﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2012v2.0" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCount="0">
    <Timestamp>2013-11-15T07:16:12-08:00</Timestamp>
    <TaxPeriodEndDate>2012-12-31</TaxPeriodEndDate>
    <PreparerFirm>
      <PreparerFirmBusinessName>
        <BusinessNameLine1>ANDREW WILLIAMS CPA</BusinessNameLine1>
      </PreparerFirmBusinessName>
      <PreparerFirmUSAddress>
        <AddressLine1>440 TITUS AVENUE</AddressLine1>
        <City>ROCHESTER</City>
        <State>NY</State>
        <ZIPCode>146173517</ZIPCode>
      </PreparerFirmUSAddress>
    </PreparerFirm>
    <ReturnType>990</ReturnType>
    <TaxPeriodBeginDate>2012-01-01</TaxPeriodBeginDate>
    <Filer>
      <EIN>223240227</EIN>
      <Name>
        <BusinessNameLine1>THE HIGHLANDS LIVING CENTER INC</BusinessNameLine1>
      </Name>
      <NameControl>HIGH</NameControl>
      <Phone>5853890988</Phone>
      <USAddress>
        <AddressLine1>500 HAHNEMANN TRAIL</AddressLine1>
        <City>PITTSFORD</City>
        <State>NY</State>
        <ZIPCode>145342356</ZIPCode>
      </USAddress>
    </Filer>
    <Officer>
      <Name>LEONARD SHUTE</Name>
      <Title>CHIEF FINANCIAL OFFICER</Title>
      <Phone>5853890988</Phone>
      <DateSigned>2013-10-18</DateSigned>
      <AuthorizeThirdParty>true</AuthorizeThirdParty>
    </Officer>
    <Preparer>
      <Name>ANDREW WILLIAMS CPA</Name>
      <Phone>5853427060</Phone>
      <DatePrepared>2013-11-15</DatePrepared>
      <SelfEmployed>X</SelfEmployed>
    </Preparer>
    <TaxYear>2012</TaxYear>
    <BuildTS>2016-02-25 16:41:14Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="7">
    <IRS990 documentId="00000001" referenceDocumentName="IRS990ScheduleO ReasonableCauseExplanation" softwareId="12000225">
      <NameOfPrincipalOfficerPerson>LEONARD SHUTE</NameOfPrincipalOfficerPerson>
      <AddressPrincipalOfficerUS>
        <AddressLine1>500 HAHNEMANN TR</AddressLine1>
        <City>PITTSFORD</City>
        <State>NY</State>
        <ZIPCode>14534</ZIPCode>
      </AddressPrincipalOfficerUS>
      <GrossReceipts>11185017</GrossReceipts>
      <GroupReturnForAffiliates>false</GroupReturnForAffiliates>
      <Organization501c3>X</Organization501c3>
      <WebSite>N/A</WebSite>
      <TypeOfOrganizationCorporation>X</TypeOfOrganizationCorporation>
      <YearFormation>1995</YearFormation>
      <StateLegalDomicile>NY</StateLegalDomicile>
      <ActivityOrMissionDescription>TO PROVIDE A CARING, COMPASSIONATE AND QUALITY-FOCUSED LIVING ENVIRONMENT IN A 122 BED SKILLED-NURSING FACILITY.</ActivityOrMissionDescription>
      <NbrVotingMembersGoverningBody>8</NbrVotingMembersGoverningBody>
      <NbrIndependentVotingMembers>6</NbrIndependentVotingMembers>
      <TotalNbrEmployees>302</TotalNbrEmployees>
      <TotalNbrVolunteers>2</TotalNbrVolunteers>
      <TotalGrossUBI>0</TotalGrossUBI>
      <ContributionsGrantsPriorYear>37126</ContributionsGrantsPriorYear>
      <ContributionsGrantsCurrentYear>34830</ContributionsGrantsCurrentYear>
      <ProgramServiceRevenuePriorYear>11877327</ProgramServiceRevenuePriorYear>
      <ProgramServiceRevenueCY>11092619</ProgramServiceRevenueCY>
      <InvestmentIncomePriorYear>1787</InvestmentIncomePriorYear>
      <InvestmentIncomeCurrentYear>1027</InvestmentIncomeCurrentYear>
      <OtherRevenuePriorYear>54458</OtherRevenuePriorYear>
      <OtherRevenueCurrentYear>56541</OtherRevenueCurrentYear>
      <TotalRevenuePriorYear>11970698</TotalRevenuePriorYear>
      <TotalRevenueCurrentYear>11185017</TotalRevenueCurrentYear>
      <GrantsAndSimilarAmntsCY>0</GrantsAndSimilarAmntsCY>
      <BenefitsPaidToMembersCY>0</BenefitsPaidToMembersCY>
      <SalariesEtcPriorYear>8679728</SalariesEtcPriorYear>
      <SalariesEtcCurrentYear>8415480</SalariesEtcCurrentYear>
      <TotalProfFundrsngExpCY>0</TotalProfFundrsngExpCY>
      <TotalFundrsngExpCurrentYear>0</TotalFundrsngExpCurrentYear>
      <OtherExpensePriorYear>3998017</OtherExpensePriorYear>
      <OtherExpensesCurrentYear>3790756</OtherExpensesCurrentYear>
      <TotalExpensesPriorYear>12677745</TotalExpensesPriorYear>
      <TotalExpensesCurrentYear>12206236</TotalExpensesCurrentYear>
      <RevenuesLessExpensesPriorYear>-707047</RevenuesLessExpensesPriorYear>
      <RevenuesLessExpensesCY>-1021219</RevenuesLessExpensesCY>
      <TotalAssetsBOY>7681621</TotalAssetsBOY>
      <TotalAssetsEOY>7759638</TotalAssetsEOY>
      <TotalLiabilitiesBOY>9481435</TotalLiabilitiesBOY>
      <TotalLiabilitiesEOY>10580671</TotalLiabilitiesEOY>
      <NetAssetsOrFundBalancesBOY>-1799814</NetAssetsOrFundBalancesBOY>
      <NetAssetsOrFundBalancesEOY>-2821033</NetAssetsOrFundBalancesEOY>
      <MissionDescription>TO PROVIDE A CARING, COMPASSIONATE</MissionDescription>
      <SignificantNewProgramServices>false</SignificantNewProgramServices>
      <SignificantChange>false</SignificantChange>
      <Expense>10343260</Expense>
      <Revenue>10637079</Revenue>
      <Description>OPERATE A 122 BED SKILLED-NURSING FACILITY AT 96% OCCUPANCY.</Description>
      <Activity2>
        <Expense>305159</Expense>
        <Revenue>455540</Revenue>
        <Description>OPERATE A 20 SLOT ADULT DAY CARE MEDICAL PROGRAM FOR RESIDENTS OF THE COMMUNITY.</Description>
      </Activity2>
      <TotalProgramServiceExpense>10648419</TotalProgramServiceExpense>
      <DescribedIn501C3 referenceDocumentId="00000002" referenceDocumentName="IRS990ScheduleA">true</DescribedIn501C3>
      <ScheduleBRequired>false</ScheduleBRequired>
      <PoliticalActivities>false</PoliticalActivities>
      <LobbyingActivities referenceDocumentId="00000003" referenceDocumentName="IRS990ScheduleC">true</LobbyingActivities>
      <SubjectToProxyTax>false</SubjectToProxyTax>
      <DonorAdvisedFunds>false</DonorAdvisedFunds>
      <ConservationEasements>false</ConservationEasements>
      <CollectionsOfArt>false</CollectionsOfArt>
      <CreditCounseling>false</CreditCounseling>
      <TermOrPermanentEndowments>false</TermOrPermanentEndowments>
      <ReportLandBldgEquip referenceDocumentId="00000004" referenceDocumentName="IRS990ScheduleD">true</ReportLandBldgEquip>
      <ReportInvestOthSecurities>false</ReportInvestOthSecurities>
      <ReportProgRelInvest>false</ReportProgRelInvest>
      <ReportOtherAssets referenceDocumentId="00000004" referenceDocumentName="IRS990ScheduleD">true</ReportOtherAssets>
      <ReportOtherLiabilities referenceDocumentId="00000004" referenceDocumentName="IRS990ScheduleD">true</ReportOtherLiabilities>
      <ReportFin48Footnote>false</ReportFin48Footnote>
      <IndependentAuditFinancialStmt referenceDocumentId="00000004" referenceDocumentName="IRS990ScheduleD">true</IndependentAuditFinancialStmt>
      <ConsolidatedAuditFinancialStmt>false</ConsolidatedAuditFinancialStmt>
      <School>false</School>
      <ForeignOffice>false</ForeignOffice>
      <ForeignActivities>false</ForeignActivities>
      <MoreThan5000KToOrganizations>false</MoreThan5000KToOrganizations>
      <MoreThan5000KToIndividuals>false</MoreThan5000KToIndividuals>
      <ProfessionalFundraising>false</ProfessionalFundraising>
      <FundraisingActivities>false</FundraisingActivities>
      <Gaming>false</Gaming>
      <Hospital>false</Hospital>
      <GrantsToOrganizations>false</GrantsToOrganizations>
      <GrantsToIndividuals>false</GrantsToIndividuals>
      <ScheduleJRequired referenceDocumentId="00000005" referenceDocumentName="IRS990ScheduleJ">true</ScheduleJRequired>
      <TaxExemptBonds>false</TaxExemptBonds>
      <ExcessBenefitTransaction>false</ExcessBenefitTransaction>
      <PriorExcessBenefitTransaction>false</PriorExcessBenefitTransaction>
      <LoanToOfficerOrDQP>false</LoanToOfficerOrDQP>
      <GrantToRelatedPerson>false</GrantToRelatedPerson>
      <BsnssRltnshpWithOrganization>false</BsnssRltnshpWithOrganization>
      <BsnssRltnshpThruFamilyMember>false</BsnssRltnshpThruFamilyMember>
      <OfficerEntityWithBsnssRltnshp>false</OfficerEntityWithBsnssRltnshp>
      <DeductibleNonCashContributions>false</DeductibleNonCashContributions>
      <DeductibleContributionsOfArt>false</DeductibleContributionsOfArt>
      <Terminated>false</Terminated>
      <PartialLiquidation>false</PartialLiquidation>
      <DisregardedEntity>false</DisregardedEntity>
      <RelatedEntity referenceDocumentId="00000007" referenceDocumentName="IRS990ScheduleR">true</RelatedEntity>
      <RelatedOrgControlledEntity>false</RelatedOrgControlledEntity>
      <TransactionRelatedEntity>false</TransactionRelatedEntity>
      <ActivitiesConductedPartnership>false</ActivitiesConductedPartnership>
      <ScheduleORequired>true</ScheduleORequired>
      <NumberFormsTransmittedWith1096>24</NumberFormsTransmittedWith1096>
      <NumberW2GIncluded>0</NumberW2GIncluded>
      <ComplianceWithBackupWitholding>true</ComplianceWithBackupWitholding>
      <NumberOfEmployees>302</NumberOfEmployees>
      <EmploymentTaxReturnsFiled>true</EmploymentTaxReturnsFiled>
      <UnrelatedBusinessIncome>false</UnrelatedBusinessIncome>
      <ForeignFinancialAccount>false</ForeignFinancialAccount>
      <ProhibitedTaxShelterTrans>false</ProhibitedTaxShelterTrans>
      <TaxablePartyNotification>false</TaxablePartyNotification>
      <NonDeductibleContributions>false</NonDeductibleContributions>
      <QuidProQuoContributions>false</QuidProQuoContributions>
      <Form8282PropertyDisposedOf>false</Form8282PropertyDisposedOf>
      <FundsToPayPremiums>false</FundsToPayPremiums>
      <PremiumsPaid>false</PremiumsPaid>
      <IndoorTanningServices>false</IndoorTanningServices>
      <InfoInScheduleOPartVI>X</InfoInScheduleOPartVI>
      <NbrVotingGoverningBodyMembers>8</NbrVotingGoverningBodyMembers>
      <NumberIndependentVotingMembers>6</NumberIndependentVotingMembers>
      <FamilyOrBusinessRelationship>false</FamilyOrBusinessRelationship>
      <DelegationOfManagementDuties>false</DelegationOfManagementDuties>
      <ChangesToOrganizingDocs>false</ChangesToOrganizingDocs>
      <MaterialDiversionOrMisuse>false</MaterialDiversionOrMisuse>
      <MembersOrStockholders>true</MembersOrStockholders>
      <ElectionOfBoardMembers>true</ElectionOfBoardMembers>
      <DecisionsSubjectToApproval>true</DecisionsSubjectToApproval>
      <MinutesOfGoverningBody>true</MinutesOfGoverningBody>
      <MinutesOfCommittees>true</MinutesOfCommittees>
      <OfficerMailingAddress>false</OfficerMailingAddress>
      <LocalChapters>false</LocalChapters>
      <Form990ProvidedToGoverningBody>true</Form990ProvidedToGoverningBody>
      <ConflictOfInterestPolicy>true</ConflictOfInterestPolicy>
      <AnnualDisclosureCoveredPersons>true</AnnualDisclosureCoveredPersons>
      <RegularMonitoringEnforcement>true</RegularMonitoringEnforcement>
      <WhistleblowerPolicy>true</WhistleblowerPolicy>
      <DocumentRetentionPolicy>true</DocumentRetentionPolicy>
      <CompensationProcessCEO>true</CompensationProcessCEO>
      <CompensationProcessOther>true</CompensationProcessOther>
      <InvestmentInJointVenture>false</InvestmentInJointVenture>
      <StatesWhereCopyOfReturnIsFiled>NY</StatesWhereCopyOfReturnIsFiled>
      <UponRequest>X</UponRequest>
      <TheBooksAreInCareOf>
        <NamePerson>DARYL DRADER</NamePerson>
        <TelephoneNumber>5854427960</TelephoneNumber>
        <AddressUS>
          <AddressLine1>5901 LAC DE VILLE BLVD</AddressLine1>
          <City>ROCHESTER</City>
          <State>NY</State>
          <ZIPCode>14618</ZIPCode>
        </AddressUS>
      </TheBooksAreInCareOf>
      <Form990PartVIISectionA>
        <NamePerson>MICHAEL P RIORDAN</NamePerson>
        <Title>BOARD CHAIR</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ELIZABETH GARRETT</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROBERT LATELLA</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROBBIE MAGEE</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>JAMES MOORE</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>GERALD VAN STRYDONK</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>WILLIAM HALL MD</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>236386</ReportableCompFromRelatedOrgs>
        <OtherCompensation>30995</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>ROBERT MCCANN MD</NamePerson>
        <Title>BOARD MEMBER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>410066</ReportableCompFromRelatedOrgs>
        <OtherCompensation>32181</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>LEONARD SHUTE</NamePerson>
        <Title>CHIEF FINANCIAL OFFICER</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>479245</ReportableCompFromRelatedOrgs>
        <OtherCompensation>258048</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>STEVEN GOLDSTEIN</NamePerson>
        <Title>PRESIDENT</Title>
        <AverageHoursPerWeek>1.00</AverageHoursPerWeek>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>919263</ReportableCompFromRelatedOrgs>
        <OtherCompensation>224672</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>KATHY GRIMES</NamePerson>
        <Title>ADMINISTRATOR</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>136711</ReportableCompFromRelatedOrgs>
        <OtherCompensation>4612</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>MICHELLE BARTLESON</NamePerson>
        <Title>DIRECTOR OF REHAB</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>119940</ReportableCompFromRelatedOrgs>
        <OtherCompensation>8194</OtherCompensation>
      </Form990PartVIISectionA>
      <TotalReportableCompFrmRltdOrgs>2301611</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>558702</TotalOtherCompensation>
      <FormersListed>false</FormersListed>
      <TotalCompGT150K>true</TotalCompGT150K>
      <CompensationFromOtherSources>false</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>UNIVERSITY OF ROCHESTER</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>601 ELMWOOD AVE</AddressLine1>
            <City>ROCHESTER</City>
            <State>NY</State>
            <ZIPCode>14642</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>PHYSICIAN SERVICES</DescriptionOfServices>
        <Compensation>191322</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>AID TO HOSPITALS</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>45 MCKEE RD</AddressLine1>
            <City>ROCHESTER</City>
            <State>NY</State>
            <ZIPCode>14611</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>LAUNDRY SERVICES</DescriptionOfServices>
        <Compensation>110803</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>2</NumberOfContractorsGT100K>
      <AllOtherContributions>34830</AllOtherContributions>
      <TotalContributions>34830</TotalContributions>
      <ProgramServiceRevenue>
        <Description>MEDICARE &amp; MEDICAID</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>6324009</TotalRevenueColumn>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>PER DIEM CHARGES</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>4768610</TotalRevenueColumn>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>11092619</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>1027</TotalRevenueColumn>
        <ExclusionAmount>1027</ExclusionAmount>
      </InvestmentIncome>
      <GrossRents>
        <Real>54105</Real>
      </GrossRents>
      <RentalIncomeOrLoss>
        <Real>54105</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>54105</TotalRevenueColumn>
        <ExclusionAmount>54105</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>MISCELLANEOUS</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>2436</TotalRevenueColumn>
        <ExclusionAmount>2436</ExclusionAmount>
      </OtherRevenueMisc>
      <TotalOtherRevenue>2436</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>11185017</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>11092619</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>57568</ExclusionAmount>
      </TotalRevenue>
      <OtherSalariesAndWages>
        <Total>6350233</Total>
        <ProgramServices>5734993</ProgramServices>
        <ManagementAndGeneral>615240</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>48161</Total>
        <ProgramServices>43495</ProgramServices>
        <ManagementAndGeneral>4666</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>1531293</Total>
        <ProgramServices>1382934</ProgramServices>
        <ManagementAndGeneral>148359</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>485793</Total>
        <ProgramServices>438727</ProgramServices>
        <ManagementAndGeneral>47066</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </PayrollTaxes>
      <FeesForServicesLegal>
        <Total>22190</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>22190</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>54000</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>54000</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesAccounting>
      <Advertising>
        <Total>16573</Total>
        <ProgramServices>12276</ProgramServices>
        <ManagementAndGeneral>4297</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Advertising>
      <OfficeExpenses>
        <Total>252188</Total>
        <ProgramServices>50351</ProgramServices>
        <ManagementAndGeneral>201837</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OfficeExpenses>
      <Occupancy>
        <Total>319086</Total>
        <ProgramServices>287432</ProgramServices>
        <ManagementAndGeneral>31654</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Occupancy>
      <ConferencesMeetings>
        <Total>15132</Total>
        <ProgramServices>6862</ProgramServices>
        <ManagementAndGeneral>8270</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </ConferencesMeetings>
      <Interest>
        <Total>268650</Total>
        <ProgramServices>241785</ProgramServices>
        <ManagementAndGeneral>26865</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Interest>
      <DepreciationDepletion>
        <Total>466717</Total>
        <ProgramServices>420045</ProgramServices>
        <ManagementAndGeneral>46672</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </DepreciationDepletion>
      <Insurance>
        <Total>34389</Total>
        <ProgramServices>30950</ProgramServices>
        <ManagementAndGeneral>3439</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Insurance>
      <OtherExpenses>
        <Description>NON-MEDICAL SUPPLIES</Description>
        <Total>725918</Total>
        <ProgramServices>650465</ProgramServices>
        <ManagementAndGeneral>75453</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>CONTRACTED SERVICES</Description>
        <Total>647136</Total>
        <ProgramServices>532133</ProgramServices>
        <ManagementAndGeneral>115003</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
        <Total>573330</Total>
        <ProgramServices>561888</ProgramServices>
        <ManagementAndGeneral>11442</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBTS</Description>
        <Total>112932</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>112932</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>282515</Total>
        <ProgramServices>254083</ProgramServices>
        <ManagementAndGeneral>28432</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>12206236</Total>
        <ProgramServices>10648419</ProgramServices>
        <ManagementAndGeneral>1557817</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>323802</BOY>
        <EOY>321072</EOY>
      </CashNonInterestBearing>
      <AccountsReceivable>
        <BOY>1466264</BOY>
        <EOY>1427538</EOY>
      </AccountsReceivable>
      <PrepaidExpensesDeferredCharges>
        <BOY>20151</BOY>
        <EOY>25495</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>14164374</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>9810001</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>4559902</BOY>
        <EOY>4354373</EOY>
      </LandBuildingsEquipmentBasisNet>
      <OtherAssetsTotal>
        <BOY>1311502</BOY>
        <EOY>1631160</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>7681621</BOY>
        <EOY>7759638</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>664632</BOY>
        <EOY>606424</EOY>
      </AccountsPayableAccruedExpenses>
      <OtherLiabilities>
        <BOY>8816803</BOY>
        <EOY>9974247</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>9481435</BOY>
        <EOY>10580671</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>-1799814</BOY>
        <EOY>-2821033</EOY>
      </UnrestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>-1799814</BOY>
        <EOY>-2821033</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>7681621</BOY>
        <EOY>7759638</EOY>
      </TotalLiabNetAssetsFundBalances>
      <ReconcilationRevenueExpenses>-1021219</ReconcilationRevenueExpenses>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementBoth>X</FinancialStatementBoth>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="00000002" softwareId="12000225">
      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
      <PublicSupportTotal170>0</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <Total>0</Total>
      </GrossInvestmentIncome170>
      <PublicSupportPertcentage170>0</PublicSupportPertcentage170>
      <GiftsGrantsContribReceived509>
        <CurrentTaxYearMinus4Years>18336</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>44091</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>29797</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>37126</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>34830</CurrentTaxYear>
        <Total>164180</Total>
      </GiftsGrantsContribReceived509>
      <GrossReceiptsFromAdmissions>
        <CurrentTaxYearMinus4Years>11254126</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>11421423</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>11475348</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>11877327</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>11092619</CurrentTaxYear>
        <Total>57120843</Total>
      </GrossReceiptsFromAdmissions>
      <Total509>
        <CurrentTaxYearMinus4Years>11272462</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>11465514</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>11505145</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>11914453</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>11127449</CurrentTaxYear>
        <Total>57285023</Total>
      </Total509>
      <PublicSupportTotal509>57285023</PublicSupportTotal509>
      <GrossInvestmentIncome509>
        <CurrentTaxYearMinus4Years>144724</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>64906</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>53342</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>54458</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>56541</CurrentTaxYear>
        <Total>373971</Total>
      </GrossInvestmentIncome509>
      <InvestmentIncomeAndUBTI>
        <CurrentTaxYearMinus4Years>144724</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>64906</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>53342</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>54458</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>56541</CurrentTaxYear>
        <Total>373971</Total>
      </InvestmentIncomeAndUBTI>
      <OtherIncome509>
        <CurrentTaxYearMinus4Years>6800</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>33946</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>4710</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1787</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1027</CurrentTaxYear>
        <Total>48270</Total>
      </OtherIncome509>
      <TotalSupportTotal>
        <Total>57707264</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.99270</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.98840</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00650</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.01010</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
      <FactsAndCircumstancesTest>OTHER INCOME PART III, LINE 12; DESCRIPTION: MISCELLANEOUS REVENUES; 2008: 6800.; 2009: 33946.; 2010: 4710.; 2011: 1787.; 2012: 1027.;</FactsAndCircumstancesTest>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="00000003">
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>true</GrantsOtherOrganizations>
      <GrantsOtherOrganizationsAmount>850</GrantsOtherOrganizationsAmount>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>false</OtherActivities>
      <TotalLobbyingExpendituresIIB>850</TotalLobbyingExpendituresIIB>
      <Form990ScheduleCPartIV>
        <Identifier>Pt II-B Line 1i</Identifier>
        <Explanation>NONE</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="00000004" softwareId="12000225">
      <Land>
        <OtherCostOrOtherBasis>250000</OtherCostOrOtherBasis>
        <BookValue>250000</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>8727327</OtherCostOrOtherBasis>
        <Depreciation>6093590</Depreciation>
        <BookValue>2633737</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>4449001</OtherCostOrOtherBasis>
        <Depreciation>3125293</Depreciation>
        <BookValue>1323708</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>738046</OtherCostOrOtherBasis>
        <Depreciation>591118</Depreciation>
        <BookValue>146928</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>4354373</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>DUE FROM RELATED PARTIES</Description>
        <BookValue>177763</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>RESIDENT ACCOUNTS</Description>
        <BookValue>21676</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>ASSETS WHOSE USE IS LIMITED - LONG TERM</Description>
        <BookValue>552885</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>ASSETS WHOSE USE IS LIMITED - SHORT TERM</Description>
        <BookValue>260650</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>OTHER NON-CURRENT ASSETS</Description>
        <BookValue>618186</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>1631160</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>DUE TO RELATED PARTIES</Description>
        <Amount>1757385</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>RESIDENT ACCOUNTS</Description>
        <Amount>21676</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>THIRD PARTY LIABILITY</Description>
        <Amount>560000</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED WORKERS COMPENSATION - LONG TERM</Description>
        <Amount>2899181</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED WORKERS COMPENSATION - SHORT TERM</Description>
        <Amount>371005</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>NOTE PAYABLE</Description>
        <Amount>4365000</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>9974247</TotalOfAmounts>
      <TotRevenueEtcAuditedFinclStmt>11185017</TotRevenueEtcAuditedFinclStmt>
      <RevenueSubtotal>11185017</RevenueSubtotal>
      <TotalRevenuePerForm990>11185017</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>12206236</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>12206236</ExpensesSubtotal>
      <TotalExpensesPerForm990>12206236</TotalExpensesPerForm990>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="00000005">
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>WILLIAM HALL MD</NamePerson>
        <CompBasedOnRelatedOrgs>236386</CompBasedOnRelatedOrgs>
        <DeferredCompRelatedOrgs>23034</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>7961</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>267381</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ROBERT MCCANN MD</NamePerson>
        <CompBasedOnRelatedOrgs>405138</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>4928</BonusRelatedOrgs>
        <DeferredCompRelatedOrgs>31113</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>1068</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>442247</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>LEONARD SHUTE</NamePerson>
        <CompBasedOnRelatedOrgs>448801</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>30444</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>236945</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>21103</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>737293</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>STEVEN GOLDSTEIN</NamePerson>
        <CompBasedOnRelatedOrgs>867354</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>51909</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>220977</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>3695</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1143935</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Pt I Line 4a</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Pt I Line 4b</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Pt I Line 3</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="00000006" softwareId="12000225">
      <GeneralExplanation>
        <Identifier>Pt VI, Line 6</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 7a</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 7b</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 19</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 11b</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 12c</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 15a</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 15b</Identifier>
        <Explanation>SEE STATEMENT ATTACHED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24f</Identifier>
        <Explanation>NYS ASSESSMENT 282515. 254083. 28432. 0.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="00000007" softwareId="12000225">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>SEE ATTACHED</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>SEE ATTACHED</AddressLine1>
          <City>SEE ATTACHED</City>
          <State>NY</State>
          <ZIPCode>000000000</ZIPCode>
        </AddressUS>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>true</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>