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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>146309</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32701</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LYDIA CELLA</PersonNm>
        <TitleTxt>ASSOC DIR OF NURSING</TitleTxt>
        <AverageHoursPerWeekRt>35.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>129078</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23509</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT HEREL</PersonNm>
        <TitleTxt>DIRECTOR OF SOCIAL WORK</TitleTxt>
        <AverageHoursPerWeekRt>35.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>129059</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41302</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHIFRA WEINGOT-COHEN</PersonNm>
        <TitleTxt>ASST DIR OF ADMISSIONS</TitleTxt>
        <AverageHoursPerWeekRt>35.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>148359</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7045</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAMERTO ALVAREZ</PersonNm>
        <TitleTxt>MAINTENANCE SUPERVISOR</TitleTxt>
        <AverageHoursPerWeekRt>35.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>154377</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44437</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1944829</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>103275</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>387520</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>37</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>THERADYNAMICS REHAB</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>225 CROSSWAYS PARK DRIVE</AddressLine1Txt>
            <CityNm>WOODBURY</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>11797</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NURSING AGENCY</ServicesDesc>
        <CompensationAmt>2376944</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>WHITE GLOVE PLACEMENT</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>85 BARTLETT STREET</AddressLine1Txt>
            <CityNm>BROOKLYN</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>11206</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NURSING AGENCY</ServicesDesc>
        <CompensationAmt>481884</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNIVERSAL MEDICAL REC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>22 THE CROSS ROAD</AddressLine1Txt>
            <CityNm>CORTLANT MANOR</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10567</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NURSING AGENCY</ServicesDesc>
        <CompensationAmt>348261</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>COMPREHENSIVE HEALTHCARE SOLUTIONS</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>36 AIRPORT ROAD</AddressLine1Txt>
            <CityNm>LAKEWOOD</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08701</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL BILLING SERV</ServicesDesc>
        <CompensationAmt>460475</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNITEX TEXTILE RENT</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>401 SO MACQUESTEN PKWY</AddressLine1Txt>
            <CityNm>MT VERNON</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10550</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LAUNDRY AGENCY</ServicesDesc>
        <CompensationAmt>441208</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>17</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>234500</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>385600</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1519</AllOtherContributionsAmt>
      <TotalContributionsAmt>621619</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>SKILLED NURSING FACILITY</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>45583726</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>45583726</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Case Management</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>842345</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>842345</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>46426071</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>522880</TotalRevenueColumnAmt>
        <ExclusionAmt>522880</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>33333</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>33333</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>33333</TotalRevenueColumnAmt>
        <ExclusionAmt>33333</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>12132481</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>12388826</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-256345</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-256345</TotalRevenueColumnAmt>
        <ExclusionAmt>-256345</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>PURCHASE DISCOUNT</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>84323</TotalRevenueColumnAmt>
        <ExclusionAmt>84323</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MEDICAL RECORDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>6017</TotalRevenueColumnAmt>
        <ExclusionAmt>6017</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>264420</TotalRevenueColumnAmt>
        <ExclusionAmt>264420</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>354760</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>47702318</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>46426071</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>654628</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1458253</TotalAmt>
        <ProgramServicesAmt>301880</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1156373</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>18940784</TotalAmt>
        <ProgramServicesAmt>17008194</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1932590</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1663385</TotalAmt>
        <ProgramServicesAmt>1484161</ProgramServicesAmt>
        <ManagementAndGeneralAmt>179224</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3962964</TotalAmt>
        <ProgramServicesAmt>3458358</ProgramServicesAmt>
        <ManagementAndGeneralAmt>504606</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1682907</TotalAmt>
        <ProgramServicesAmt>1438833</ProgramServicesAmt>
        <ManagementAndGeneralAmt>244074</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>87603</TotalAmt>
        <ManagementAndGeneralAmt>87603</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>332443</TotalAmt>
        <ManagementAndGeneralAmt>332443</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>56550</TotalAmt>
        <ManagementAndGeneralAmt>56550</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>4577</TotalAmt>
        <ManagementAndGeneralAmt>4577</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>97639</TotalAmt>
        <ManagementAndGeneralAmt>97639</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>6634371</TotalAmt>
        <ProgramServicesAmt>5199328</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1435043</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>107843</TotalAmt>
        <ProgramServicesAmt>81945</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25898</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>3786206</TotalAmt>
        <ProgramServicesAmt>2876984</ProgramServicesAmt>
        <ManagementAndGeneralAmt>909222</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ProgramServicesAmt>315597</ProgramServicesAmt>
        <ManagementAndGeneralAmt>99739</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>1231689</TotalAmt>
        <ProgramServicesAmt>1049369</ProgramServicesAmt>
        <ManagementAndGeneralAmt>182320</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>15858</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5011</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2116481</TotalAmt>
        <ProgramServicesAmt>2116481</ProgramServicesAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2658629</TotalAmt>
        <ProgramServicesAmt>2536332</ProgramServicesAmt>
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      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1130783</TotalAmt>
        <ProgramServicesAmt>859236</ProgramServicesAmt>
        <ManagementAndGeneralAmt>271547</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>cash receipts assessment</Desc>
        <TotalAmt>2465300</TotalAmt>
        <ProgramServicesAmt>2465300</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>48854612</TotalAmt>
        <ProgramServicesAmt>41207856</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7646756</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>7847541</BOYAmt>
        <EOYAmt>9650224</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>395821</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>8303512</BOYAmt>
        <EOYAmt>9621657</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>45328</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>81788616</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>19576599</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
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      <IntangibleAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>2332412</EOYAmt>
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      <TotalAssetsGrp>
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      <DeferredRevenueGrp>
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        <EOYAmt>0</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>321866</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
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        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>31818260</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
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        <EOYAmt>10924900</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
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        <EOYAmt>47626995</EOYAmt>
      </TotalLiabilitiesGrp>
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      <UnrestrictedNetAssetsGrp>
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        <EOYAmt>41660804</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
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        <EOYAmt>176417</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
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        <EOYAmt>0</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>43365785</BOYAmt>
        <EOYAmt>41837221</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>90684311</BOYAmt>
        <EOYAmt>89464216</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1152294</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-1781887</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>1405617</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <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>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>4577</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>4577</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1, LOBBYING ACTIVITIES</FormAndLineReferenceDesc>
        <ExplanationTxt>The $4,577 is an allocation of trade association dues for lobbying expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <AgentTrusteeEtcInd>false</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>true</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
        <OtherCostOrOtherBasisAmt>237000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>237000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>72048529</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>28196000</DepreciationAmt>
        <BookValueAmt>43852529</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp />
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>9032898</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>5817794</DepreciationAmt>
        <BookValueAmt>3215104</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>470189</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>429353</DepreciationAmt>
        <BookValueAmt>40836</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>47345469</TotalBookValueLandBuildingsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>SWAP AGREEMENTS</Desc>
        <Amt>8643749</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO THIRD PARTIES</Desc>
        <Amt>621078</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>REFUND LIABILITIES</Desc>
        <Amt>1660073</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>10924900</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>45822792</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-1781887</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-1781887</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>47604679</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>97639</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>97639</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>47702318</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>48756973</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>48756973</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>97639</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>97639</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>48854612</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 2B</FormAndLineReferenceDesc>
        <ExplanationTxt>RESIDENT PERSONAL FUNDS ARE MAINTAINED IN BANK ACCOUNTS SEPARATE FROM THE CENTERS ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS ACCOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Pat Slinger-Harvey</PersonNm>
        <TitleTxt>Dir. Of Food &amp; Nutrition</TitleTxt>
        <BaseCompensationFilingOrgAmt>124754</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>21555</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15777</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16924</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>179010</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANTHONY LEWIS</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>323810</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3277</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>31898</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22276</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>381261</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIEL TUCHMAN</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>295064</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>73765</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>39162</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>9792</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>25518</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>6380</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24884</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>6221</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>384628</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>96158</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WARREN LITMAN</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>153313</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>129</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11714</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>165156</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NEIL SCHLISSEL</PersonNm>
        <TitleTxt>DIRECTOR OF FINANCE</TitleTxt>
        <BaseCompensationFilingOrgAmt>176831</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>19718</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>627</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>20015</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>2224</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27855</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>3095</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>225328</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>25037</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LYDIA CELLA</PersonNm>
        <TitleTxt>ASSOC DIR OF NURSING</TitleTxt>
        <BaseCompensationFilingOrgAmt>119020</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10058</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13081</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10428</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>152587</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT HEREL</PersonNm>
        <TitleTxt>DIRECTOR OF SOCIAL WORK</TitleTxt>
        <BaseCompensationFilingOrgAmt>122928</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6131</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13710</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27592</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>170361</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHIFRA WEINGOT-COHEN</PersonNm>
        <TitleTxt>ASST DIR OF ADMISSIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>135000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13359</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7045</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>155404</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MENUCHA ACKERMAN</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING</TitleTxt>
        <BaseCompensationFilingOrgAmt>227393</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3041</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>28838</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27608</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>301880</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MAMERTO ALVAREZ</PersonNm>
        <TitleTxt>MAINTENANCE SUPERVISOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>131131</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13246</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>16833</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27604</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>198814</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD APPROVES MERIT BASED BONUSES FOR ITS OFFICERS AND TOP EMPLOYEES FOR THEIR DEDICATION TO THE CENTER DURING THE YEAR. THESE BONUSES ARE APPROVED TOWARDS THE END OF THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER ENDED ITS CASE MANAGEMENT PROGRAM IN APRIL OF 2018.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>COBBLE HILL LIFECARE, INC. IS THE SOLE MEMBER OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBER CAN ELECT BOARD MEMBERS WHEN THERE ARE VACANCIES ON THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>APPROVAL BY THE MEMBER IS REQUIRED TO AMEND THE BYLAWS. THE MEMBER CAN ALSO REMOVE BOARD MEMBERS WITHOUT CAUSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE CFO AND PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. ANY QUESTIONS THAT ARISE ARE DISCUSSED AND RESOLVED PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS REVIEWED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEES. THE AUDIT COMMITTEE IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST WHICH OCCUR, AND WILL ENSURE SUCH INDIVIDUALS DO NOT PARTICIPATE IN DISCUSSIONS OR DECISIONS INVOLVING THE CONFLICT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION IS DETERMINED BY A RECOMMENDATION BY THE PRESIDENT/CEO AND APPROVAL OF THE BOARD. THE PRESIDENT/CEOS COMPENSATION IS DETERMINED BY THE GOVERNING BOARD. THIS PROCESS WAS LAST DONE IN 2017. THE PROCESS INCLUDES A BOARD REVIEW OF COMPENSATION OF SIMILAR POSITIONS AT OTHER HEALTH CARE FACILITIES OBTAINED FROM IRS FORM 990S FILED ON GUIDESTAR OR CANVASSING OF THOSE FACILITES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of other officers/key employees is determined and approved by the board of directors. THIS PROCESS WAS LAST DONE IN 2017. THE PROCESS INCLUDES A BOARD REVIEW OF COMPENSATION OF SIMILAR POSITIONS AT OTHER HEALTH CARE FACILITIES OBTAINED FROM IRS FORM 990S FILED ON GUIDESTAR OR CANVASSING OF THOSE FACILITES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in value of Swap Value Agreement: 1,405,617</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>the process did not change from prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Cobble Hill LifeCare Plus LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>380 Henry Street</AddressLine1Txt>
          <CityNm>Brooklyn</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>11201</ZIPCd>
        </USAddress>
        <EIN>461226428</EIN>
        <PrimaryActivitiesTxt>Elderly Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <TotalIncomeAmt>842345</TotalIncomeAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CHHC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Cobble hill foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>380 Henry street</AddressLine1Txt>
          <CityNm>brooklyn</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>11201</ZIPCd>
        </USAddress>
        <EIN>113122301</EIN>
        <PrimaryActivitiesTxt>fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>PF</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CH LIFECARE</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>YOUR CHOICE AT HOME INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>380 Henry street</AddressLine1Txt>
          <CityNm>brooklyn</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>11201</ZIPCd>
        </USAddress>
        <EIN>461256502</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Cobble Hill Lifecare Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>380 Henry street</AddressLine1Txt>
          <CityNm>brooklyn</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>11201</ZIPCd>
        </USAddress>
        <EIN>461388106</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12C</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>nA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>