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      <Form990PartVIISectionAGrp>
        <PersonNm>STANLEY J SAVINESE</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DAWN E SEIDERS</PersonNm>
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        <TitleTxt>UNION NURSE</TitleTxt>
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      <Form990PartVIISectionAGrp>
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          <BusinessName>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6403 MCPHERSON ST</AddressLine1Txt>
            <CityNm>LEVITTOWN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19057</ZIPCd>
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        <ServicesDesc>HOME HEALTHCARE STAFFING</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MCKESSON INFORMATION SOLUTIONS LLC</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>400 DELRAN PKWY</AddressLine1Txt>
            <CityNm>DELRAN</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08075</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INFORMATION TECHNOLOGY</ServicesDesc>
        <CompensationAmt>313417</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BLACKTREE HEALTHCARE CONSULTING</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>ONE FAYETTE STREET SUITE 425</AddressLine1Txt>
            <CityNm>CONSHOHOCKEN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19428</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTHCARE CONSULTANTS</ServicesDesc>
        <CompensationAmt>209316</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JANI-KING OF PHILADELPHIA INC</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2500 EISENHOWER AVE</AddressLine1Txt>
            <CityNm>NORRISTOWN</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19403</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICE</ServicesDesc>
        <CompensationAmt>182699</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SKILLED NURSING INC</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>955 HORSHAM RD 205</AddressLine1Txt>
            <CityNm>HORSHAM</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19044</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SKILLED NURSING AGENCY</ServicesDesc>
        <CompensationAmt>180169</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>11</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>4676</FederatedCampaignsAmt>
      <FundraisingAmt>70895</FundraisingAmt>
      <RelatedOrganizationsAmt>1103134</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>259535</AllOtherContributionsAmt>
      <TotalContributionsAmt>1438240</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>29748769</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29748769</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>29748769</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3853</TotalRevenueColumnAmt>
        <ExclusionAmt>3853</ExclusionAmt>
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      <FundraisingGrossIncomeAmt>7020</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>70895</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>30270</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-23250</TotalRevenueColumnAmt>
        <ExclusionAmt>-23250</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>INSURANCE PROCEEDS-WATER DAMAGE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>29923</TotalRevenueColumnAmt>
        <ExclusionAmt>29923</ExclusionAmt>
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        <Desc>MISCELLANEOUS INCOME</Desc>
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        <ExclusionAmt>4090</ExclusionAmt>
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      <CompCurrentOfcrDirectorsGrp>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>74051</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>70900</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>238133</ProgramServicesAmt>
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        <ProgramServicesAmt>24319</ProgramServicesAmt>
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        <ProgramServicesAmt>977568</ProgramServicesAmt>
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      <AllOtherExpensesGrp>
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        <EOYAmt>276731</EOYAmt>
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      <AccountsReceivableGrp>
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      <LandBldgEquipCostOrOtherBssAmt>5259435</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <CurrentTaxYearAmt>34013</CurrentTaxYearAmt>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus2YearsAmt>32961727</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>34021462</CurrentTaxYearMinus1YearAmt>
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      <PublicSupportPY509Pct>0.99880</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00010</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00020</InvestmentIncomePYPct>
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      <Form990ScheduleAPartVIGrp>
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        <ExplanationTxt>MISCELLANEOUS INCOME - 2013 AMOUNT: $ 14,968. 2014 AMOUNT: $ 5,988. 2015 AMOUNT: $ 9,464. 2016 AMOUNT: $ 36,886. 2017 AMOUNT: $ 4,090. INSURANCE PROCEEDS - 2017 AMOUNT: $ 29,923.</ExplanationTxt>
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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2018 AND 2017. THE ORGANIZATION DOES NOT PERFORM ANY ACTIVITIES THAT WOULD BE SUBJECT TO UNRELATED BUSINESS INCOME TAX; THEREFORE, IT HAS NOT FILED FORM 990-T, EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN. THE ORGANIZATION'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX DEFICIENCIES IN SUPPLIES AND OTHER EXPENSES.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY APPLIES TO ANY TRUSTEE OR PRINCIPAL OFFICER. A POTENTIAL CONFLICT MUST BE DISCLOSED TO THE TRUSTEES. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT AND ALL MATERIAL FACTS BY THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING TRUSTEES. IF A CONFLICT IS IDENTIFIED, THE TRUSTEES SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE, THE TRUSTEES SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER OR NOT TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. EACH PERSON COVERED UNDER THIS POLICY IS REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY.</ExplanationTxt>
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        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
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      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>