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        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>437695</TotalAmt>
        <ProgramServicesAmt>167637</ProgramServicesAmt>
        <ManagementAndGeneralAmt>270058</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <OtherExpensesGrp>
        <Desc>Managed Long Term Care Program Expense</Desc>
        <TotalAmt>39108562</TotalAmt>
        <ProgramServicesAmt>37451567</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1656995</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Social Day Program Expense</Desc>
        <TotalAmt>52303</TotalAmt>
        <ProgramServicesAmt>160</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52143</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Community Home Health Agency Expense</Desc>
        <TotalAmt>300695</TotalAmt>
        <ProgramServicesAmt>40691</ProgramServicesAmt>
        <ManagementAndGeneralAmt>260004</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Provision for Doubtful Accounts</Desc>
        <TotalAmt>167545</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>167545</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>46202578</TotalAmt>
        <ProgramServicesAmt>41216893</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4985685</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>4081778</BOYAmt>
        <EOYAmt>1223090</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>209994</BOYAmt>
        <EOYAmt>693868</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>78724</BOYAmt>
        <EOYAmt>102143</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>3693899</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1615444</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2403513</BOYAmt>
        <EOYAmt>2078455</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>2443209</BOYAmt>
        <EOYAmt>2459624</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>4440407</BOYAmt>
        <EOYAmt>7091314</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>13657625</BOYAmt>
        <EOYAmt>13648494</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>8830703</BOYAmt>
        <EOYAmt>12628891</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1145195</BOYAmt>
        <EOYAmt>1068929</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>111624</BOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>10087522</BOYAmt>
        <EOYAmt>13697820</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>3570103</BOYAmt>
        <EOYAmt>-49326</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>3570103</BOYAmt>
        <EOYAmt>-49326</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>13657625</BOYAmt>
        <EOYAmt>13648494</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-3619429</ReconcilationRevenueExpnssAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="00000002" softwareId="16000371">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus2YearsAmt>2452</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2184</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64928</CurrentTaxYearAmt>
        <TotalAmt>69564</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus2YearsAmt>2452</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2184</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64928</CurrentTaxYearAmt>
        <TotalAmt>69564</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>69564</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>69564</TotalSupportAmt>
      <PublicSupportCY170Pct>1.00000</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>1.00000</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <PublicSupportTotal509Amt>0</PublicSupportTotal509Amt>
      <PublicSupportCY509Pct>0</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0</InvestmentIncomeCYPct>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="00000003" softwareId="16000371">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>264707</OtherCostOrOtherBasisAmt>
        <BookValueAmt>264707</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1973538</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>798119</DepreciationAmt>
        <BookValueAmt>1175419</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1455654</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>817325</DepreciationAmt>
        <BookValueAmt>638329</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>2078455</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Due From Previously Affiliated Companies</Desc>
        <BookValueAmt>3586636</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due From Third Party Payor</Desc>
        <BookValueAmt>3504278</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Security Deposit</Desc>
        <BookValueAmt>400</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Financing, Net</Desc>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>7091314</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Pension Liability</Desc>
      </OtherLiabilitiesOrgGrp>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>42619037</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>35888</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>35888</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>42583149</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>42583149</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>46202578</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>46202578</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>46202578</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Choice recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Management has determined that Elant choice had no uncertain tax positions that would require financial statement recognition and/or disclosure. Elant Choice is no longer subject to examinations by applicable taxing jurisdictions for periods prior to December 31, 2011.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="00000004">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SYLVIA MCTIGUE</PersonNm>
        <BaseCompensationFilingOrgAmt>222211</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>222211</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Officers and key employees in 2015 were compensated by a previously related party, Elant, Inc. The following was their compensation policy. The board of directors reviews and approves salary recommendations of top management employees and officers. Salary recommendations are derived from reputable top tier survey houses as well as local industries and association specific sources. World at work standards are followed in the selection and use of said compensation surveys to assure reliability and validity of data sources. The policy was last undertaken in 2011.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="00000005" softwareId="16000371">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Elant Choice Inc has contracted with Elant, Inc (Parent Organization) for services through an administrative services agreement. This agreement included finance, information technology, human resources, marketing, and corporate compliance services, as well as, being responsible for the maintenance and retention of all corporate documents and records for the organization. Elant Inc. received a fee for the services provided which was paid monthly by Elant Choice, Inc. Elant Choice Inc, and Elant , Inc (including other affiliates - Elant at Goshen, Inc., Elant at Newburgh, Inc, Elant at Fishkill, Inc, Elant Foundation, Inc, Elant at Brandywine, Inc, Glen Arden, Inc, and Lifestyle Concepts, LLC) have shared common board members. In May 2014 , both the Elant Inc. board of directors and the Elant Choice, Inc board of directors agreed to remove Elant, Inc. as the active parent of Elant Choice, Inc. Over the course of the next few months, Elant Choice Inc. created the infrastructure in the above areas so there would be a transition of services to Elant Choice, Inc and a termination of the administrative services agreement. The termination occurred as of December 31, 2014.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Elant, Inc. was the sole member of Elant Choice, Inc.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>As active parent of Elant Choice, Inc., Elant, Inc. had exclusive power to elect and remove members of the board. This ended effective May 2014.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>As active parent of Elant Choice,Inc., Elant, Inc. was able to make governance decisions on behalf of the organization. This ended effective May 2014.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its form 990 available for public inspection as required under section 6104 of the internal revenue code. The disclosures are covered under the organization's annual public disclosure policy which lists government documents, conflict of interest policy and financials statements. All other relevant documents are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>We have a corporate compliance committee that regularly meets and monitors matters of compliance and areas of risk. We train , review and audit on an ongoing basis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>There were no significant changes made to it's governing documents since the prior form 990 was filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A copy of the 990's will be present in the Board's packet. It will be reviewed, discussed and appropved at the the next quarterly board meeting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The process included 3rd party compensation data from Mercer, a compensation analysis firm, board discussion via executive session, board approval compensation philosophy policy statement and a resolution of the board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Disclosure is covered by our annual public disclosure policy which lists government documents, conflicts of interest, and financial statements. Other relevant documents are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>The finance committee of the board in accordance with its charter assumes the responsibility as authorized above, including the engagement of independent auditors. The committee recommends for approval by the trustees of the board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The process included 3rd party compensation data from Mercer, a compensation analysis firm, board discussion via executive session, board approval compensation philosophy policy statement and a resolution of the board.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>