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        <ProgramServicesAmt>3241</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31500</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>215990</TotalAmt>
        <ProgramServicesAmt>215990</ProgramServicesAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>4068</TotalAmt>
        <ProgramServicesAmt>3300</ProgramServicesAmt>
        <ManagementAndGeneralAmt>768</ManagementAndGeneralAmt>
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      <InterestGrp>
        <TotalAmt>181581</TotalAmt>
        <ProgramServicesAmt>181581</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>250402</TotalAmt>
        <ProgramServicesAmt>250402</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>523430</TotalAmt>
        <ProgramServicesAmt>523430</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>752699</TotalAmt>
        <ProgramServicesAmt>752699</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>68719</TotalAmt>
        <ProgramServicesAmt>68719</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>EQUIPMENT RENTAL &amp; MINO</Desc>
        <TotalAmt>61294</TotalAmt>
        <ProgramServicesAmt>61294</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>OTHER</Desc>
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        <ProgramServicesAmt>41561</ProgramServicesAmt>
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        <ProgramServicesAmt>9438288</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
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        <EOYAmt>-97198</EOYAmt>
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        <EOYAmt>301070</EOYAmt>
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        <EOYAmt>5490969</EOYAmt>
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        <EOYAmt>188536</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>9375375</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <EOYAmt>-3884406</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>-3884406</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>5490969</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>388541</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>87</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
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        <CurrentTaxYearMinus3YearsAmt>14733</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>161191</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1421211</CurrentTaxYearMinus1YearAmt>
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        <TotalAmt>4606127</TotalAmt>
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        <CurrentTaxYearMinus2YearsAmt>9172607</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7109004</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7438080</CurrentTaxYearAmt>
        <TotalAmt>43875897</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>10362100</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9333798</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8530215</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10425940</CurrentTaxYearAmt>
        <TotalAmt>48482024</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
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      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
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      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
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      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>48482024</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
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        <CurrentTaxYearMinus3YearsAmt>558</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1324</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>67</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>6130</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus2YearsAmt>1324</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>67</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>6130</TotalAmt>
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        <TotalAmt>276248</TotalAmt>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus3YearsAmt>10362658</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9611370</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8530282</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10425940</CurrentTaxYearAmt>
        <TotalAmt>48764402</TotalAmt>
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      <PublicSupportPY509Pct>0.99440</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00010</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00020</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>INSURANCE PROCEEDS - 2019 AMOUNT: $ 276,248.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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      <InclEscrowCustodialAcctLiabInd>0</InclEscrowCustodialAcctLiabInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>45000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>45000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>5651715</DepreciationAmt>
        <BookValueAmt>2451214</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>429637</DepreciationAmt>
        <BookValueAmt>903741</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>3399955</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>CONSTRUCTION IN PROGRESS</Desc>
        <BookValueAmt>3637</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DEFERRED LOAN COSTS</Desc>
        <BookValueAmt>197214</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>ESCROW</Desc>
        <BookValueAmt>160662</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
        <BookValueAmt>-60443</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>301070</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RELATED PARTY NOTES PAYABLE</Desc>
        <Amt>188536</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>188536</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF ADMINISTRATOR AND OTHER MANAGEMENT STAFF IS ADMINISTERED BY THE EXECUTIVE COMMITTEE AND THE BOARD OF DIRECTORS. COMPENSATION IS BASED ON AREA MARKET AND THE EXPERIENCE OF THE MANAGEMENT STAFF.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATIONS'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND IT'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACT MAINTENANCE: PROGRAM SERVICE EXPENSES 81,670. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,670. DATA PROCESSING: PROGRAM SERVICE EXPENSES 230,950. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,950. BOD FEES: PROGRAM SERVICE EXPENSES 4,200. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,200. QUALITY ASSESSMENT: PROGRAM SERVICE EXPENSES 627,845. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 627,845. CONTRACT NURSING: PROGRAM SERVICE EXPENSES 1,872,084. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,872,084. OTHER NURSING HOME CONSULTANTS: PROGRAM SERVICE EXPENSES 122,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 122,686.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
