﻿<?xml version="1.0" encoding="utf-8"?>
<Return returnVersion="2024v5.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-13T11:53:35-07:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>161502150</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>NIAGARA LUTHERAN DEVELOPMENT INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>NIAG</BusinessNameControlTxt>
      <PhoneNum>7166840202</PhoneNum>
      <USAddress>
        <AddressLine1Txt>5949 Broadway Street</AddressLine1Txt>
        <CityNm>Lancaster</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>140869523</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Steven Chizuk</PersonNm>
      <PersonTitleTxt>Chief Financial Officer</PersonTitleTxt>
      <PhoneNum>7166840202</PhoneNum>
      <SignatureDt>2025-11-13</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="R000001" referenceDocumentId="R000006" softwareId="24021167" softwareVersionNum="v1.00">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>GREENFIELD HEALTH AND REHABILITATION CENTER</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>Christopher Koenig</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
        <CityNm>Lancaster</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14086</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>25148903</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.niagaralutheran.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1996</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Our mission is to provide for the physical, social and spiritual needs of the individuals we serve, in a Christian environment. The organization is a 1632 bed facility providing 24 hour skilled nursing and rehabilitation services.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>590</TotalEmployeeCnt>
      <TotalVolunteersCnt>17</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>61076</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>58051</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>24699398</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>24302197</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>120147</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>255547</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>58215</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>71414</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>24938836</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>24687209</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>14714398</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>16343601</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11905181</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>10162828</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>26619579</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>26506429</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-1680743</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1819220</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>27261074</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>25547584</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>9263017</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>9185710</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>17998057</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>16361874</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Our mission is to provide for the physical, social and spiritual needs of the individuals we serve, in a Christian environment. The organization is a 162 bed facility providing 24 hour skilled nursing and rehabilitation services.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>19973047</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>24373611</RevenueAmt>
      <Desc>A 162 bed facility providing 24 hour skilled nursing care, rehabilitation services, specialized nutrition programs, home-style meals tailored to meet individual needs, activities programs, on site barber and beauty salon, case management, dental, optical and podiatry services, ecumenical worship and pastoral care services and 24 hour security at a reasonable cost to all of our residents. Approximately 62% of our residents receive government support (Medicare and Medicaid). During 2023, we provided services to 1,359 residents (1,059 inpatient and 300 outpatient) needing short term rehabilitation and or long term skilled nursing services. The facility is also used for block club meetings, seminars, blood drives and various other community activities such as local health fairs. (55,005 days)</Desc>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>19973047</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="R000002">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="R000003">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>0</DonorAdvisedFundInd>
      <ConservationEasementsInd>0</ConservationEasementsInd>
      <CollectionsOfArtInd>0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="R000004">1</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="R000004">1</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="R000004">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="R000004">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="R000004">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="R000004">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="R000004">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="R000005">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="R000007">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>23</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>590</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</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>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>Steven Chizuk CFO</PersonNm>
        <PhoneNum>7166840202</PhoneNum>
        <USAddress>
          <AddressLine1Txt>5949 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christopher E Koenig</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <AverageHoursPerWeekRt>5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>32.5</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>385290</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23648</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Steven Chizuk</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>32.5</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>225143</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22301</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Shane Setlock</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>148340</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3048</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Oksana Melnchuk</PersonNm>
        <TitleTxt>Registered Nurse</TitleTxt>
        <AverageHoursPerWeekRt>55</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>129009</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14229</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Patricia Mann</PersonNm>
        <TitleTxt>Director of Rehabilitation Services</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>109714</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19212</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jody Mazurek</PersonNm>
        <TitleTxt>Nursing Supervisor</TitleTxt>
        <AverageHoursPerWeekRt>51</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>116407</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8621</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeannine May</PersonNm>
        <TitleTxt>Director of Nursing</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>102047</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8752</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Arianna Wilson</PersonNm>
        <TitleTxt>Registered Nurse</TitleTxt>
        <AverageHoursPerWeekRt>53</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>103219</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1620</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rev Carol L Lankes</PersonNm>
        <TitleTxt>Board Member/Chairman</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ms Candyce Ingwersen</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dan Joyce</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cary Haller</PersonNm>
        <TitleTxt>Board Member/Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mr Gerald C Saxe</PersonNm>
        <TitleTxt>Board Member/Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rev Paul R Mertzlufft</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>708736</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>610433</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>101431</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>26540</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>31511</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>0</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>58051</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Adult Facility Services</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>24302197</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24302197</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>24302197</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>180041</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>180041</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>537200</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>461694</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>75506</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>75506</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>75506</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <OtherRevenueMiscGrp>
        <Desc>Gift Shop and Cafeteria</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>30188</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30188</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Interest and Rebilling</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>4403</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4403</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>36823</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>36823</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>71414</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>24687209</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24373611</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>255547</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>13798818</TotalAmt>
        <ProgramServicesAmt>13147408</ProgramServicesAmt>
        <ManagementAndGeneralAmt>651410</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>220049</TotalAmt>
        <ProgramServicesAmt>207797</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12252</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1291815</TotalAmt>
        <ProgramServicesAmt>1191296</ProgramServicesAmt>
        <ManagementAndGeneralAmt>100519</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1032919</TotalAmt>
        <ProgramServicesAmt>983322</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49597</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>15879</TotalAmt>
        <ManagementAndGeneralAmt>15879</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>23665</TotalAmt>
        <ManagementAndGeneralAmt>23665</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1347630</TotalAmt>
        <ProgramServicesAmt>1346371</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1259</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>3052</TotalAmt>
        <ManagementAndGeneralAmt>3052</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>365492</TotalAmt>
        <ProgramServicesAmt>280231</ProgramServicesAmt>
        <ManagementAndGeneralAmt>85261</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>255699</TotalAmt>
        <ProgramServicesAmt>27589</ProgramServicesAmt>
        <ManagementAndGeneralAmt>228110</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>304110</TotalAmt>
        <ProgramServicesAmt>304110</ProgramServicesAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>4054</TotalAmt>
        <ProgramServicesAmt>454</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3600</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>171875</TotalAmt>
        <ManagementAndGeneralAmt>171875</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1055194</TotalAmt>
        <ManagementAndGeneralAmt>1055194</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>983480</TotalAmt>
        <ManagementAndGeneralAmt>983480</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Corporate Allocation</Desc>
        <TotalAmt>2181548</TotalAmt>
        <ProgramServicesAmt>139743</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2041805</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Health Facility Assessment</Desc>
        <TotalAmt>1040616</TotalAmt>
        <ProgramServicesAmt>500</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1040116</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>894627</TotalAmt>
        <ProgramServicesAmt>894627</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Food and dietary Supplies</Desc>
        <TotalAmt>876260</TotalAmt>
        <ProgramServicesAmt>868958</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7302</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>639647</TotalAmt>
        <ProgramServicesAmt>580641</ProgramServicesAmt>
        <ManagementAndGeneralAmt>59006</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>26506429</TotalAmt>
        <ProgramServicesAmt>19973047</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6533382</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2769926</BOYAmt>
        <EOYAmt>1406109</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2663146</BOYAmt>
        <EOYAmt>2374511</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>150185</BOYAmt>
        <EOYAmt>146274</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>141587</BOYAmt>
        <EOYAmt>162367</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>29639497</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>17828927</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>11944470</BOYAmt>
        <EOYAmt>11810570</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>9570674</BOYAmt>
        <EOYAmt>9636302</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>21086</BOYAmt>
        <EOYAmt>11451</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>27261074</BOYAmt>
        <EOYAmt>25547584</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2566069</BOYAmt>
        <EOYAmt>3020399</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>1371492</BOYAmt>
        <EOYAmt>863666</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>4746830</BOYAmt>
        <EOYAmt>3944150</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>21086</BOYAmt>
        <EOYAmt>11451</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>557540</BOYAmt>
        <EOYAmt>1346044</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>9263017</BOYAmt>
        <EOYAmt>9185710</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>17998057</BOYAmt>
        <EOYAmt>16361874</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>17998057</BOYAmt>
        <EOYAmt>16361874</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>27261074</BOYAmt>
        <EOYAmt>25547584</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1819220</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>183037</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="24021167" softwareVersionNum="v1.00">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1137880</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2450314</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>406048</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>61076</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>58051</CurrentTaxYearAmt>
        <TotalAmt>4113369</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>20682923</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>20929894</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21812280</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24722186</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24373611</CurrentTaxYearAmt>
        <TotalAmt>112520894</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus4YearsAmt>21220</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>22291</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>24251</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35427</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30188</CurrentTaxYearAmt>
        <TotalAmt>133377</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>21842023</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>23402499</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22242579</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24818689</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24461850</CurrentTaxYearAmt>
        <TotalAmt>116767640</TotalAmt>
      </Total509Grp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>116767640</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>41537</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>51360</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>62645</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>114407</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>180041</CurrentTaxYearAmt>
        <TotalAmt>449990</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>41537</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>51360</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>62645</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>114407</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>180041</CurrentTaxYearAmt>
        <TotalAmt>449990</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>21883560</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>23453859</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22305224</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24933096</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24641891</CurrentTaxYearAmt>
        <TotalAmt>117217630</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99616</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99719</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00384</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00281</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsPY509Ind>X</ThirtyThrPctSuprtTestsPY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="R000003" softwareId="24021167" softwareVersionNum="v1.00">
      <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="R000004" softwareId="24021167" softwareVersionNum="v1.00">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>0</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>0</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>0</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>0</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>0</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>0</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>0</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>0</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>0</BeginningYearBalanceAmt>
        <ContributionsAmt>0</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>0</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>0</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>1</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>1</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>1</RelatedOrgListSchRInd>
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>354411</OtherCostOrOtherBasisAmt>
        <BookValueAmt>354411</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>23982793</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>13564934</DepreciationAmt>
        <BookValueAmt>10417859</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>5302293</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4263993</DepreciationAmt>
        <BookValueAmt>1038300</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>0</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>11810570</TotalBookValueLandBuildingsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Dues from Affiliates</Desc>
        <Amt>873502</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Estimated Amount Due from Third Party</Desc>
        <Amt>472542</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1346044</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>24870246</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>183037</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>183037</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>24687209</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>24687209</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>26506429</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>26506429</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>26506429</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part IV, Line 2b</FormAndLineReferenceDesc>
        <ExplanationTxt>Resident Funds that are deposited with the Organization are held, safeguarded, managed and accounted for by the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Niagara Lutheran Health Foundation, Inc., the Organization's related party, holds endowment funds for the benefit of the Organization and its related organizations. The uses of the endowment funds are reported on the related parties IRS Form 990 and are used based on the intention of the donor.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The entities comprising the Organization are all not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and accordingly, are exempt from Federal Income Taxes on related Income Pursuant to Section 501 (a) of the Code. Accordingly, no provision for income taxes has been reflected in the accompanying consolidated financial statements. The Organization accounts for uncertain tax positions in accordance with US GAAP, which requires the recognition and measurement of uncertain tax positions that the Organization has taken or expects to take in the Organization's tax returns.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="R000005" softwareId="24021167" softwareVersionNum="v1.00">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <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>Christopher E Koenig</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>340290</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>45000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4872</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18776</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>408938</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Chizuk</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>213177</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>11966</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>3513</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18788</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>247444</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Shane Setlock</PersonNm>
        <TitleTxt>Administrator</TitleTxt>
        <BaseCompensationFilingOrgAmt>143980</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>4360</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2148</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>900</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>151388</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000006" softwareId="24021167" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Niagara Lutheran Health System Inc is the sole member for the Organization and elects the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's sole member is Niagara Lutheran Health System, Inc. The Organization's sole member elects the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The process to review the form 990 is as follows: - The 990 is prepared by the Finance Department. The final Form 990 is then reviewed by the Finance Committee of the Board of Directors - A copy of the Form 990 is provided to all board members prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The conflict of interest policy is reviewed annually with the board of directors. Questionnaires are filled out by the board and key personnel and reviewed by the corporate compliance officer on an annual basis. If any conflicts of interest or related matters arise as a result of the review, the corporate compliance officer will address with the board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation of the officers and other key employees of the Organization (who are paid through Niagara Lutheran Health System, Inc. the sole member) is approved by the executive committee of the board of directors. The process for determining includes a review by the executive committee of the board of directors and the personnel committee of the board of directors. The review includes information from the Form 990 of other organizations and compensation surveys conducted from independent sources.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization does not make available to the public its governing documents, conflict of interest policy, and Financial Statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Other fees for services include staffing agency fees for LPNs and CNAs, and other physician fees.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="R000007" softwareId="24021167" softwareVersionNum="v1.00">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Lutheran Church Home of Buffalo Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>160763163</EIN>
        <PrimaryActivitiesTxt>To provide housing, meals, and other necessities for elderly residents of the home</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greenfield Manor Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161564089</EIN>
        <PrimaryActivitiesTxt>Senior Independent Living Facility</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Lutheran Church Home at Greenfield Inc</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>dba Greenfield Court</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161579391</EIN>
        <PrimaryActivitiesTxt>Maintain and operate an enriched housing facility in Lancaster New York</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161501206</EIN>
        <PrimaryActivitiesTxt>The Organization provides a centralized administrative and afinancial service to related NFP Orgs</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12b</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161315868</EIN>
        <PrimaryActivitiesTxt>Fundraising on behalf of affiliated not for profit Organizations</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>