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      <FSAuditedInd>true</FSAuditedInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
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      <PublicSupportCY509Pct>0.99810</PublicSupportCY509Pct>
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      <InvestmentIncomePYPct>0.00120</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Pt III Ln 12</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income Part III, Line 12 Description: MISCELLANEOUS REVENUES 2012: 6928. 2013: 9614. 2014: 12025. 2015: 13410. 2016: 14564.</ExplanationTxt>
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      <LandGrp>
        <OtherCostOrOtherBasisAmt>899333</OtherCostOrOtherBasisAmt>
        <BookValueAmt>899333</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>15689557</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3924659</DepreciationAmt>
        <BookValueAmt>11764898</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2090854</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1578872</DepreciationAmt>
        <BookValueAmt>511982</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>13176213</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>RESIDENT ACCOUNTS</Desc>
        <BookValueAmt>38723</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ASSETS WHOSE USE IS LIMITED</Desc>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER NON - CURRENT ASSETS</Desc>
        <BookValueAmt>538669</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>DUE FROM RELATED PARTIES - LONG TERM</Desc>
        <BookValueAmt>527423</BookValueAmt>
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      <TotalBookValueOtherAssetsAmt>1104815</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RESIDENT ACCOUNTS</Desc>
        <Amt>38723</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED WORKERS COMPENSATION - SHORT TERM</Desc>
        <Amt>151758</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED PAYROLL/EMPLOYEE BENEFITS</Desc>
        <Amt>742103</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO UNIVERSITY OF ROCHESTER - LONG TERM</Desc>
        <Amt>5160906</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES - LONG TERM</Desc>
        <Amt>6394550</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>ESTIMATED THIRD PARTY PAYABLE</Desc>
        <Amt>999911</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED WORKERS COMPENSATION - LONG TERM</Desc>
        <Amt>1681911</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES - SHORT TERM</Desc>
        <Amt>510012</Amt>
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    <IRS990ScheduleJ documentId="00000004">
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      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM J HALL MD</PersonNm>
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        <OtherCompensationRltdOrgsAmt>55</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>22881</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>9052</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>268367</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT MCCANN MD</PersonNm>
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        <OtherCompensationRltdOrgsAmt>523</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>36399</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>24580</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>634952</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LEONARD SHUTE</PersonNm>
        <CompensationBasedOnRltdOrgsAmt>188461</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>32844</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>19724</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>13260</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>254289</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEVEN GOLDSTEIN</PersonNm>
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        <OtherCompensationRltdOrgsAmt>71968</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>584899</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>16618</NontaxableBenefitsRltdOrgsAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WALTER WINIARCZYK</PersonNm>
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        <NontaxableBenefitsFilingOrgAmt>5764</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>158025</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ADAM ANOLIK</PersonNm>
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        <OtherCompensationRltdOrgsAmt>438</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>57599</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>17960</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>500525</TotalCompensationRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
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    <IRS990ScheduleO documentId="00000005" softwareId="16000371">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE STATEMENT ATTACHED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI</FormAndLineReferenceDesc>
        <ExplanationTxt>LINE 9 - TRANSFERS FROM UNIVERSITY OF ROCHESTER $1,461,660 AND HIGHLAND HOSPITAL $338,340.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBTS 1111409. 0. 1111409. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>NYS ASSESSMENT 226799. 0. 226799. 0.</ExplanationTxt>
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          <BusinessNameLine1Txt>SEE ATTACHED</BusinessNameLine1Txt>
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          <AddressLine1Txt>SEE ATTACHED</AddressLine1Txt>
          <CityNm>SEE ATTACHED</CityNm>
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          <BusinessNameLine1Txt>SEE ATTACHED</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>SEE ATTACHED</AddressLine1Txt>
          <CityNm>SEE ATTACHED</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>000000000</ZIPCd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SEE ATTACHED</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>SEE ATTACHED</AddressLine1Txt>
          <CityNm>SEE ATTACHED</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>000000000</ZIPCd>
        </USAddress>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>true</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>