFIED RETIREMENT PLAN IN WHICH HE MAY RECEIVE UP TO 10% OF HIS COMPENSATION IN A DEFERRED PLAN. THE AMOUNT DEFERRED FOR THE YEAR ENDED dECEMBER 31, 2016 WAS $43,644.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE TEAM MEMBERS RECEIVED BONUSES BASED UPON A NUMBER OF SET OPERATIONAL AND FINANCIAL CRITERIA. THE BONUSES ARE DETERMINED BY THE BOARD ON A DISCRETIONARY BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>LancASTER COUNTY HOSPITAL AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>236648018</BondIssuerEIN>
        <BondIssuedDt>2016-09-29</BondIssuedDt>
        <IssuePriceAmt>52817000</IssuePriceAmt>
        <PurposeDesc>to refund bonds &amp; debt from M&amp;T to pay for issuance and construction</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>406000</RetiredAmt>
        <TotalProceedsAmt>52817000</TotalProceedsAmt>
        <RefundingEscrowAmt>46026932</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>569459</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>6002299</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>217910</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2017</SubstantialCompletionYr>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>1</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>1</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>PNC BANK</BusinessNameLine1Txt>
        </HedgeProviderName>
        <TermOfHedgePct>10.000000000000</TermOfHedgePct>
        <SuperintegratedHedgeInd>0</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>0</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>BENCHMARK CONSTRUCTION</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ROBERT A. BRANDT JR. IS CHAIRMAN OF BENCHMARK CONST. AND A BOARD MEMBER.</RelationshipDescriptionTxt>
        <TransactionAmt>6590484</TransactionAmt>
        <TransactionDesc>BENCHMARK CONSTRUCTION undertakes CONSTRUCTION PROJECTs FOR LUTHERCARE. IN 2016, TOTAL invoiced BILLINGS WERE $6,590,484. TRANSACTIONs Were AT ARM'S LENGTH AND REPRESENTED FAIR MARKET VALUE FOR THE WORK.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>KMRD Partners Inc</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Kevin McPoyle is on the board member and President of KMRD Partners, Inc.</RelationshipDescriptionTxt>
        <TransactionAmt>653217</TransactionAmt>
        <TransactionDesc>KMRD Partners, Inc. provided insurance coverage to Luthercare during the calendar year 2016. IN 2016, TOTAL invoiced BILLINGS WERE $653,217. TRANSACTIONs Were AT ARM'S LENGTH AND REPRESENTED FAIR MARKET VALUE FOR THE WORK.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>LAUREN GROFF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>LAUREN GROFF IS AN EMPLOYEE AND THE DAUGHTER OF KEY EMPLOYEE CURTIS EVANS.</RelationshipDescriptionTxt>
        <TransactionAmt>78839</TransactionAmt>
        <TransactionDesc>LAUREN GROFF IS EMPLOYED BY THE ORGANIZATION.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS DELEGATES DECISION-MAKING POWER TO THE EXECUTIVE COMMITTEE AS NEEDED. THE EXECUTIVE COMMITTEE WILL MAKE DECISIONS WHEN IT ISN'T POSSIBLE TO CONVENE THE ENTIRE BOARD ON A VOTING MATTER IN A TIMELY FASHION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S BY-LAWS STIPULATE THAT THE TOTAL BOARD OF DIRECTORS WILL BE ELECTED BY THE LOWER SUSQUEHANNA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA) AND AT LEAST 51% OF THE MEMBERS SHALL BE VOTING MEMBERS OF AN ELCA CONGREGATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA) MUST GIVE WRITTEN APPROVAL TO ANY AMENDMENT OF AN ARTICLE OR PARAGRAPH OF GOVERNING DOCUMENTS WITH REGARD TO: A. AFFILIATION B. THE PURPOSE STATEMENT C. THE MISSION STATEMENT D. DISSOLUTION OF THE CORPORATION E. RESPONSIBILITY FOR MANAGEMENT AND FISCAL AFFAIRS F. CORPORATE LIABILITY DISCLAIMER G. BOARD MEMBERSHIP ANY PROPOSED AMENDMENT MUST BE SUBMITTED TO THE DIVISION FOR CHURCH IN SOCIETY OF THE ELCA FOR REVIEW PRIOR TO ACTION BY THE SYNOD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's president and all vice presidents will review a draft of the federal form 990. AFTER MANAGEMENT HAS REVIEWED THE FORM 990, THE BOARD OF DIRECTORS WILL BE PROVIDED WITH AN eLECTRONIC COPY OF THE FORM 990 FOR THEIR REVIEW. AFTER THE BOARD AND MANAGEMENT are SATISFIED WITH THE FILING COPY, The chief financial officer will sign the form 990 and release the electronic version to the irs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL NEWLY ELECTED BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST FORM. ALL EXISTING BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST, THE RELATED PARTY TRANSACTION IS MONITORED AND EVALUATED BY THE remaining BOARD AND MANAGEMENT TO ENSURE THAT THE TRANSACTION IS AT ARM'S LENGTH. HAVING A RELATED PARTY TRANSACTION WITH A BOARD MEMBER DOES NOT PRECLUDE THAT PERSON FROM SERVING ON THE BOARD. If a conflict does exist, the interested individual may make a presentation at a board or committee meeting. However, after the presentation has been made, the interested person must leave the meeting during the discussion of, and vote on, the transaction or arrangement that results in the conflict of interest. The conflict of interest policy includes language that indicates family and business relationships can be a source of conflicts of interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>LUTHERCARE CONTRACTS WITH AN INDEPENDENT PARTY TO PERFORM A SALARY MARKET REVIEW FOR THE CEO AND VP'S. THE SALARY MARKET REVIEW INCLUDES A REVIEW OF THE COMPENSATION AGREEMENTS IN PLACE BETWEEN COMPARABLE NON-PROFIT ORGANIZATIONS AND THEIR EXECUTIVES TO ENSURE THAT COMPENSATION IS WITHIN FAIR VALUE RANGE. THE REPORT IS SUBMITTED TO THE BOARD AND COMPENSATION COMMITTEE WHICH APPROVES ANY INCREASE FOR THE CEO. THE CEO USES THE REPORT TO DETERMINE INCREASES FOR THE VP'S. THE PROCESS IS PERFORMED IN CONJUNCTION WITH ANNUAL EMPLOYEE SALARY INCREASES. THIS PROCESS HAS BEEN DISCUSSED AT THE EXECUTIVE COMMITTEE LEVEL AND THEN DISCUSSED IN AN EXECUTIVE SESSION WITH THE BOARD. Executive commitees document board and committee discussions on CEO compensation as well as compensation of senior executives.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Contracted Services: Program service expenses 2,765,777. Management and general expenses 505,446. Fundraising expenses 11,569. Total expenses 3,282,792. Pharmacy Fees: Program service expenses 78,540. Management and general expenses 0. Fundraising expenses 0. Total expenses 78,540. Laboratory Fees: Program service expenses 64,260. Management and general expenses 0. Fundraising expenses 0. Total expenses 64,260. Contracted Services - Lawncare: Program service expenses 69,894. Management and general expenses 0. Fundraising expenses 0. Total expenses 69,894. Maintenance Contracts: Program service expenses 55,018. Management and general expenses 0. Fundraising expenses 0. Total expenses 55,018. Consulting Fees: Program service expenses 102,996. Management and general expenses 135,642. Fundraising expenses 0. Total expenses 238,638. Cardiology Fees: Program service expenses 468. Management and general expenses 0. Fundraising expenses 0. Total expenses 468. Contracted Services - Psychiatric: Program service expenses 3,000. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,000. Contracted Services - Housekeeping: Program service expenses 18,257. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,257. X-Ray Fees: Program service expenses 29,028. Management and general expenses 0. Fundraising expenses 0. Total expenses 29,028. Contracted Services - Barber: Program service expenses 125,477. Management and general expenses 0. Fundraising expenses 0. Total expenses 125,477. Contracted Services - Food Services: Program service expenses 803,724. Management and general expenses 0. Fundraising expenses 0. Total expenses 803,724. Contracted Services - Therapy: Program service expenses 2,262,092. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,262,092.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Unrealized Depreciation on Interest Rate Swap Agreement -3,294,200. Change in value of deferred gifts 26,348. Change in FV of Swap Agreements 5,157,334. Loss on Refinancing -1,257,052.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>your neighborhood connection</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 e main st</AddressLine1Txt>
          <CityNm>lititz</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>17543</ZIPCd>
        </USAddress>
        <EIN>475266288</EIN>
        <PrimaryActivitiesTxt>home health</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>PERPETUAL TRUST (1)</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FULTON FINANCIAL ADVISORS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>T</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PERPETUAL TRUST (1)</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SUSQUEHANNA TRUST</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>T</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PERPETUAL TRUST (1)</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BNY MELLON</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>T</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PERPETUAL TRUST (1)</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SEPSYNOD-ELCA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>T</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>