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        <ProgramServices>940508</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>11066</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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        <ProgramServices>132369</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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        <Fundraising>0</Fundraising>
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        <ProgramServices>12401</ProgramServices>
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        <Description>MISCELLANEOUS &amp; OTHER EXPENSE</Description>
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        <ManagementAndGeneral>217312</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>EQUIPMENT RENTALS</Description>
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        <ProgramServices>633610</ProgramServices>
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      <OtherExpenses>
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        <ManagementAndGeneral>10230</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>ADMINISTRATIVE CORPORATE SERVICES</Description>
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        <ProgramServices>6296240</ProgramServices>
        <ManagementAndGeneral>3002071</ManagementAndGeneral>
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      <TotalFunctionalExpenses>
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        <ProgramServices>26517434</ProgramServices>
        <ManagementAndGeneral>5805800</ManagementAndGeneral>
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      <LandBldgEquipmentAccumDeprec>13164760</LandBldgEquipmentAccumDeprec>
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        <EOY>2710669</EOY>
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        <EOY>10273188</EOY>
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      <OtherLiabilities>
        <BOY>8819171</BOY>
        <EOY>5426168</EOY>
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      <TotalLiabilities>
        <BOY>25824994</BOY>
        <EOY>22382321</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>-4753807</BOY>
        <EOY>-372449</EOY>
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      <PermanentlyRestrictedNetAssets>
        <BOY>226064</BOY>
        <EOY>220273</EOY>
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      <TotalNetAssetsFundBalances>
        <BOY>-4527743</BOY>
        <EOY>-152176</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>21297251</BOY>
        <EOY>22230145</EOY>
      </TotalLiabNetAssetsFundBalances>
      <ReconcilationRevenueExpenses>4375567</ReconcilationRevenueExpenses>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="00000002" softwareId="11000175">
      <PubliclySupportedOrg509a2>X</PubliclySupportedOrg509a2>
      <PublicSupportTotal170>0</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <Total>0</Total>
      </GrossInvestmentIncome170>
      <PublicSupportPertcentage170>0</PublicSupportPertcentage170>
      <GrossReceiptsFromAdmissions>
        <CurrentTaxYearMinus4Years>33740256</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>34441288</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>35966570</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>35941663</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>36626627</CurrentTaxYear>
        <Total>176716404</Total>
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      <Total509>
        <CurrentTaxYearMinus4Years>33740256</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>34441288</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>35966570</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>35941663</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>36626627</CurrentTaxYear>
        <Total>176716404</Total>
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      <PublicSupportTotal509>176716404</PublicSupportTotal509>
      <GrossInvestmentIncome509>
        <CurrentTaxYearMinus4Years>47</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>869</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1123</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>540</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>813</CurrentTaxYear>
        <Total>3392</Total>
      </GrossInvestmentIncome509>
      <InvestmentIncomeAndUBTI>
        <CurrentTaxYearMinus4Years>47</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>869</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1123</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>540</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>813</CurrentTaxYear>
        <Total>3392</Total>
      </InvestmentIncomeAndUBTI>
      <OtherIncome509>
        <CurrentTaxYearMinus4Years>155</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>130872</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>22743</CurrentTaxYearMinus2Years>
        <CurrentTaxYear>71361</CurrentTaxYear>
        <Total>225131</Total>
      </OtherIncome509>
      <TotalSupportTotal>
        <Total>176944927</Total>
      </TotalSupportTotal>
      <PublicSupportPercentage509>0.99870</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.99900</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00000</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
      <FactsAndCircumstancesTest>OTHER INCOME PART III, LINE 12; DESCRIPTION: OTHER REVENUE; 2007: 155.; 2008: 130872.; 2009: 22743.; 2011: 71361.;</FactsAndCircumstancesTest>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="00000003" softwareId="11000175">
      <Land>
        <OtherCostOrOtherBasis>790000</OtherCostOrOtherBasis>
        <BookValue>790000</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>16528490</OtherCostOrOtherBasis>
        <Depreciation>8851201</Depreciation>
        <BookValue>7677289</BookValue>
      </Buildings>
      <LeaseholdImprovements>
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        <Depreciation>511442</Depreciation>
        <BookValue>65935</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>4340111</OtherCostOrOtherBasis>
        <Depreciation>3802117</Depreciation>
        <BookValue>537994</BookValue>
      </Equipment>
      <TotalOfBookValueLandBuildings>9071218</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>LIMITED USE ASSETS</Description>
        <BookValue>220273</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>MISCELLANEOUS RECEIVABLES</Description>
        <BookValue>13313</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>CONSTRUCTION IN PROGRESS</Description>
        <BookValue>1716823</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>GOODWILL</Description>
        <BookValue>59964</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>FINANCING COSTS - NET</Description>
        <BookValue>400052</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>SECURITY DEPOSITS</Description>
        <BookValue>51079</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>PATIENT FUNDS</Description>
        <BookValue>249165</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DUE FROM MEDICAID</Description>
      </OtherAssets>
      <TotalBookValueOtherAssets>2710669</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>PATIENT FUNDS LIABILITY</Description>
        <Amount>246459</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO THIRD PARTY PAYORS</Description>
        <Amount>4179423</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO RELATED PARTIES</Description>
        <Amount>1000286</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>5426168</TotalOfAmounts>
      <TotalRevenue>36698801</TotalRevenue>
      <TotalExpenses>32323234</TotalExpenses>
      <ExcessOrDeficitForYear>4375567</ExcessOrDeficitForYear>
      <ExcessOrDeficitPerFS>4375567</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>36698801</TotRevenueEtcAuditedFinclStmt>
      <RevenueSubtotal>36698801</RevenueSubtotal>
      <TotalRevenuePerForm990>36698801</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>32323234</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>32323234</ExpensesSubtotal>
      <TotalExpensesPerForm990>32323234</TotalExpensesPerForm990>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="00000004">
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>MORRIS KLEIN</NamePerson>
        <CompBasedOnRelatedOrgs>695546</CompBasedOnRelatedOrgs>
        <TotalCompensationRelatedOrgs>695546</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Pt I Line 4b</Identifier>
        <Explanation>MORRIS KLEIN PARTICIPATES IN A NON QUALIFIED PENSION PLAN IN A RELATED ORGANIZATION, NSG INC.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="00000005" softwareId="11000175">
      <GeneralExplanation>
        <Identifier>Pt VI, Line 2</Identifier>
        <Explanation>BOARD MEMBER, BENJAMIN KLEIN IS RELATED TO EXEC DIR MORRIS KLEIN</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 11a</Identifier>
        <Explanation>THE BOARD OF DIRECTORS WILL MEET &amp; REVIEW THE 990</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 12c</Identifier>
        <Explanation>ANNUALLY, BOARD MEMBERS ARE REQUIRED TO FILE DISCLOSURES &amp; CONTRACTS &amp; VENDORS ARE REVIEWED</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 15</Identifier>
        <Explanation>A PRICE WATERHOUSE COOPERS STUDY REVIEWED &amp; SUBSTANTIATED THE TOP MANAGEMENT COMPENSATION</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Pt VI, Line 19</Identifier>
        <Explanation>990 is available on guidestar.org and at location upon request</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24f</Identifier>
        <Explanation>NYS MEDICAID ASSSESSMENT 1811697. 0. 1811697. 0. SUPPLIES &amp; EXPENSES 4106944. 3797103. 309841. 0. CONTRACTED SERVICES &amp; CONSULTANTS 3379670. 2499137. 880533. 0.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NORTHERN RIVERVIEW HEALTH CARE CENTER INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>89 SOUTH ROUTE 9W</AddressLine1>
          <City>HAVERSTRAW</City>
          <State>NY</State>
          <ZIPCode>10927</ZIPCode>
        </AddressUS>
        <EIN>133832251</EIN>
        <PrimaryActivities>NURSING HOME</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NORTHERN METROPOLITAN INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>225 MAPLE AVENUE</AddressLine1>
          <City>MONSEY</City>
          <State>NY</State>
          <ZIPCode>10952</ZIPCode>
        </AddressUS>
        <EIN>133070759</EIN>
        <PrimaryActivities>NURSING HOME</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>ASSISTED LIVING NORTHERN RIVERVIEW INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>87 SOUTH ROUTE 9W</AddressLine1>
          <City>HAVERSTRAW</City>
          <State>NY</State>
          <ZIPCode>10927</ZIPCode>
        </AddressUS>
        <EIN>133976617</EIN>
        <PrimaryActivities>ASSISTED LIVING FACILITY</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>FOUNTAINVIEW AT COLLEGE ROAD INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2000 FOUNTAINVIEW DRIVE</AddressLine1>
          <City>MONSEY</City>
          <State>NY</State>
          <ZIPCode>10952</ZIPCode>
        </AddressUS>
        <EIN>133935070</EIN>
        <PrimaryActivities>INDEPENDANT LIVING FACILITY</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2000 FOUNTAINVIEW DRIVE</AddressLine1>
          <City>MONSEY</City>
          <State>NY</State>
          <ZIPCode>10952</ZIPCode>
        </AddressUS>
        <EIN>113354023</EIN>
        <PrimaryActivities>CHARITABLE FOUNDATION</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NORTHERN SERVICES GROUP INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
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          <State>NY</State>
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        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>LIFESTYLE OPTIONS FOR SENIORS FOUNDATION INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
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          <City>MONSEY</City>
          <State>NY</State>
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        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(C)3</ExemptCodeSection>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
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      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
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        </NameOfOtherOrganization>
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        <AmountInvolved>2834548</AmountInvolved>
        <MethodOfAmtDetermination>D</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
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        </NameOfOtherOrganization>
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        <AmountInvolved>65744</AmountInvolved>
        <MethodOfAmtDetermination>D</MethodOfAmtDetermination>
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    </IRS990ScheduleR>
  </ReturnData>
</Return>