﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-05-15T14:21:39-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>450250958</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>EIDE BAILLY LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>18081 BURT ST STE 200</AddressLine1Txt>
        <CityNm>OMAHA</CityNm>
        <StateAbbreviationCd>NE</StateAbbreviationCd>
        <ZIPCd>680224722</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>471108168</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>VETT</BusinessNameControlTxt>
      <PhoneNum>4028953932</PhoneNum>
      <USAddress>
        <AddressLine1Txt>20220 HARNEY ST</AddressLine1Txt>
        <CityNm>ELKHORN</CityNm>
        <StateAbbreviationCd>NE</StateAbbreviationCd>
        <ZIPCd>68022</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BRIAN STUHR</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>4028953932</PhoneNum>
      <SignatureDt>2025-05-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>WENDY R COOLEY CPA</PreparerPersonNm>
      <PTIN>P01523804</PTIN>
      <PhoneNum>4023302660</PhoneNum>
      <PreparationDt>2025-05-14</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>BRIAN STUHR</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>20220 HARNEY ST</AddressLine1Txt>
        <CityNm>ELKHORN</CityNm>
        <StateAbbreviationCd>NE</StateAbbreviationCd>
        <ZIPCd>68022</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>256991386</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.VETTERSENIORLIVING.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2014</FormationYr>
      <LegalDomicileStateCd>NE</LegalDomicileStateCd>
      <ActivityOrMissionDesc>OPERATE AND MANAGE HEALTH CARE FACILITIES AND EXTENDED CARE FACILITIES FOR THE ELDERLY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>4</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>1</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>4695</TotalEmployeeCnt>
      <TotalVolunteersCnt>200</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>11133116</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1709787</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>244501334</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>245630013</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>-4174343</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1063804</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>403089</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>429895</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>251863196</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>248833499</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>155274004</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>169289258</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>95630742</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>89510309</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>250904746</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>258799567</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>958450</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-9966068</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>311836561</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>317561865</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>132215235</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>147906607</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>179621326</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>169655258</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>DIGNITY IN LIFE</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>237727779</ExpenseAmt>
      <RevenueAmt>245800333</RevenueAmt>
      <Desc>VETTER SENIOR LIVING PROVIDES SERVICES AND LIVING OPTIONS FOR REHABILITATION, INDEPENDENT, ASSISTED LIVING, AND SKILLED NURSING RESIDENTS IN FOUR STATES. MANY OF THESE INDIVIDUALS ARE MEDICAID AND WITHOUT US PROVIDING THEIR CARE, WOULD HAVE NO OTHER OPTIONS. WITH A MISSION OF "DIGNITY IN LIFE," VETTER SENIOR LIVING IS WELL KNOWN FOR QUALITY CARE. MORE THAN 3,300 TEAM MEMBERS CONTINUOUSLY STRIVE FOR IMPROVEMENT IN ALL AREAS OF SERVICE. FOLLOWING OUR VISION: QUALITY LIFE, QUALITY CARE, EXCELLENT TEAMS, OUTSTANDING FACILITIES, QUALITY REPUTATION, AND STEWARDSHIP IS SIMPLY EXPECTED. SERVING, INTEGRITY, TEAMWORK, AND EXCELLENCE ARE OUR CORE VALUES.</Desc>
      <TotalProgramServiceExpensesAmt>237727779</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">1</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>1</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>287</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>4695</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>4</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>1</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <OwnWebsiteInd>X</OwnWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>BRIAN STUHR CFO</PersonNm>
        <PhoneNum>4028953932</PhoneNum>
        <USAddress>
          <AddressLine1Txt>20220 HARNEY STREET</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68022</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>GLENN VAN EKEREN</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>298353</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>298353</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39006</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACK VETTER</PersonNm>
        <TitleTxt>CHAIRMAN AND CEO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>493630</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23386</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELDORA D VETTER</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHARI TERRY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN STUHR</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>30.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>237306</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15260</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RHONDA FLANIGAN</PersonNm>
        <TitleTxt>CPO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>259476</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49464</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HEATH BODDY</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>277576</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20507</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AARON DUNLAP</PersonNm>
        <TitleTxt>CFA</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>211159</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42294</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOEL WICHMAN</PersonNm>
        <TitleTxt>DIRECTOR OF FACILITY DEVELOPMENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>200067</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38001</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY ANTHONE</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>248194</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23601</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1732131</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>791983</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>251519</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>81</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SELECT REHABILITATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 71985</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606941985</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY STAFFING</ServicesDesc>
        <CompensationAmt>5029197</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>KARE TECHNOLOGIES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 4738</AddressLine1Txt>
            <CityNm>HOUSTON</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>77210</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING</ServicesDesc>
        <CompensationAmt>1736329</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FUSION MEDICAL STAFFING LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>11608 GRANT STREET</AddressLine1Txt>
            <CityNm>OMAHA</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68164</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING</ServicesDesc>
        <CompensationAmt>1242014</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRIME TIME HEALTHCARE LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3544</AddressLine1Txt>
            <CityNm>OMAHA</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68103</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING</ServicesDesc>
        <CompensationAmt>985692</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ONESTAFF MEDICAL LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3544</AddressLine1Txt>
            <CityNm>OMAHA</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68103</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACT NURSING</ServicesDesc>
        <CompensationAmt>899929</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>25</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>1709787</GovernmentGrantsAmt>
      <TotalContributionsAmt>1709787</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>RESIDENT AND PATIENT SERVICE REVE</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>244310541</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>244310541</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT REVENUE</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>329922</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>329922</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>989550</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>989550</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>245630013</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2489545</TotalRevenueColumnAmt>
        <ExclusionAmt>2489545</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>259575</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>259575</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>259575</TotalRevenueColumnAmt>
        <ExclusionAmt>259575</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>6732146</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>8157887</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-1425741</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-1425741</TotalRevenueColumnAmt>
        <ExclusionAmt>-1425741</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>170320</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>170320</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>170320</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>248833499</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>245800333</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1323379</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>570422</TotalAmt>
        <ManagementAndGeneralAmt>570422</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>131021586</TotalAmt>
        <ProgramServicesAmt>119907369</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11114217</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>3550674</TotalAmt>
        <ProgramServicesAmt>3249480</ProgramServicesAmt>
        <ManagementAndGeneralAmt>301194</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>24036813</TotalAmt>
        <ProgramServicesAmt>21997833</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2038980</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>10109763</TotalAmt>
        <ProgramServicesAmt>9252178</ProgramServicesAmt>
        <ManagementAndGeneralAmt>857585</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>184743</TotalAmt>
        <ManagementAndGeneralAmt>184743</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>215021</TotalAmt>
        <ManagementAndGeneralAmt>215021</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>10915896</TotalAmt>
        <ProgramServicesAmt>10915896</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>485761</TotalAmt>
        <ManagementAndGeneralAmt>485761</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2426277</TotalAmt>
        <ManagementAndGeneralAmt>2426277</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>3668100</TotalAmt>
        <ProgramServicesAmt>1834050</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1834050</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>18855464</TotalAmt>
        <ProgramServicesAmt>18289800</ProgramServicesAmt>
        <ManagementAndGeneralAmt>565664</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>585963</TotalAmt>
        <ProgramServicesAmt>585963</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>348022</TotalAmt>
        <ProgramServicesAmt>160900</ProgramServicesAmt>
        <ManagementAndGeneralAmt>187122</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2454159</TotalAmt>
        <ProgramServicesAmt>2454159</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>9146282</TotalAmt>
        <ProgramServicesAmt>8871894</ProgramServicesAmt>
        <ManagementAndGeneralAmt>274388</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>545467</TotalAmt>
        <ProgramServicesAmt>529103</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16364</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>RESIDENT EXPENSES</Desc>
        <TotalAmt>14987679</TotalAmt>
        <ProgramServicesAmt>14987679</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>THERAPY COST</Desc>
        <TotalAmt>13684597</TotalAmt>
        <ProgramServicesAmt>13684597</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE SUPPLIES</Desc>
        <TotalAmt>5593454</TotalAmt>
        <ProgramServicesAmt>5593454</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY COST</Desc>
        <TotalAmt>3914459</TotalAmt>
        <ProgramServicesAmt>3914459</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1498965</TotalAmt>
        <ProgramServicesAmt>1498965</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>258799567</TotalAmt>
        <ProgramServicesAmt>237727779</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21071788</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>20281474</BOYAmt>
        <EOYAmt>3268342</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>26687021</BOYAmt>
        <EOYAmt>55972342</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>17973662</BOYAmt>
        <EOYAmt>21740620</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>800000</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>258220</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>398918</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>218970725</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>46851201</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>171679355</BOYAmt>
        <EOYAmt>172119524</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>1495598</BOYAmt>
        <EOYAmt>1331871</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>73062313</BOYAmt>
        <EOYAmt>62329166</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>311836561</BOYAmt>
        <EOYAmt>317561865</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>19594198</BOYAmt>
        <EOYAmt>21623921</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>40837222</BOYAmt>
        <EOYAmt>65264965</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>71783815</BOYAmt>
        <EOYAmt>61017721</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>132215235</BOYAmt>
        <EOYAmt>147906607</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>179621326</BOYAmt>
        <EOYAmt>169655258</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>179621326</BOYAmt>
        <EOYAmt>169655258</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>311836561</BOYAmt>
        <EOYAmt>317561865</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-9966068</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1263000</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12240618</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>93563486</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11133116</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1709787</CurrentTaxYearAmt>
        <TotalAmt>119910007</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>227819146</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>221368065</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>231810643</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>244501334</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>245630013</CurrentTaxYearAmt>
        <TotalAmt>1171129201</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>229082146</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>233608683</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>325374129</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>255634450</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>247339800</CurrentTaxYearAmt>
        <TotalAmt>1291039208</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus2YearsAmt>63834949</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>63834949</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus2YearsAmt>63834949</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>63834949</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>1227204259</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>116296</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>74471</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>198321</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1260048</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2749120</CurrentTaxYearAmt>
        <TotalAmt>4398256</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>116296</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>74471</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>198321</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1260048</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2749120</CurrentTaxYearAmt>
        <TotalAmt>4398256</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>263532</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>76564</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>100231</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>125404</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>170320</CurrentTaxYearAmt>
        <TotalAmt>736051</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>229461974</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>233759718</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>325672681</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>257019902</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>250259240</CurrentTaxYearAmt>
        <TotalAmt>1296173515</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.94680</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.94760</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00340</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00140</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>10966008</OtherCostOrOtherBasisAmt>
        <BookValueAmt>10966008</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>180006235</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>34928173</DepreciationAmt>
        <BookValueAmt>145078062</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>14683131</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9885632</DepreciationAmt>
        <BookValueAmt>4797499</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>13315351</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2037396</DepreciationAmt>
        <BookValueAmt>11277955</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>172119524</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>THIRD-PARTY PAYOR SETTLEMENTS</Desc>
        <BookValueAmt>348600</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>INVESTMENT IN JOINT VENTURE</Desc>
        <BookValueAmt>1563585</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT OF USE ASSET</Desc>
        <BookValueAmt>60416981</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>62329166</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES</Desc>
        <Amt>60416981</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <Amt>600740</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>61017721</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAINTAINS ACCOUNTS TO HOLD CAPTIVE LIABILITY AMOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>FASB ASC TOPIC 740, INCOME TAXES, PROVIDES GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT EVALUATED THE COMPANY'S TAX POSITIONS AND CONCLUDED THAT THE COMPANY HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GLENN VAN EKEREN</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>235853</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>235853</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>62500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>62500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8250</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>8250</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11253</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>11253</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>317856</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>317856</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JACK VETTER</PersonNm>
        <TitleTxt>CHAIRMAN AND CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>493630</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>23386</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>517016</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RHONDA FLANIGAN</PersonNm>
        <TitleTxt>CPO</TitleTxt>
        <BaseCompensationFilingOrgAmt>214476</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>45000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13340</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>36124</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>308940</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HEATH BODDY</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>247576</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11121</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9386</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>298083</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY ANTHONE</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>248194</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23601</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>271795</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AARON DUNLAP</PersonNm>
        <TitleTxt>CFA</TitleTxt>
        <BaseCompensationFilingOrgAmt>191159</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>20000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10948</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>31346</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>253453</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN STUHR</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>192306</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>45000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11865</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3395</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>252566</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOEL WICHMAN</PersonNm>
        <TitleTxt>DIRECTOR OF FACILITY DEVELOPMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>165067</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9738</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28263</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>238068</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>VETTER LEASING INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>VETTER LEASING, INC IS 100% OWNED BY JACK VETTER, CHAIRMAN OF THE BOARD</RelationshipDescriptionTxt>
        <TransactionAmt>458336</TransactionAmt>
        <TransactionDesc>AUTO LEASE PAYMENTS</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>VETTER ENTERPRISES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>VETTER ENTERPRISES, LLC IS 75% OWNED BY FAMILY MEMBERS OF JACK VETTER</RelationshipDescriptionTxt>
        <TransactionAmt>372000</TransactionAmt>
        <TransactionDesc>RENT OF OFFICE SPACE</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>VETTER HOLDINGS INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>VETTER HOLDING, INC. IS OVER 35% OWNED BY DIRECTORS OF VSL</RelationshipDescriptionTxt>
        <TransactionAmt>13144000</TransactionAmt>
        <TransactionDesc>LEASE PAYMENTS OF SENIOR LIVING FACILITIES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>VETTER HOLDINGS INC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>VETTER HOLDING, INC. IS OVER 35% OWNED BY DIRECTORS OF VSL</RelationshipDescriptionTxt>
        <TransactionAmt>136620</TransactionAmt>
        <TransactionDesc>SHARED SERVICES AGREEMENT FOR ADMIN/SUPPORT SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS MAY BY APPROPRIATE RESOLUTION DESIGNATE ONE OR MORE COMMITTEES, EACH OF WHICH SHALL CONSIST OF TWO (2) OR MORE DIRECTORS ELECTED BY THE BOARD OF DIRECTORS, WHICH TO THE EXTENT PROVIDED IN SAID RESOLUTIONS OR IN THE BYLAWS, SHALL HAVE AND MAY EXERCISE WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>JACK VETTER AND ELDORA VETTER HAVE A FAMILY RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM WITH THE ASSISTANCE OF THE CFO, AND IS THEN REVIEWED BY THE CFO. COPIES OF THE REVIEWED RETURN ARE PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE POLICY STATES THAT THE BOARD OF DIRECTORS MUST SIGN THE CONFLICT OF INTEREST POLICY AND DISCLOSE ALL CONFLICTS ANNUALLY. THE REMAINING BOARD OF DIRECTORS MEMBERS WILL DETERMINE IF AN INTERESTED MEMBER HAS A CONFLICT OF INTEREST. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE INTERESTED MEMBER WILL NOT VOTE ON THAT MATTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>WAGES ARE REVIEWED AND COMPARED WITH INDUSTRY DATA AND OTHER INDEPENDENT LONG-TERM CARE PROVIDERS ON AN ANNUAL BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>VETTER SENIOR LIVING DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF VETTER SENIOR LIVING'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VETTER HOME HEALTH CARE LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 BROOKESTONE MEADOWS PLZ 100</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>680224401</ZIPCd>
        </USAddress>
        <EIN>300979831</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>1597770</TotalIncomeAmt>
        <EndOfYearAssetsAmt>4860</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL ALLIANCE ASSISTED LIVING LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>150 W 24TH ST</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>693012156</ZIPCd>
        </USAddress>
        <EIN>825432444</EIN>
        <PrimaryActivitiesTxt>ASSISTED LIVING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>926330</TotalIncomeAmt>
        <EndOfYearAssetsAmt>4073720</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL ALLIANCE LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1633 SWEETWATER PO BOX 950</AddressLine1Txt>
          <CityNm>ALLIANCE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>693010950</ZIPCd>
        </USAddress>
        <EIN>300963042</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>6045350</TotalIncomeAmt>
        <EndOfYearAssetsAmt>8104690</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL BROKEN BOW LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>850 LAUREL PARKWAY DRIVE</AddressLine1Txt>
          <CityNm>BROKEN BOW</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68822</ZIPCd>
        </USAddress>
        <EIN>364855688</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>6014000</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9302960</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL COLUMBUS LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4715 38TH ST</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>686011622</ZIPCd>
        </USAddress>
        <EIN>300964463</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>8874280</TotalIncomeAmt>
        <EndOfYearAssetsAmt>126480</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL DAVID CITY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>260 SOUTH TENTH STREET</AddressLine1Txt>
          <CityNm>DAVID CITY</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>686322032</ZIPCd>
        </USAddress>
        <EIN>611811905</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>5000290</TotalIncomeAmt>
        <EndOfYearAssetsAmt>16400400</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL ELKHORN LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 BROOKESTONE MEADOWS PLAZA</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>680224401</ZIPCd>
        </USAddress>
        <EIN>352581723</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>20453810</TotalIncomeAmt>
        <EndOfYearAssetsAmt>328830</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL EMERSON LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>607 NEBRASKA ST</AddressLine1Txt>
          <CityNm>EMERSON</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>687333627</ZIPCd>
        </USAddress>
        <EIN>611812157</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>2886910</TotalIncomeAmt>
        <EndOfYearAssetsAmt>2513850</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL FAIRBURY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>909 17TH STREET</AddressLine1Txt>
          <CityNm>FAIRBURY</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>683520667</ZIPCd>
        </USAddress>
        <EIN>611812442</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>5345350</TotalIncomeAmt>
        <EndOfYearAssetsAmt>4265340</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL GENEVA LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>501 NORTH 13TH STREET</AddressLine1Txt>
          <CityNm>GENEVA</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>683611549</ZIPCd>
        </USAddress>
        <EIN>611812645</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>6046900</TotalIncomeAmt>
        <EndOfYearAssetsAmt>24248340</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL GERING LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2325 LODGE DRIVE</AddressLine1Txt>
          <CityNm>GERING</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>693416825</ZIPCd>
        </USAddress>
        <EIN>611817126</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>12306920</TotalIncomeAmt>
        <EndOfYearAssetsAmt>34128060</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL GRAND ISLAND LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3119 WEST FAIDLEY AVENUE</AddressLine1Txt>
          <CityNm>GRAND ISLAND</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>688034114</ZIPCd>
        </USAddress>
        <EIN>320515898</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>9484370</TotalIncomeAmt>
        <EndOfYearAssetsAmt>96250</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL KEARNEY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2615 WEST 11TH ST</AddressLine1Txt>
          <CityNm>KEARNEY</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68845</ZIPCd>
        </USAddress>
        <EIN>371849431</EIN>
        <PrimaryActivitiesTxt>NH AND AL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>8671430</TotalIncomeAmt>
        <EndOfYearAssetsAmt>35360810</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL LINCOLN SOUTHLAKE LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>9401 ANDERMATT DRIVE</AddressLine1Txt>
          <CityNm>LINCOLN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>685269507</ZIPCd>
        </USAddress>
        <EIN>352583045</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>16939820</TotalIncomeAmt>
        <EndOfYearAssetsAmt>206940</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL LINCOLN SUMNER LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1750 SOUTH 20TH STREET</AddressLine1Txt>
          <CityNm>LINCOLN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>685022611</ZIPCd>
        </USAddress>
        <EIN>300964875</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>10414820</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9412380</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL LOUP CITY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1005 NORTH 8TH STREET</AddressLine1Txt>
          <CityNm>LOUP CITY</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>688538215</ZIPCd>
        </USAddress>
        <EIN>352583738</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>4986620</TotalIncomeAmt>
        <EndOfYearAssetsAmt>7890560</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL NORFOLK LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1203 N 13TH STREET PO BOX 429</AddressLine1Txt>
          <CityNm>NORFOLK</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>687020429</ZIPCd>
        </USAddress>
        <EIN>300965494</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>11420800</TotalIncomeAmt>
        <EndOfYearAssetsAmt>20419930</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL NORTH PLATTE COURT LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4000 WEST PHILIP AVENUE</AddressLine1Txt>
          <CityNm>NORTH PLATTE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>691010305</ZIPCd>
        </USAddress>
        <EIN>352583599</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>12408290</TotalIncomeAmt>
        <EndOfYearAssetsAmt>466810</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL NORTH PLATTE ESTATES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3700 WEST PHILIP AVENUE</AddressLine1Txt>
          <CityNm>NORTH PLATTE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>691010305</ZIPCd>
        </USAddress>
        <EIN>300968051</EIN>
        <PrimaryActivitiesTxt>ASSISTED LIVING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>3390350</TotalIncomeAmt>
        <EndOfYearAssetsAmt>24583380</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL OMAHA LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4330 SOUTH 144TH STREET</AddressLine1Txt>
          <CityNm>OMAHA</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>681371051</ZIPCd>
        </USAddress>
        <EIN>371848338</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>19275000</TotalIncomeAmt>
        <EndOfYearAssetsAmt>41502140</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL PAPILLION LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>610 SOUTH POLK STREET</AddressLine1Txt>
          <CityNm>PAPILLION</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>680462548</ZIPCd>
        </USAddress>
        <EIN>364858444</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>10171730</TotalIncomeAmt>
        <EndOfYearAssetsAmt>308310</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL RED CLOUD LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>636 NORTH LOCUST</AddressLine1Txt>
          <CityNm>RED CLOUD</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>689702463</ZIPCd>
        </USAddress>
        <EIN>611815663</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>1833410</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL SEWARD LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>624 PINEWOOD AVE</AddressLine1Txt>
          <CityNm>SEWARD</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>684341055</ZIPCd>
        </USAddress>
        <EIN>320518584</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>6567650</TotalIncomeAmt>
        <EndOfYearAssetsAmt>195600</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL SPRINGFIELD CREEKSIDE LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1601 SOUTH FORT</AddressLine1Txt>
          <CityNm>SPRINGFIELD</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>658078401</ZIPCd>
        </USAddress>
        <EIN>300967430</EIN>
        <PrimaryActivitiesTxt>SENIOR LIVING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MO</LegalDomicileStateCd>
        <TotalIncomeAmt>4065010</TotalIncomeAmt>
        <EndOfYearAssetsAmt>15917080</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL SPRINGFIELD MANOR LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1707 WEST ELFINDALE STREET</AddressLine1Txt>
          <CityNm>SPRINGFIELD</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>658071295</ZIPCd>
        </USAddress>
        <EIN>611815992</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MO</LegalDomicileStateCd>
        <TotalIncomeAmt>10576650</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9650520</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL ST EDWARD LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>301 N 13TH ST</AddressLine1Txt>
          <CityNm>ST EDWARD</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68660</ZIPCd>
        </USAddress>
        <EIN>364859287</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>3447910</TotalIncomeAmt>
        <EndOfYearAssetsAmt>5433690</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL ST PAUL LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1405 HERITAGE DR</AddressLine1Txt>
          <CityNm>SAINT PAUL</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>688733618</ZIPCd>
        </USAddress>
        <EIN>611815917</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>6215050</TotalIncomeAmt>
        <EndOfYearAssetsAmt>105440</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL VETTER HEALTH SERVICES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>20220 HARNEY STREET</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68022</ZIPCd>
        </USAddress>
        <EIN>371845522</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>12930500</TotalIncomeAmt>
        <EndOfYearAssetsAmt>19179570</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL WAHOO LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 MARK DRIVE</AddressLine1Txt>
          <CityNm>WAHOO</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>680664023</ZIPCd>
        </USAddress>
        <EIN>371849602</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>9151390</TotalIncomeAmt>
        <EndOfYearAssetsAmt>266460</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL NORTH PLATTE REGENCY LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>700 W PHILLIP AVENUE</AddressLine1Txt>
          <CityNm>NORTH PLATTE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>69101</ZIPCd>
        </USAddress>
        <EIN>843990042</EIN>
        <PrimaryActivitiesTxt>INDEPENDENT LIVING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL SPRINGFIELD ASSISTED LIVING LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1401 WEST ELFINDALE STREET</AddressLine1Txt>
          <CityNm>SPRINGFIELD</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>65807</ZIPCd>
        </USAddress>
        <EIN>841939413</EIN>
        <PrimaryActivitiesTxt>ASSISTED LIVING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MO</LegalDomicileStateCd>
        <TotalIncomeAmt>2299460</TotalIncomeAmt>
        <EndOfYearAssetsAmt>23026060</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL VETTER HOME HEALTH CARE OF CENTRAL NEBRASKA</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>507 WEST AVENUE</AddressLine1Txt>
          <CityNm>HOLDREGE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68949</ZIPCd>
        </USAddress>
        <EIN>882457189</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>2456810</TotalIncomeAmt>
        <EndOfYearAssetsAmt>13300</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL VETTER HOME HEALTH CARE OF NORTH PLATTE LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>904 PARKVIEW COURT</AddressLine1Txt>
          <CityNm>NORTH PLATTE</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>69101</ZIPCd>
        </USAddress>
        <EIN>931718311</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL VETTER HOME HEALTH CARE OF GERING LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1335 M ST SUITE 100</AddressLine1Txt>
          <CityNm>GERING</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>69341</ZIPCd>
        </USAddress>
        <EIN>933486921</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>1221850</TotalIncomeAmt>
        <EndOfYearAssetsAmt>14080</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BROOKESTONE REHABILITATION LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>20220 HARNEY STREET</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68022</ZIPCd>
        </USAddress>
        <EIN>933533122</EIN>
        <PrimaryActivitiesTxt>THERAPY SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>2917123</TotalIncomeAmt>
        <EndOfYearAssetsAmt>15025</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VSL GERING II LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2325 LODGE DRIVE</AddressLine1Txt>
          <CityNm>GERING</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>683416825</ZIPCd>
        </USAddress>
        <EIN>300995540</EIN>
        <PrimaryActivitiesTxt>NURSING HOME SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VETTER SENIOR LIVING</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>VETTER HOLDING INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>20220 HARNEY ST</AddressLine1Txt>
          <CityNm>ELKHORN</CityNm>
          <StateAbbreviationCd>NE</StateAbbreviationCd>
          <ZIPCd>68022</ZIPCd>
        </USAddress>
        <EIN>470672044</EIN>
        <PrimaryActivitiesTxt>NURSING HOME RENTAL PROPERTY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>S</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>