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        <PersonNm>John MacRae</PersonNm>
        <TitleTxt>Chaplain</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>71770</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28723</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heath Hopstetter</PersonNm>
        <TitleTxt>VP/Facility Services</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>119694</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45663</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Bagdon</PersonNm>
        <TitleTxt>Sr. Admin Healthcare Svcs</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>59298</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5184</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kim Focht</PersonNm>
        <TitleTxt>Director of Human Resource</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>118800</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31892</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tom Wieland</PersonNm>
        <TitleTxt>Controller</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>116977</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17322</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heather Wagner</PersonNm>
        <TitleTxt>Director of Nursing</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>103612</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42122</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Andrea Vega</PersonNm>
        <TitleTxt>Certified Nursing Assistant</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>110310</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1314341</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>248999</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>7</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>B K Campbell Enterprises Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1771 Limestone Road</AddressLine1Txt>
            <CityNm>Cochranville</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19330</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction Services</ServicesDesc>
        <CompensationAmt>1009288</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Spectrum Parent Inc &amp; Subsidiaries</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 69268</AddressLine1Txt>
            <CityNm>Baltimore</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>212649268</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Therapy Services</ServicesDesc>
        <CompensationAmt>1004356</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Culinesse</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>250 Wyandotte Street</AddressLine1Txt>
            <CityNm>Bethlehem</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>18015</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contract Services</ServicesDesc>
        <CompensationAmt>408151</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Trago Mechanical</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5 W Wynwood Dr</AddressLine1Txt>
            <CityNm>Willow Street</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>175849486</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HVAC Services</ServicesDesc>
        <CompensationAmt>400929</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Nickel Mine Floor Covering Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>359 Buck Road</AddressLine1Txt>
            <CityNm>Quarryville</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17566</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Flooring/Install</ServicesDesc>
        <CompensationAmt>289684</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>356476</AllOtherContributionsAmt>
      <NoncashContributionsAmt>3800</NoncashContributionsAmt>
      <TotalContributionsAmt>356476</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Skilled Care Services</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>15280158</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>15275624</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>4534</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Residential Living Svcs</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>9993753</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8658472</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1335281</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Personal Care Services</Desc>
        <BusinessCd>623000</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>6476290</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>31750201</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>180667</TotalRevenueColumnAmt>
        <ExclusionAmt>180667</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
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        <ExclusionAmt>4295</ExclusionAmt>
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      <LessRentalExpensesGrp>
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      <RentalIncomeOrLossGrp>
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      <NetRentalIncomeOrLossGrp>
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      <GainOrLossGrp>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>197892</ExclusionAmt>
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        <ExclusionAmt>40820</ExclusionAmt>
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        <Desc>Other Income</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>4952</TotalRevenueColumnAmt>
        <ExclusionAmt>4952</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Postage Income</Desc>
        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>2377</ExclusionAmt>
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      <TotalRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1891622</ExclusionAmt>
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      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>6000</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>665621</ProgramServicesAmt>
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        <ProgramServicesAmt>2660575</ProgramServicesAmt>
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        <ProgramServicesAmt>1769885</ProgramServicesAmt>
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        <ProgramServicesAmt>806200</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>33614</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>71781</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>201278</ProgramServicesAmt>
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        <ProgramServicesAmt>1795347</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>9315</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>2044464</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4344</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>30312</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5757</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>9744</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2497</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>872365</ProgramServicesAmt>
        <ManagementAndGeneralAmt>229711</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>4156262</ProgramServicesAmt>
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        <ProgramServicesAmt>110431</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26809</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <TotalAmt>584797</TotalAmt>
        <ProgramServicesAmt>584797</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>NH Assessment Tax</Desc>
        <TotalAmt>244939</TotalAmt>
        <ProgramServicesAmt>244939</ProgramServicesAmt>
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        <EOYAmt>4433164</EOYAmt>
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        <EOYAmt>1260433</EOYAmt>
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        <EOYAmt>1517129</EOYAmt>
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        <EOYAmt>104714</EOYAmt>
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        <EOYAmt>648079</EOYAmt>
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        <EOYAmt>54212583</EOYAmt>
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        <EOYAmt>8959530</EOYAmt>
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        <EOYAmt>1829385</EOYAmt>
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        <EOYAmt>173732</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>73138749</EOYAmt>
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        <EOYAmt>25915</EOYAmt>
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        <EOYAmt>5764124</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>59968509</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>82876</EOYAmt>
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        <EOYAmt>13170240</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>73138749</EOYAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
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      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
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      <GiftsGrantsContrisRcvd509Grp>
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        <CurrentTaxYearMinus3YearsAmt>2714178</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>249611</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>205781</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>356476</CurrentTaxYearAmt>
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      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>24994530</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>25361744</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27241411</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30410386</CurrentTaxYearAmt>
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      <GrossReceiptsNonUnrltBusGrp>
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        <CurrentTaxYearMinus3YearsAmt>1131611</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1218264</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1367857</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1475069</CurrentTaxYearAmt>
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      <Total509Grp>
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        <CurrentTaxYearMinus3YearsAmt>28840319</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>26829619</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>28815049</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>32241931</CurrentTaxYearAmt>
        <TotalAmt>141921387</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>63193</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2300</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22025</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1850</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5575</CurrentTaxYearAmt>
        <TotalAmt>94943</TotalAmt>
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      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>63193</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2300</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22025</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1850</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5575</CurrentTaxYearAmt>
        <TotalAmt>94943</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>141826444</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>398422</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>376261</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>356238</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>491112</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>548230</CurrentTaxYearAmt>
        <TotalAmt>2170263</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>398422</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>376261</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>356238</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>491112</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>548230</CurrentTaxYearAmt>
        <TotalAmt>2170263</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus2YearsAmt>7557</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>7557</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>12657</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8065</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5607</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6225</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7329</CurrentTaxYearAmt>
        <TotalAmt>39883</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>25605548</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>29224645</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>27199021</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>29312386</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>32797490</CurrentTaxYearAmt>
        <TotalAmt>144139090</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98400</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98450</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01510</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01410</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12, Explanation of Other Income:</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income - 2020 Amount: $ 2,621. 2021 Amount: $ 4,594. 2022 Amount: $ 2,571. 2023 Amount: $ 2,134. 2024 Amount: $ 4,952. Postage - 2020 Amount: $ 4,104. 2021 Amount: $ 3,426. 2022 Amount: $ 3,036. 2023 Amount: $ 2,881. 2024 Amount: $ 2,377. Non-charitable Fundraising Income - 2020 Amount: $ 5,932. 2021 Amount: $ 45. IT Assistance - 2023 Amount: $ 1,210.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </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>
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>12463</BeginningYearBalanceAmt>
        <ContributionsAmt>750</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>66</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>13279</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12279</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>184</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12463</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12266</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>13</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12279</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12265</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12266</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12260</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>5</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12265</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.00000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.75309</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.24691</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>922613</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>692607</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1615220</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>1925423</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>54747712</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>29880835</DepreciationAmt>
        <BookValueAmt>26792300</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <InvestmentCostOrOtherBasisAmt>318601</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>27439240</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>19669100</DepreciationAmt>
        <BookValueAmt>8088741</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <InvestmentCostOrOtherBasisAmt>851502</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>48988894</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>32124074</DepreciationAmt>
        <BookValueAmt>17716322</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>54212583</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Liabilities to Residents</Desc>
        <Amt>5764124</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>5764124</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>32734738</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>173165</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-433809</OtherRevenueAmt>
      <RevenueNotReportedAmt>-260644</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>32995382</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-336898</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-336898</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>32658484</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>30384901</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>336898</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>336898</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>30048003</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>3635119</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>3635119</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>33683122</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 2b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The funds held belong to the residents who are not able to manage their own finances. The funds are used to pay for services the organization provides to the resident and also provides the resident with funds for their own personal needs. The resident can request a payment from the account by completing a check request form or can obtain cash by completing a petty cash voucher. The residents receive a monthly statement showing the account activity and balance. Funds are maintained in a separate account earning interest if the balance is over $50. Any balance remaining at death or discharge is returned within 30 days.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Endowments Funds are used for nursing scholarships.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Diaconal Support -665,621. Minimum Pension Liability Adjustment 3,201,310. Investment Fees -71,781. Pension Expense -2,897,717.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Rental Expenses -242,464. Cost of Goods Sold -94,434.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Rental Expenses 242,464. Cost of Goods Sold 94,434.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Diaconal Support 665,621. Investment Fees 71,781. Pension Expense 2,897,717.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>QUARRYVILLE FIRE COMPANY 1</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 143</AddressLine1Txt>
          <CityNm>QUARRYVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>17566</ZIPCd>
        </USAddress>
        <RecipientEIN>236297242</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>6000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CONTRIBUTION TOWARDS AED MACHINE PURCHASE</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Charity care is provided to residents of QPRC who have run out of money.</GrantTypeTxt>
        <RecipientCnt>19</RecipientCnt>
        <CashGrantAmt>0</CashGrantAmt>
        <NonCashAssistanceAmt>665621</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>Difference between amount charged and amount received as payment</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>Write off of amounts due to QPRC for services rendered to residents who have been approved for charity care.</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Diaconal support is provided to residents who demonstrate their financial resources have been depleted, they are unable to pay for services rendered, and they are not eligible for third party reimbursement, via a financial assistance application. Personal spending for those who qualify is monitored and services provided by QPRC above the resident's monthly income is written off as charity care. Because the organization provided charity assistance to residents who are unable to pay for these services, it is reported as an expense under assistance to individuals.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <HousingAllowanceOrResidenceInd>X</HousingAllowanceOrResidenceInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <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>Robert Hayward Jr</PersonNm>
        <TitleTxt>President, CEO</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompensationFlngOrgAmt>8625</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>33182</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>415927</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Diane Aston</PersonNm>
        <TitleTxt>VP/CFO</TitleTxt>
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        <TotalCompensationFilingOrgAmt>255626</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Heath Hopstetter</PersonNm>
        <TitleTxt>VP/Facility Services</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>113</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>10</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3220</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>42443</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>165357</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kim Focht</PersonNm>
        <TitleTxt>Director of Human Resource</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>113</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3060</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28832</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>150692</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chaplain is provided a housing allowance. The organization conforms to the non-taxable housing allowance guidelines per the IRS' rules and regulations. The value of the housing allowance is $24,000. In addition, board members who become residents may receive tax gross-up payments to mitigate the tax effect of the entrance fee discounts provided by Quarryville. During the calendar year, Mark Van Gilst received a board discount of $18,564 and a tax gross up payment of $1,856.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>National Finance Authority</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521304598</BondIssuerEIN>
        <BondIssuedDt>2023-08-10</BondIssuedDt>
        <IssuePriceAmt>18651500</IssuePriceAmt>
        <PurposeDesc>refince debt and capital projects</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>91667</RetiredAmt>
        <TotalProceedsAmt>18660917</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>153908</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>1366554</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>16651489</OtherSpentProceedsAmt>
        <UnspentAmt>488966</UnspentAmt>
        <SubstantialCompletionYr>2024</SubstantialCompletionYr>
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        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
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        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
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        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The total proceeds on issuance differ from the amount in part I, column e, due to interest income generated from bond issue proceeds.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Jonathan Sneller and Andrew Fiol have a family relationship.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>The committees do not have the authority to act on behalf of the board. All matters are taken to the full board for approval and action.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The CFO and CEO will perform the initial review of the form 990. The Form 990 will then distributed via e-mail to the Audit and Finance Committee for review and comment. Once approved, the form 990 will be distributed via e-mail to each board member, prior to filing the return with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>All employees receive annual training on the code of conduct/conflict of interest policy. All employees are required to sign a code of ethics/conflict of interest statement. All conflict of interest statements are reviewed by human resources. Any disclosures are reviewed by the CFO and CEO. Reports of ethical issues are reviewed and resolved by the head of the ethics committee and the CEO. The Board of Directors are also required to sign the code of ethics/conflict of interest statement annually. There is a place on this form to disclose relationships, such as family or business contacts, that could be considered a conflict of interest. In the event a matter involving a potential or actual conflict of interest arises, the party to the conflict shall fully disclose the conflict's nature and extent immediately to the compliance officer who, after making a thorough review of the circumstances, will report to the QPRC Board of Directors who will determine appropraite action to be taken.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The officers' salaries are recommended by the Compensation Committee of the Board of Directors and are approved by the full Board. Salary surveys and Forms 990 of other not-for-profits are used for comparative purposes to ensure any compensation decisions are within fair market range for the industry. Deliberations and decisions are documented in the minutes of the Executive Committee. The Finance committee recommends approval of the budget to the full board. The budget includes a maximum percentage increase in salary for all staff. The job performance of each employee is taken into consideration as part of the performance review process.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The form 990 is available on Guidestar and is also available upon request. The Disclosure Statements as required by the Department of Insurance are also available upon request. The organization will make its governing documents and conflict of interest policy available upon request. The organization includes a copy of its financial statements with the state registration filed with the Pennsylvania Department of State, Bureau of Charitable Organizations. These documents are a matter of public record and can be viewed at the bureau office.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Minimum Pension Liability Adjustment 3,201,310.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>