﻿<?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="2014v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2016-05-11T08:08:33-05:00</ReturnTs>
    <TaxPeriodEndDt>2015-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>520982413</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>GROSS MENDELSOHN &amp; ASSOCIATES PA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>36 SOUTH CHARLES ST 18TH FLOOR</AddressLine1Txt>
        <CityNm>BALTIMORE</CityNm>
        <StateAbbreviationCd>MD</StateAbbreviationCd>
        <ZIPCd>21201</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2014-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>520591485</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>KESWICK MULTI-CARE CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>KESW</BusinessNameControlTxt>
      <PhoneNum>4102358860</PhoneNum>
      <USAddress>
        <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
        <CityNm>BALTIMORE</CityNm>
        <StateAbbreviationCd>MD</StateAbbreviationCd>
        <ZIPCd>21211</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ERIC TURNBAUGH</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>4102358860</PhoneNum>
      <SignatureDt>2016-05-11</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>JAMES E CRISP</PreparerPersonNm>
      <PTIN>P00025401</PTIN>
      <PhoneNum>4106855512</PhoneNum>
      <PreparationDt>2016-05-04</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2014</TaxYr>
    <BuildTS>2016-08-17 19:52:53Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>ERIC TURNBAUGH</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
        <CityNm>BALTIMORE</CityNm>
        <StateAbbreviationCd>MD</StateAbbreviationCd>
        <ZIPCd>21211</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>39182031</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.KESWICK-MULTICARE.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1883</FormationYr>
      <LegalDomicileStateCd>MD</LegalDomicileStateCd>
      <ActivityOrMissionDesc>LONG TERM HEALTH CARE FOR SENIORS</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>16</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>16</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>572</TotalEmployeeCnt>
      <TotalVolunteersCnt>118</TotalVolunteersCnt>
      <TotalGrossUBIAmt>198662</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>-454730</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>5233498</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>6731348</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>30850135</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>32355525</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>586</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1109</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>84680</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>94049</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>36168899</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>39182031</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>20700986</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>22112930</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>16189271</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>18468639</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>36890257</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>40581569</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-721358</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1399538</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>29280840</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>27627648</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>18978133</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>20684157</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>10302707</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>6943491</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>LONG TERM HEALTH CARE FOR SENIORS</MissionDesc>
      <SignificantNewProgramSrvcInd>1</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>31106571</ExpenseAmt>
      <RevenueAmt>30089139</RevenueAmt>
      <Desc>NURSING HOME CARE - KESWICK SUPPORTS INDIVIDUALS TO MAINTAIN THEIR HIGHEST POSSIBLE QUALITY OF LIFE AS THEY FACE THE CHALLENGES OF AGING, CHRONIC DISEASES, REHABILITATION, AND DISABILITY. IN DOING SO, KESWICK PROVIDES A BROAD SPECTRUM OF SOCIAL AND HEALTHCARE SERVICES IN A CARING, DIGNIFIED, AND RESPECTFUL MANNER. CURRENTLY WE SERVE APPROXIMATELY 242 PERSON PER DAY WHICH IS COMPRISED OF 159 PERSONS PER DAY IN LONG TERM-TERM CARE AND APPROXIMATELY 83 PERSONS PER DAY IN SUBACUTE REHABILITATION SERVICES. EACH RESIDENT'S DAILY SCHEDULE IS AN OUTCOME OF THEIR INDIVIDUAL MEDICAL CARE PLAN GOALS AND OBJECTIVES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>2378475</ExpenseAmt>
        <RevenueAmt>1524465</RevenueAmt>
        <Desc>MEMORY CARE ASSISTED LIVING - KESWICK PROVIDES A 26-BED MEMORY CARE ASSISTED LIVING PROGRAM FOR THOSE PEOPLE DIAGNOSED WITH DEMENTIA AND WHO NEED SOME ASSISTANCE WITH THEIR ACTIVITIES OF DAILY LIVING. THE GOAL OF THE PROGRAM IS TO ENABLE EACH PERSON TO REACH HIS OR HER HIGHEST LEVEL OR FUNCTION. OUR RECREATIONAL THERAPY TAKES IT CUE FROM THE WORLD-RENOWNED MONTESSORI TEACHING METHOD, IT IS AN APPROACH THAT FOCUSES ON INSTILLING A FEELING OF SUCCESS AND WORTHINESS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>612304</ExpenseAmt>
        <RevenueAmt>434286</RevenueAmt>
        <Desc>HEALTH CARE DELIVERY - ADULT DAY CARE PROVIDES A NONINSTITUTIONAL &amp; AMBULATORY PROGRAM CONSISTING OF A VARIETY OF HEALTHCARE, SOCIAL, &amp; RELATED SUPPORT SERVICES FOR OLDER &amp; CHRONICALLY ILL PERSONS. SERVICES ARE PROVIDED DURING THE DAY IN GROUP SETTINGS TO INDIVIDUALS WHO RETURN TO THEIR RESIDENCES IN THE EVENINGS. THE PROGRAM ALLOWS INDIVIDUALS WHO ARE NOT TOTALLY INDEPENDENT TO REMAIN IN THE COMMUNITY &amp; RECEIVE THE SUPPORT NEEDED TO FUNCTION AT THEIR OPTIMAL LEVEL WHILE IMPROVING THEIR OVERALL QUALITY OF LIFE. THE PROGRAM ALSO PROVIDES THE NEEDED RESPITE FOR CAREGIVERS &amp; ALLOWS CAREGIVERS TO CONTINUE TO WORK WHILE PARTICIPANTS RECEIVE THE NEEDED CARE AND MONITORING. ADDITIONALLY, THE PROGRAM PROVIDES SUPPORT GROUPS TO HELP CAREGIVERS THROUGH THE TRANSITION PROCESS TO INSTITUTIONAL CARE WHEN NEEDED.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>80537</ExpenseAmt>
        <Desc>COMMUNITY HEALTH SERVICES -KESWICK HAS CREATED A COMMUNITY HEALTH RESOURCE DIVISION (CHRD) THE GOAL OF WHICH IS TO DEVELOP AN INTEGRATED HEALTH RESOURCE FOR OLDER ADULTS AND THEIR CAREGIVERS THAT INCREASES THEIR ABILITY TO LIVE AT HOME AND MEET THEIR HEALTH GOALS. THE KESWICK CHRD STRATEGIES INCLUDE DELIVERING A CHRONIC DISEASE PREVENTION AND MANAGEMENT PROGRAM WITH A FOCUS ON DIABETES AND COGNITIVE FUNCTIONING; PROVIDING EFFECTIVE CARE TRANSITION COORDINATION TO HELP ENABLE CLIENTS TO LIVE AT HOME AND STAY HEALTHY FOR AS LONG AS POSSIBLE; AND, ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THROUGH EFFECTIVE PARTNERSHIPS AND DIVERSE PROGRAM EXPERIENCES.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>80537</TotalOtherProgSrvcExpenseAmt>
      <TotalProgramServiceExpensesAmt>34177887</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">1</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">1</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</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 referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>67</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>572</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>16</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>16</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>1</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>1</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MD</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>THE BUSINESS OFFICE</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>4102358860</PhoneNum>
        <USAddress>
          <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
          <CityNm>BALTIMORE</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21211</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT J AUMILLER</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES R SEBA</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDMOND B NOLLEY JR</PersonNm>
        <TitleTxt>SECRETARY/2ND VP</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GRAYLIN E SMITH</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CRAIG S HORNER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSE J HARRIS PHD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LENWOOD M IVEY PHD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL A MEREDITH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>T EDGIE RUSSELL III</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CATHERINE J BOYNE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN H WEST III</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN DONOVAN PHD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY W CARTER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RON DIEGELMAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT M ROCKSTROH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN C WEISS III</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARMEL ROQUES</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>235825</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28232</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY JEAN HERRON</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>154608</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17861</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LYNN GORDON</PersonNm>
        <TitleTxt>DIRECTOR OF PLANNING ANALY</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>144536</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22717</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARROLL SIMMONS</PersonNm>
        <TitleTxt>DIRECTOR OF BLDG SVCS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>113076</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16566</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELINDA BRANDT</PersonNm>
        <TitleTxt>EXECUTIVE DIR.</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>150301</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7695</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FLORENCE DADA</PersonNm>
        <TitleTxt>NURSING SUPERVISOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>146823</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9631</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW BYRD</PersonNm>
        <TitleTxt>EXECUTIVE DIR.</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>143991</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7829</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1089160</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>110531</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>7</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ASSISTED REHAB INCORPORATED</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 490</AddressLine1Txt>
            <CityNm>LISBON</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21765</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY SERVICES</ServicesDesc>
        <CompensationAmt>3319102</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UNIDINE CORPORATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1000 WASHINGTON ST SUITE 510</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02118</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FOOD SERVICE</ServicesDesc>
        <CompensationAmt>1734475</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DECISIVE DATA SYSTEMS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3445-C BOX HILL</AddressLine1Txt>
            <CityNm>ABINGDON</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21009</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTANT</ServicesDesc>
        <CompensationAmt>365611</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AINSLEY &amp; CO</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>720 S MONTFORD AVEUNUE SUITE 101</AddressLine1Txt>
            <CityNm>BALTIMORE</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21224</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MARKETING CONSULTANT</ServicesDesc>
        <CompensationAmt>343509</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DYNAMED SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>8182 LARK BROWN ROAD SUITE 330</AddressLine1Txt>
            <CityNm>ELKRIDGE</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21075</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTANT</ServicesDesc>
        <CompensationAmt>228466</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>12</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>6672627</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>58721</AllOtherContributionsAmt>
      <TotalContributionsAmt>6731348</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE/MEDICAID PYMTS</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>28042958</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28042958</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SKILLED NURSING SERVICES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>3638289</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3638289</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL ADULT DAY CARE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>366643</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>366643</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT FEES</Desc>
        <BusinessCd>541610</BusinessCd>
        <TotalRevenueColumnAmt>126391</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>126391</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>108973</TotalRevenueColumnAmt>
        <ExclusionAmt>108973</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>72271</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>72271</UnrelatedBusinessRevenueAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>32355525</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1109</TotalRevenueColumnAmt>
        <ExclusionAmt>1109</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>94049</TotalRevenueColumnAmt>
        <ExclusionAmt>94049</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>94049</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>39182031</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>32047890</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>198662</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>204131</ExclusionAmt>
      </TotalRevenueGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>424468</TotalAmt>
        <ManagementAndGeneralAmt>424468</ManagementAndGeneralAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>17733303</TotalAmt>
        <ProgramServicesAmt>15705788</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2027515</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>470907</TotalAmt>
        <ProgramServicesAmt>454633</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16274</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2635740</TotalAmt>
        <ProgramServicesAmt>2543938</ProgramServicesAmt>
        <ManagementAndGeneralAmt>91802</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>848512</TotalAmt>
        <ProgramServicesAmt>686912</ProgramServicesAmt>
        <ManagementAndGeneralAmt>161600</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>174381</TotalAmt>
        <ProgramServicesAmt>9670</ProgramServicesAmt>
        <ManagementAndGeneralAmt>164711</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>74818</TotalAmt>
        <ManagementAndGeneralAmt>74818</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <AdvertisingGrp>
        <TotalAmt>303628</TotalAmt>
        <ProgramServicesAmt>367</ProgramServicesAmt>
        <ManagementAndGeneralAmt>303261</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>3933260</TotalAmt>
        <ProgramServicesAmt>3707445</ProgramServicesAmt>
        <ManagementAndGeneralAmt>225815</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>962316</TotalAmt>
        <ProgramServicesAmt>928945</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33371</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>20884</TotalAmt>
        <ProgramServicesAmt>10868</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10016</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>57938</TotalAmt>
        <ProgramServicesAmt>22145</ProgramServicesAmt>
        <ManagementAndGeneralAmt>35793</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>620288</TotalAmt>
        <ProgramServicesAmt>598851</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21437</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2305938</TotalAmt>
        <ProgramServicesAmt>2227514</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78424</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>522389</TotalAmt>
        <ProgramServicesAmt>504335</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18054</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACT LABOR</Desc>
        <TotalAmt>7203146</TotalAmt>
        <ProgramServicesAmt>6073220</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1129926</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROVIDER TAX</Desc>
        <TotalAmt>1368968</TotalAmt>
        <ManagementAndGeneralAmt>1368968</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>518038</TotalAmt>
        <ProgramServicesAmt>518038</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RESIDENT PROGRAMS</Desc>
        <TotalAmt>126366</TotalAmt>
        <ProgramServicesAmt>99554</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26812</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>276281</TotalAmt>
        <ProgramServicesAmt>85664</ProgramServicesAmt>
        <ManagementAndGeneralAmt>190617</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>40581569</TotalAmt>
        <ProgramServicesAmt>34177887</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6403682</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2021068</BOYAmt>
        <EOYAmt>935570</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3038385</BOYAmt>
        <EOYAmt>3908654</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>224026</BOYAmt>
        <EOYAmt>421140</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>53798520</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>32445344</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>21873934</BOYAmt>
        <EOYAmt>21353176</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>540394</BOYAmt>
        <EOYAmt>369516</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1583033</BOYAmt>
        <EOYAmt>639592</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>29280840</BOYAmt>
        <EOYAmt>27627648</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4504349</BOYAmt>
        <EOYAmt>2664581</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>72720</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>11520000</BOYAmt>
        <EOYAmt>11520000</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>161281</BOYAmt>
        <EOYAmt>155508</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>2719783</BOYAmt>
        <EOYAmt>6344068</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>18978133</BOYAmt>
        <EOYAmt>20684157</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>10203471</BOYAmt>
        <EOYAmt>6852563</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>5000</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>94236</BOYAmt>
        <EOYAmt>90928</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>10302707</BOYAmt>
        <EOYAmt>6943491</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>29280840</BOYAmt>
        <EOYAmt>27627648</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1399538</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-1959678</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">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>1</AgentTrusteeEtcInd>
      <BeginningBalanceAmt>35514</BeginningBalanceAmt>
      <AdditionsDuringYearAmt>683941</AdditionsDuringYearAmt>
      <DistributionsDuringYearAmt>688167</DistributionsDuringYearAmt>
      <EndingBalanceAmt>31288</EndingBalanceAmt>
      <InclEscrowCustodialAcctLiabInd>0</InclEscrowCustodialAcctLiabInd>
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>94236</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-3308</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>90928</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>83770</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>10466</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>94236</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>78381</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>5389</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>83770</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>82090</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-3709</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>78381</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>70842</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>11248</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>82090</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <PrmnntEndowmentBalanceEOYPct>1.00000</PrmnntEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>1</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>43809927</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>25125489</DepreciationAmt>
        <BookValueAmt>18684438</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>9078018</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6565879</DepreciationAmt>
        <BookValueAmt>2512139</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>910575</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>753976</DepreciationAmt>
        <BookValueAmt>156599</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>21353176</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <Amt>4317</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED SALARIES AND VACATION</Desc>
        <Amt>845815</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <Amt>82757</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ANNUITY PAYABLE</Desc>
        <Amt>600</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED PENSION</Desc>
        <Amt>1721738</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>INTEREST RATE SWAP ARRANGEMENT</Desc>
        <Amt>1299325</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LOAN FROM AFFILIATE</Desc>
        <Amt>2389516</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>6344068</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>38294749</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>5785345</OtherRevenueAmt>
      <RevenueNotReportedAmt>5785345</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>32509404</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>6672627</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>6672627</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>39182031</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>42572744</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>1991175</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>1991175</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>40581569</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>40581569</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 1B:</FormAndLineReferenceDesc>
        <ExplanationTxt>KESWICK ACTS IN AN AGENCY CAPACITY REGARDING THE HOLDING OF PATIENT CASH FUNDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>KESWICK'S ENDOWMENT FUND IS COMPRISED OF A BENEFICIAL INTEREST IN A TRUST. THE INCOME FROM THE TRUST IS TO BE USED FOR THE BENEFIT OF ONE OR MORE RESIDENTS OF KESWICK MULTI-CARE'S LONG TERM CARE FACILITY WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THE COSTS OF CARE AND WHO DO NOT QUALIFY FOR STATE ASSISTANCE -- $90,928</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAD NO LIABILITY FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION'S FEDERAL AND STATE TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE IRS AND STATE TAX AUTHORITIES, GENERALLY FOR A PERIOD OF THREE YEARS AFTER THE RETURNS ARE FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED PARTY UNREALIZED GAIN -4,486,264. CHANGE IN BENEFICIAL INT IN IRREV TRUST -3,308. RELATED PARTY REVENUE 10,274,917.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED PARTY CONTRIBUTIONS ELIMINATED 6,672,627.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>EXPENSE OF RELATED ENTITY IN CONS. AUDIT 34,805. CHANGE IN INTEREST RATE SWAP 281,581. INCREASE IN MINIMUM PENSION LIABILITY 1,674,789.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>1</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>CARMEL ROQUES</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>235825</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14498</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13734</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>264057</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY JEAN HERRON</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>154608</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9163</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8698</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>172469</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LYNN GORDON</PersonNm>
        <TitleTxt>DIRECTOR OF PLANNING ANALY</TitleTxt>
        <BaseCompensationFilingOrgAmt>144536</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8983</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13734</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>167253</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MELINDA BRANDT</PersonNm>
        <TitleTxt>EXECUTIVE DIR.</TitleTxt>
        <BaseCompensationFilingOrgAmt>150301</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7695</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>157996</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>FLORENCE DADA</PersonNm>
        <TitleTxt>NURSING SUPERVISOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>146823</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>4930</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>4701</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>156454</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANDREW BYRD</PersonNm>
        <TitleTxt>EXECUTIVE DIR.</TitleTxt>
        <BaseCompensationFilingOrgAmt>143991</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3808</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>4021</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>151820</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>ANDREW BYRD RECEIVED A SEVERANCE PAYMENT OF $18,464.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MARYLAND HEALTH &amp; HIGHER</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>520936091</BondIssuerEIN>
        <CUSIPNum>574217G41</CUSIPNum>
        <BondIssuedDt>2007-08-09</BondIssuedDt>
        <IssuePriceAmt>11520000</IssuePriceAmt>
        <PurposeDesc>TO REFINANCE COSTS OF ACQUISITION</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>11520000</TotalProceedsAmt>
        <CurrentRefundingInd>0</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV ARBITRAGE</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS PART IS NOT APPLICABLE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY HEALTH SERVICES -KESWICK HAS CREATED A COMMUNITY HEALTH RESOURCE DIVISION (CHRD) THE GOAL OF WHICH IS TO DEVELOP AN INTEGRATED HEALTH RESOURCE FOR OLDER ADULTS AND THEIR CAREGIVERS THAT INCREASES THEIR ABILITY TO LIVE AT HOME AND MEET THEIR HEALTH GOALS. THE KESWICK CHRD STRATEGIES INCLUDE DELIVERING A CHRONIC DISEASE PREVENTION AND MANAGEMENT PROGRAM WITH A FOCUS ON DIABETES AND COGNITIVE FUNCTIONING; PROVIDING EFFECTIVE CARE TRANSITION COORDINATION TO HELP ENABLE CLIENTS TO LIVE AT HOME AND STAY HEALTHY FOR AS LONG AS POSSIBLE; AND, ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THROUGH EFFECTIVE PARTNERSHIPS AND DIVERSE PROGRAM EXPERIENCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH YEAR ALL BOARD MEMBERS AND EMPLOYEES MUST SIGN OFF THAT THEY RECEIVED, READ, UNDERSTAND AND WILL COMPLY WITH THE CONFLICT OF INTEREST POLICY. IF AN ISSUE ARISES IT IS PRESENTED AT THE GOVERNING BOARD OR COMMITTEE MEETING AND A DECISION IS MADE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE CEO, TOP MANAGEMENT OFFICIALS AND OFFICERS AND OTHER KEY EMPLOYEES ARE REVIEWED AND APPROVED BY THE MANAGEMENT REVIEW COMMITTEE OF THE BOARD OF DIRECTORS. COMPARABLE DATA FROM AVAILABLE SOURCES, SUCH AS THE FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION STUDIES, ARE USED TO ASSESS THE APPROPRIATE COMPENSATION RANGES OF THESE POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR REVIEW BY THE PUBLIC UPON RECEIPT OF A WRITTEN REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN BENEFICIAL INT IN IRREV TRUST -3,308. INCREASE IN MINIMUM PENSION LIABILITY -1,674,789. INCREASE IN THE VALUE OF INTEREST RATE SWAP -281,581.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>KESWICK AT HOME LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
          <CityNm>BALTIMORE</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21211</ZIPCd>
        </USAddress>
        <EIN>205872464</EIN>
        <PrimaryActivitiesTxt>IN HOME NURSING CARE AIDS AND CARE MGMT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <TotalIncomeAmt>-167421</TotalIncomeAmt>
        <EndOfYearAssetsAmt>21612</EndOfYearAssetsAmt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>KESWICK MANAGEMENT LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
          <CityNm>BALTIMORE</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21211</ZIPCd>
        </USAddress>
        <EIN>205872391</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <TotalIncomeAmt>-287309</TotalIncomeAmt>
        <EndOfYearAssetsAmt>710405</EndOfYearAssetsAmt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>KESWICK FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>700 W 40TH STREET</AddressLine1Txt>
          <CityNm>BALTIMORE</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21211</ZIPCd>
        </USAddress>
        <EIN>521066144</EIN>
        <PrimaryActivitiesTxt>TO MANAGE FUNDS FOR RESIDENT BENEFITS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3)</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</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>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>KESWICK FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>6672627</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>KESWICK FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>2389516</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>