<?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="2021v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-11-11T13:11:46-06:00</ReturnTs>
    <TaxPeriodEndDt>2021-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>593070669</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>MSL PA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>255 S ORANGE AVENUE SUITE 600</AddressLine1Txt>
        <CityNm>ORLANDO</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>32801</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>263411635</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SILVER LAKE CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SILV</BusinessNameControlTxt>
      <PhoneNum>2153466454</PhoneNum>
      <USAddress>
        <AddressLine1Txt>TWO BALA CYNWYD PLAZA 300</AddressLine1Txt>
        <CityNm>BALA CYNWYD</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>19004</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>HOWARD JAFFE</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>5618017600</PhoneNum>
      <SignatureDt>2022-11-11</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>HOWARD</PersonFirstNm>
        <PersonLastNm>JAFFE</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>HARRY E HARP CPA</PreparerPersonNm>
      <PTIN>P00176471</PTIN>
      <PhoneNum>4077405400</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>HOWARD JAFFE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>TWO BALA CYNWYD PLAZA 300</AddressLine1Txt>
        <CityNm>BALA CYNWYD</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>19004</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2937953</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2008</FormationYr>
      <LegalDomicileStateCd>PA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>OPERATE NURSING HOMES, PROVIDE HOUSING, AND DEVELOP MEDICAL PROGRAMS FOR THE CARE OF THE ELDERLY.</ActivityOrMissionDesc>
      <ContractTerminationInd>X</ContractTerminationInd>
      <VotingMembersGoverningBodyCnt>5</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>3</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>148</TotalEmployeeCnt>
      <TotalVolunteersCnt>3</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>1102638</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>308423</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>14971264</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>2627598</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>10709</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>-3552475</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>16084611</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>-616454</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7607401</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1500057</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>10431658</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2310798</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>18039059</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>3810855</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-1954448</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-4427309</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>6177801</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>125204</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3476830</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>1851542</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>2700971</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-1726338</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>SILVER LAKE CENTER, INC.'S MISSION INCLUDES OPERATION OF ONE OR MORE NURSING HOMES, PROVISION OF HOUSING FOR THE ELDERLY, DEVELOPMENT OF MEDICAL PROGRAMS FOR THE CARE OF THE ELDERLY AND EDUCATION OF HEALTHCARE PERSONNEL IN PROPER CARE OF THE ELDERLY.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>3046172</ExpenseAmt>
      <RevenueAmt>2627598</RevenueAmt>
      <Desc>THE ORGANIZATION OPERATES A SKILLED NURSING FACILITY, WITH A CAPACITY OF 174 BEDS, DEDICATED AND COMMITTED TO PROVIDING REHABILITATION AND SHORT AND LONG TERM NURSING AND MEDICAL CARE OF PATIENTS AND RESIDENTS. THE ORGANIZATION PROVIDES NUMEROUS ACTIVITIES AND PROGRAMS INCORPORATING AND PROMOTING FAMILY ACTIVITIES AND INVOLVEMENT WITH RESIDENTS AND STAFF. THESE ACTIVITIES PROMOTE A NORMALIZED ENVIRONMENT. DURING THE CURRENT YEAR, THERE WERE 8,175 RESIDENT DAYS.</Desc>
      <TotalProgramServiceExpensesAmt>3046172</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">1</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd referenceDocumentId="RetDoc1043200001">0</TerminateOperationsInd>
      <PartialLiquidationInd referenceDocumentId="RetDoc1043200001">1</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>26</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>148</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>5</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>3</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>KANE FINANCIAL SERVICES CO SUSAN SHAIN</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5612234161</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1665 PALM BEACH LAKES BLVD SUITE</AddressLine1Txt>
          <CityNm>WEST PALM BEACH</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33401</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>HOWARD JAFFE</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDY OLIVER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>2000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRUCE HALL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ADRIENNE SCHMOLLINGER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN SEAL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3982</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SELECT REHABILITATION INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2600 COMPASS ROAD</AddressLine1Txt>
            <CityNm>GLENVIEW</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60026</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY SERVICES</ServicesDesc>
        <CompensationAmt>197256</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>308423</GovernmentGrantsAmt>
      <TotalContributionsAmt>308423</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET RESIDENT SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>2627216</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2627216</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER RESIDENT REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>382</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>382</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>2627598</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1932</TotalRevenueColumnAmt>
        <ExclusionAmt>1932</ExclusionAmt>
      </InvestmentIncomeGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>3554407</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-3554407</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-3554407</TotalRevenueColumnAmt>
        <ExclusionAmt>-3554407</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>-616454</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2627598</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-3552475</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>4518</TotalAmt>
        <ManagementAndGeneralAmt>4518</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>982959</TotalAmt>
        <ProgramServicesAmt>890679</ProgramServicesAmt>
        <ManagementAndGeneralAmt>92280</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>400437</TotalAmt>
        <ProgramServicesAmt>385315</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15122</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>112143</TotalAmt>
        <ProgramServicesAmt>106321</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5822</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>51086</TotalAmt>
        <ManagementAndGeneralAmt>51086</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>77420</TotalAmt>
        <ManagementAndGeneralAmt>77420</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>47500</TotalAmt>
        <ManagementAndGeneralAmt>47500</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>321285</TotalAmt>
        <ProgramServicesAmt>284502</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36783</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>2174</TotalAmt>
        <ManagementAndGeneralAmt>2174</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>38082</TotalAmt>
        <ProgramServicesAmt>280</ProgramServicesAmt>
        <ManagementAndGeneralAmt>37802</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>13711</TotalAmt>
        <ManagementAndGeneralAmt>13711</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>1048480</TotalAmt>
        <ProgramServicesAmt>1026758</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21722</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>24529</TotalAmt>
        <ProgramServicesAmt>24529</ProgramServicesAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>24</TotalAmt>
        <ProgramServicesAmt>24</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>57738</TotalAmt>
        <ProgramServicesAmt>51964</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5774</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>342948</TotalAmt>
        <ProgramServicesAmt>3089</ProgramServicesAmt>
        <ManagementAndGeneralAmt>339859</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>STATE ASSESSMENT FEE</Desc>
        <TotalAmt>186162</TotalAmt>
        <ProgramServicesAmt>186162</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>63724</TotalAmt>
        <ProgramServicesAmt>63724</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES &amp; EQUIPMENT</Desc>
        <TotalAmt>33874</TotalAmt>
        <ProgramServicesAmt>20764</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13110</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD</Desc>
        <TotalAmt>1221</TotalAmt>
        <ProgramServicesAmt>1221</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>840</TotalAmt>
        <ProgramServicesAmt>840</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>3810855</TotalAmt>
        <ProgramServicesAmt>3046172</ProgramServicesAmt>
        <ManagementAndGeneralAmt>764683</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>254279</BOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>889882</BOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1232545</BOYAmt>
        <EOYAmt>125204</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>490481</BOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>0</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1692089</BOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>1460192</BOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>158333</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>6177801</BOYAmt>
        <EOYAmt>125204</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1591466</BOYAmt>
        <EOYAmt>516214</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>1294360</BOYAmt>
        <EOYAmt>1262660</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>591004</BOYAmt>
        <EOYAmt>72668</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3476830</BOYAmt>
        <EOYAmt>1851542</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2700971</BOYAmt>
        <EOYAmt>-1726338</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2700971</BOYAmt>
        <EOYAmt>-1726338</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>6177801</BOYAmt>
        <EOYAmt>125204</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-4427309</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>90743</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>100000</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1102638</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>308423</CurrentTaxYearAmt>
        <TotalAmt>1601804</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>16369841</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>17373716</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16393658</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>14971264</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2627598</CurrentTaxYearAmt>
        <TotalAmt>67736077</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>16460584</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>17373716</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16493658</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16073902</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2936021</CurrentTaxYearAmt>
        <TotalAmt>69337881</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>69337881</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>7189</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3830</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6196</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10709</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1932</CurrentTaxYearAmt>
        <TotalAmt>29856</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>7189</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3830</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6196</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10709</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1932</CurrentTaxYearAmt>
        <TotalAmt>29856</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>5741</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>5322</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2954</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>14017</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>16473514</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>17382868</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16502808</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16084611</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2937953</CurrentTaxYearAmt>
        <TotalAmt>69381754</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99940</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99880</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00040</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00030</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>1</AgentTrusteeEtcInd>
      <BeginningBalanceAmt>203261</BeginningBalanceAmt>
      <DistributionsDuringYearAmt>203261</DistributionsDuringYearAmt>
      <EndingBalanceAmt>0</EndingBalanceAmt>
      <InclEscrowCustodialAcctLiabInd>0</InclEscrowCustodialAcctLiabInd>
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS</Desc>
        <Amt>53058</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO/FROM OTHERS</Desc>
        <Amt>19610</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>72668</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 1B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION OFFERED CASH MANAGEMENT SERVICES TO ITS RESIDENTS. THESE FUNDS REMAINED THE SOLE PROPERTY OF THE RESIDENTS AND WERE FULLY DISBURSED AS OF DECEMBER 31, 2021. THE ORGANIZATION NO LONGER HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS AND ACTED ONLY AS A CUSTODIAN. AT DECEMBER 31, 2021 AND 2020, THE FUND BALANCE WAS APPROXIMATELY $0 AND $203,000 RESPECTIVELY.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
    </IRS990ScheduleJ>
    <IRS990ScheduleN documentId="RetDoc1043200001">
      <DispositionOfAssetsDetail>
        <AssetsDistriOrExpnssPaidDesc>DISPOSAL OF ASSETS RELATED TO CLOSING OF FACILITY</AssetsDistriOrExpnssPaidDesc>
        <DistributionDt>2021-03-01</DistributionDt>
        <FairMarketValueOfAssetAmt>3554407</FairMarketValueOfAssetAmt>
        <MethodOfFMVDeterminationTxt>APPRAISAL</MethodOfFMVDeterminationTxt>
        <BusinessName>
          <BusinessNameLine1Txt>TOWER LEASING CO LLC DBA SILVER LAKE HEALTHCARE CENTER</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>905 TOWER RD</AddressLine1Txt>
          <CityNm>BRISTOL</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19007</ZIPCd>
        </USAddress>
        <IRCSectionTxt>LIMITED LIABILITY COMPANY</IRCSectionTxt>
      </DispositionOfAssetsDetail>
      <DirectorOfSuccessor2Ind>0</DirectorOfSuccessor2Ind>
      <EmployeeOfSuccessor2Ind>0</EmployeeOfSuccessor2Ind>
      <OwnerOfSuccessor2Ind>0</OwnerOfSuccessor2Ind>
      <ReceiveCompensation2Ind>0</ReceiveCompensation2Ind>
    </IRS990ScheduleN>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FILING ORGANIZATION HAS DELEGATED MANAGEMENT DUTIES OVER ITS FINANCIAL OPERATIONS TO KANE FINANCIAL SERVICES, LLC PURSUANT TO A BOARD-APPROVED AGREEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE BOARD PRESIDENT AND THE CONSULTING COMPANY. THE RETURN IS MADE AVAILABLE TO ALL VOTING BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS CONTAINED IN THE EMPLOYEE HANDBOOK. THE POLICY EXTENDS TO THE ORGANIZATION'S OFFICERS AND DIRECTORS. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ITS ANNUAL DISCLOSURE PROCESS. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS EXIST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS HAS THE AUTHORITY TO FIX THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR AS WELL AS OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION LEVELS ARE SET BASED ON CONSULTATION WITH THE CONSULTING COMPANY. ALL PARTIES ARE INDEPENDENT WITH RESPECT TO THE COMPENSATION DECISIONS. COMPENSATION LEVELS ARE SET BASED ON CURRENT MARKET CONDITIONS, THE ECONOMY AND FUNDING SOURCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
