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        <PersonNm>Mark Smeltzer</PersonNm>
        <TitleTxt>VP/Resident Services</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>132550</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21399</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John MacRae</PersonNm>
        <TitleTxt>Chaplain</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>42167</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46254</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kim Focht</PersonNm>
        <TitleTxt>Director of Human Resources</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>110813</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31059</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tom Wieland</PersonNm>
        <TitleTxt>Controller</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>104166</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16646</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>932972</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>194672</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>5</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>804904</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>758047</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>613199</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Lapp Electrical Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2420 Gehman Lane</AddressLine1Txt>
            <CityNm>Lancaster</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17602</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Electrical Install</ServicesDesc>
        <CompensationAmt>541612</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Robert J Work R Work Excavating Tru</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 536</AddressLine1Txt>
            <CityNm>Quarryville</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17566</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction Services</ServicesDesc>
        <CompensationAmt>415390</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>11</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>158374</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>91237</AllOtherContributionsAmt>
      <NoncashContributionsAmt>9600</NoncashContributionsAmt>
      <TotalContributionsAmt>249611</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Skilled Care Services</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>12223760</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12218806</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>4954</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Residential Living Svcs</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>8153227</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7077285</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1075942</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Personal Care Services</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>6065653</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6065653</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>26442640</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>128844</TotalRevenueColumnAmt>
        <ExclusionAmt>128844</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>227394</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>204725</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>22669</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>22669</TotalRevenueColumnAmt>
        <ExclusionAmt>22669</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2447472</SecuritiesAmt>
        <OtherAmt>102845</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>2182882</SecuritiesAmt>
        <OtherAmt>77564</OtherAmt>
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      <GainOrLossGrp>
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        <OtherAmt>25281</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>289871</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>50472</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>239399</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>137368</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>81311</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>56057</TotalRevenueColumnAmt>
        <ExclusionAmt>56057</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
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        <BusinessCd>110000</BusinessCd>
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        <UnrelatedBusinessRevenueAmt>216662</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Postage Income</Desc>
        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>3036</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Other Income</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1463</TotalRevenueColumnAmt>
        <ExclusionAmt>1463</ExclusionAmt>
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      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1108</TotalRevenueColumnAmt>
        <ExclusionAmt>1108</ExclusionAmt>
      </MiscellaneousRevenueGrp>
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      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>27411961</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>25361744</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>267134</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1533472</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>11000</TotalAmt>
        <ProgramServicesAmt>11000</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>1157485</TotalAmt>
        <ProgramServicesAmt>1157485</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>911566</TotalAmt>
        <ProgramServicesAmt>269484</ProgramServicesAmt>
        <ManagementAndGeneralAmt>642082</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>10374764</TotalAmt>
        <ProgramServicesAmt>9446131</ProgramServicesAmt>
        <ManagementAndGeneralAmt>928633</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>81696</ProgramServicesAmt>
        <ManagementAndGeneralAmt>325949</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>1607609</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98038</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>720017</ProgramServicesAmt>
        <ManagementAndGeneralAmt>55506</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>45260</TotalAmt>
        <ManagementAndGeneralAmt>45260</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>8411</ProgramServicesAmt>
        <ManagementAndGeneralAmt>133776</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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        <ManagementAndGeneralAmt>847</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>59440</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>2795411</TotalAmt>
        <ProgramServicesAmt>2621247</ProgramServicesAmt>
        <ManagementAndGeneralAmt>174164</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
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        <ProgramServicesAmt>185789</ProgramServicesAmt>
        <ManagementAndGeneralAmt>506</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2879141</TotalAmt>
        <ProgramServicesAmt>2696486</ProgramServicesAmt>
        <ManagementAndGeneralAmt>182655</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ManagementAndGeneralAmt>14155</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>1989944</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6823</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>53096</TotalAmt>
        <ProgramServicesAmt>44341</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8755</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>7510</TotalAmt>
        <ProgramServicesAmt>5923</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1587</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
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        <ProgramServicesAmt>9275</ProgramServicesAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>4069378</ProgramServicesAmt>
        <ManagementAndGeneralAmt>157167</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>103542</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24476</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Other Operational Exp.</Desc>
        <TotalAmt>670682</TotalAmt>
        <ProgramServicesAmt>312888</ProgramServicesAmt>
        <ManagementAndGeneralAmt>357794</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Med Supplies/svc</Desc>
        <TotalAmt>443952</TotalAmt>
        <ProgramServicesAmt>443952</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>NH Assessment Tax</Desc>
        <TotalAmt>243643</TotalAmt>
        <ProgramServicesAmt>243643</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Farm Expenses</Desc>
        <TotalAmt>100471</TotalAmt>
        <ManagementAndGeneralAmt>100471</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>20</TotalAmt>
        <FundraisingAmt>20</FundraisingAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>26028241</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3318084</ManagementAndGeneralAmt>
        <FundraisingAmt>20</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>1648517</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>1389845</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>1796420</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>103017</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>521723</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>130117296</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>73810930</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>56306366</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>4743564</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>1725906</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>183873</BOYAmt>
        <EOYAmt>180664</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>64748313</BOYAmt>
        <EOYAmt>68416022</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>6358295</EOYAmt>
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        <EOYAmt>21941978</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>15459679</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>11360</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>7454102</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
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      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>8127761</BOYAmt>
        <EOYAmt>6415477</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>57640891</EOYAmt>
      </TotalLiabilitiesGrp>
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        <EOYAmt>10695658</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>79473</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>10775131</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>64748313</BOYAmt>
        <EOYAmt>68416022</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1934384</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>48607</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>2484767</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>129409</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>618788</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1167337</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2714178</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>249611</CurrentTaxYearAmt>
        <TotalAmt>4879323</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>24131582</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>22864680</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24994530</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25361744</CurrentTaxYearAmt>
        <TotalAmt>120918619</TotalAmt>
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      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus4YearsAmt>1512130</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1287748</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1162452</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1131611</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1218264</CurrentTaxYearAmt>
        <TotalAmt>6312205</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>25207622</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>26038118</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>25194469</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>28840319</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26829619</CurrentTaxYearAmt>
        <TotalAmt>132110147</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
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        <CurrentTaxYearMinus3YearsAmt>57600</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>63193</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2300</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>22025</CurrentTaxYearAmt>
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      <SubstantialContributorsAmtGrp>
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      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>81500</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>57600</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>2300</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>22025</CurrentTaxYearAmt>
        <TotalAmt>226618</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>131883529</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
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        <CurrentTaxYearMinus3YearsAmt>317796</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>398422</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>376261</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>356238</CurrentTaxYearAmt>
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      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>329860</CurrentTaxYearMinus4YearsAmt>
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        <CurrentTaxYearMinus2YearsAmt>398422</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>376261</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>356238</CurrentTaxYearAmt>
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      <NetIncomeFromOtherUBIGrp>
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        <TotalAmt>7557</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>13516</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>12657</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8065</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5607</CurrentTaxYearAmt>
        <TotalAmt>46430</TotalAmt>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus3YearsAmt>26369430</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>25605548</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>29224645</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>27199021</CurrentTaxYearAmt>
        <TotalAmt>133942711</TotalAmt>
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      <PublicSupportCY509Pct>0.98460</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98440</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01330</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01360</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12, Explanation of Other Income:</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income - 2018 Amount: $ 3,371. 2019 Amount: $ 8,810. 2020 Amount: $ 2,621. 2021 Amount: $ 4,594. 2022 Amount: $ 2,571. Postage - 2018 Amount: $ 3,214. 2019 Amount: $ 3,356. 2020 Amount: $ 4,104. 2021 Amount: $ 3,426. 2022 Amount: $ 3,036. Non-charitable Fundraising Income - 2019 Amount: $ 1,350. 2020 Amount: $ 5,932. 2021 Amount: $ 45. 2022 Amount: $ 0.</ExplanationTxt>
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    </IRS990ScheduleA>
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        <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>
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      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>847</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>847</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization pays dues to a member organization dedicated to issues involving continuing care facilities and help and support for the elderly. The percentage of dues dedicated to lobbying is 8.6%. The organization paid $9,797 in dues for a total of $847 dues allocated to lobbying.</ExplanationTxt>
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    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <InclEscrowCustodialAcctLiabInd>1</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>12266</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>13</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12279</EndYearBalanceAmt>
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      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12265</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12266</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12260</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>5</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12265</EndYearBalanceAmt>
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      <CYMinus3YrEndwmtFundGrp>
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        <InvestmentEarningsOrLossesAmt>6</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12260</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12248</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>6</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>12254</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.00000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.81440</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.18560</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
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        <OtherCostOrOtherBasisAmt>692607</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1615220</BookValueAmt>
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      <BuildingsGrp>
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        <BookValueAmt>26563766</BookValueAmt>
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        <BookValueAmt>8057792</BookValueAmt>
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        <BookValueAmt>20069588</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>56306366</TotalBookValueLandBuildingsAmt>
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        <Desc>Liabilities to Residents</Desc>
        <Amt>6293001</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Accrued Pension Liability</Desc>
        <Amt>122476</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>6415477</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>28917282</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>48607</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>1170678</OtherRevenueAmt>
      <RevenueNotReportedAmt>1219285</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>27697997</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-286036</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-286036</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>27411961</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>28318292</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>286036</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>286036</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>28032256</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>1314089</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>1314089</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>29346345</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>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Diaconal Support 1,157,485. Investment Fees 59,440. Pension Expense 97,164.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
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        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Investments</TypeOfActivitiesConductedTxt>
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      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
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      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>287031</TotalSpentAmt>
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      <ForeignCorpOwnershipInd>0</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>0</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>1</ForeignPartnershipInd>
      <BoycottCountriesInd>0</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Accounting Method:</FormAndLineReferenceDesc>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, part VI, lines 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization had investments in foreign partnerships but did not meet thresholds for filing Forms 8865.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Charity care is provided to residents of QPRC who have run out of money.</GrantTypeTxt>
        <RecipientCnt>23</RecipientCnt>
        <CashGrantAmt>0</CashGrantAmt>
        <NonCashAssistanceAmt>1157485</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>
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    </IRS990ScheduleI>
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      <HousingAllowanceOrResidenceInd>X</HousingAllowanceOrResidenceInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
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      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robert Hayward Jr</PersonNm>
        <TitleTxt>President, CEO</TitleTxt>
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        <TotalCompensationFilingOrgAmt>372652</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Diane Aston</PersonNm>
        <TitleTxt>VP/CFO</TitleTxt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mark Smeltzer</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>3402</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>153949</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 $28,800. 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 $20,111 and a tax gross up payment of $2,011.</ExplanationTxt>
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          <BusinessNameLine1Txt>Quarryville Borough Authority</BusinessNameLine1Txt>
        </IssuerName>
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      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
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        <IssuerName>
          <BusinessNameLine1Txt>Paradise Township Sewer Authority</BusinessNameLine1Txt>
        </IssuerName>
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        <IssuePriceAmt>7500000</IssuePriceAmt>
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      </TaxExemptBondsIssuesGrp>
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        <BondReferenceCd>A</BondReferenceCd>
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        <IssuanceCostsFromProceedsAmt>50001</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>3949999</CapitalExpendituresAmt>
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      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
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        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
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        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <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>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <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>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</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>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </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 2,484,767.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
