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            <AddressLine1Txt>9954 MARYLAND DR STE 5176A</AddressLine1Txt>
            <CityNm>HENRICO</CityNm>
            <StateAbbreviationCd>VA</StateAbbreviationCd>
            <ZIPCd>23233</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL SUPPLY</ServicesDesc>
        <CompensationAmt>383396</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DIAMOND PHARMAC INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>645 KOLTER DRIVE</AddressLine1Txt>
            <CityNm>INDIANA</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHARMACY</ServicesDesc>
        <CompensationAmt>222979</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>THE LANCASTER GROUP LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>813 COOPERS COURT</AddressLine1Txt>
            <CityNm>LANCASTER</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17601</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BILLING SERVICE</ServicesDesc>
        <CompensationAmt>175947</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>16</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>12419</AllOtherContributionsAmt>
      <TotalContributionsAmt>12419</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>16993399</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16993399</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>69575</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>69575</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>17062974</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <ExclusionAmt>195758</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>2400</RealAmt>
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      <RentalIncomeOrLossGrp>
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      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-238</TotalRevenueColumnAmt>
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      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>732692</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
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        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>42292</ExclusionAmt>
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      <OtherRevenueTotalAmt>42292</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
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        <ProgramServicesAmt>8516926</ProgramServicesAmt>
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      <PensionPlanContributionsGrp>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>26008</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>42317</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <TotalAmt>3081054</TotalAmt>
        <ProgramServicesAmt>3081054</ProgramServicesAmt>
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      <AdvertisingGrp>
        <TotalAmt>111663</TotalAmt>
        <ManagementAndGeneralAmt>111663</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OccupancyGrp>
        <TotalAmt>394737</TotalAmt>
        <ProgramServicesAmt>364068</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30669</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>267854</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18107</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
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        <ProgramServicesAmt>716956</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>PURCHASED SERVICES</Desc>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>407331</ProgramServicesAmt>
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        <BaseCompensationFilingOrgAmt>137386</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14041</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>151427</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc4">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FINAL DRAFT COPY OF FORM 990 IS PROVIDED TO EACH BOARD MEMBER FOR QUESTIONS OR COMMENTS BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED AND SIGNED ON AN ANNUAL BASIS BY ALL BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION. THE STATEMENTS ARE REVIEWED BY THE EXECUTIVE DIRECTOR. THE POLICY REQUIRES THAT NO BOARD MEMBER OR OFFICER MAY ENTER INTO ANY TRANSACTION OR ARRANGEMENT WITH AN OUTSIDE PARTY, EITHER DIRECTLY OR INDIRECTLY, WHICH WILL RESULT IN PERSONAL BENEFIT AT THE EXPENSE OF THE ORGANIZATION WITHOUT THE KNOWLEDGE AND CONSENT OF THE ORGANIZATION. INDIVIDUALS WHO VIOLATE THIS POLICY ARE, AMONG OTHER THINGS, SUBJECT TO LOSS OF THEIR ELECTION TO THE BOARD OR THEIR ELECTION AS AN OFFICER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE POSITIONS OF ADMINISTRATOR AND CHIEF FINANCIAL OFFICER ARE REVIEWED ANNUALLY BY THE BOARD FOR REASONABLENESS AND ALSO COMPARED TO OTHER NURSING FACILITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE POSITION OF ADMINISTRATOR, CHIEF FINANCIAL OFFICER AND DIRECTOR OF NURSING IS REVIEWED ANNUALLY BY THE BOARD FOR REASONABLENESS AND ALSO COMPARED TO OTHER NURSING FACILITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>THERAPY CONTRACT SERVICES 1,525,749 0 0 DIETARY CONTRACT SERVICES 1,555,305 0 0 TOTAL 3,081,054 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>