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        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN MURPHY 22-23</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS DENNISON 22-23</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ROANN DESTITO 22-23</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MARY KATE ROLF</PersonNm>
        <TitleTxt>PRESIDENT AND CEO</TitleTxt>
        <AverageHoursPerWeekRt>4.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>35.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>445438</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>159428</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JUNE CASTLE</PersonNm>
        <TitleTxt>CFO/CAO</TitleTxt>
        <AverageHoursPerWeekRt>27.00</AverageHoursPerWeekRt>
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        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>304492</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30836</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BASIL ARIGLIO</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>26.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>14.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>342969</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42458</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA LAZAREK-LAQUAY</PersonNm>
        <TitleTxt>CCO</TitleTxt>
        <AverageHoursPerWeekRt>28.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>12.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>304578</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22291</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHERYL MANNA</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>286121</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43781</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH TWARDY</PersonNm>
        <TitleTxt>CTO (CH TRANSFORM OFF/EVP)</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>337709</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48437</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOEL AMIDON</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>375579</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25784</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JANET BILLINGTON</PersonNm>
        <TitleTxt>VP PERFORM EXCEL</TitleTxt>
        <AverageHoursPerWeekRt>38.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>235784</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20763</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RYAN BLEHAR</PersonNm>
        <TitleTxt>VP HR</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>185327</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31928</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMANDA FREDERICK</PersonNm>
        <TitleTxt>VP, HEALTH PLAN OPERATIONS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>189413</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34633</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY BESAW</PersonNm>
        <TitleTxt>VP, HOUSING DEVELOPMENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>171502</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7157</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH CHEVRETTE</PersonNm>
        <TitleTxt>VP, INFORMATION TECHNOLOGY</TitleTxt>
        <AverageHoursPerWeekRt>31.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>9.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>164123</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14806</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>946149</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2396886</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>482302</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>30</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>THE HAYNER HOYT CORPORATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>625 ERIE BLVD WEST</AddressLine1Txt>
            <CityNm>SYRACUSE</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13204</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CAPITAL PROJECT CONSTRUCTION</ServicesDesc>
        <CompensationAmt>4452722</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RAM TECHNOLOGIES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>275 COMMERCE DR SUITE 100</AddressLine1Txt>
            <CityNm>FORT WASHINGTON</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19034</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>2353359</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTH RECOVERY SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>50 HARRISON STREET STE 310</AddressLine1Txt>
            <CityNm>HOBOKEN</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>07030</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>313006</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WEX BANK</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 6293</AddressLine1Txt>
            <CityNm>CAROL STREAM</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60197</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FLEET VEHICLE MAINTENANCE</ServicesDesc>
        <CompensationAmt>305504</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TRHC OPCO INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>228 STRAWBRIDGE DRIVE SUITE 100</AddressLine1Txt>
            <CityNm>MOORESTOWN</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08057</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>276238</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>37</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>829361</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>326119</AllOtherContributionsAmt>
      <TotalContributionsAmt>1155480</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PREMIUM &amp; MEDICAID EXCESS REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>153588033</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>153588033</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>11695057</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11695057</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COVID TESTING-PRG SVC FEES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>144488</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>144488</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>UPSTATE ACUTE HOSPITAL CARE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>126385</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>126385</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>DOH HOME CARE WORKER BONUS</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>74279</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>74279</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>165628242</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>714086</TotalRevenueColumnAmt>
        <ExclusionAmt>714086</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>263562</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>813319</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-549757</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-549757</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>-183864</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-365893</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>13140002</SecuritiesAmt>
        <OtherAmt>50916</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>12360270</SecuritiesAmt>
        <OtherAmt>15817</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>779732</SecuritiesAmt>
        <OtherAmt>35099</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>814831</TotalRevenueColumnAmt>
        <ExclusionAmt>814831</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>CONTRACT SUPPORT SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2066271</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2066271</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>8396</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>8396</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FLU SHOTS, MED RECORDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>4063</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4063</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueTotalAmt>2078730</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>169841612</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>167706972</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>-183864</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1163024</ExclusionAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>23222111</TotalAmt>
        <ProgramServicesAmt>17073168</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6133058</ManagementAndGeneralAmt>
        <FundraisingAmt>15885</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>772505</TotalAmt>
        <ProgramServicesAmt>558330</ProgramServicesAmt>
        <ManagementAndGeneralAmt>213339</ManagementAndGeneralAmt>
        <FundraisingAmt>836</FundraisingAmt>
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        <TotalAmt>2577964</TotalAmt>
        <ProgramServicesAmt>1764745</ProgramServicesAmt>
        <ManagementAndGeneralAmt>813207</ManagementAndGeneralAmt>
        <FundraisingAmt>12</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>2197420</TotalAmt>
        <ProgramServicesAmt>1616803</ProgramServicesAmt>
        <ManagementAndGeneralAmt>579408</ManagementAndGeneralAmt>
        <FundraisingAmt>1209</FundraisingAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>170688</TotalAmt>
        <ProgramServicesAmt>127054</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43634</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>69530</TotalAmt>
        <ProgramServicesAmt>69530</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>150347</TotalAmt>
        <ManagementAndGeneralAmt>150347</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>5502326</TotalAmt>
        <ProgramServicesAmt>4212322</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1290004</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>184036</TotalAmt>
        <ProgramServicesAmt>8617</ProgramServicesAmt>
        <ManagementAndGeneralAmt>175419</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>813697</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1197527</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>325656</ProgramServicesAmt>
        <ManagementAndGeneralAmt>121919</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>1004638</TotalAmt>
        <ProgramServicesAmt>804537</ProgramServicesAmt>
        <ManagementAndGeneralAmt>200101</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>41637</TotalAmt>
        <ProgramServicesAmt>18605</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23032</ManagementAndGeneralAmt>
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      <InterestGrp>
        <TotalAmt>480699</TotalAmt>
        <ProgramServicesAmt>49663</ProgramServicesAmt>
        <ManagementAndGeneralAmt>431036</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>1475926</TotalAmt>
        <ProgramServicesAmt>887012</ProgramServicesAmt>
        <ManagementAndGeneralAmt>588567</ManagementAndGeneralAmt>
        <FundraisingAmt>347</FundraisingAmt>
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      <InsuranceGrp>
        <TotalAmt>659448</TotalAmt>
        <ProgramServicesAmt>302613</ProgramServicesAmt>
        <ManagementAndGeneralAmt>356835</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>PATIENT CARE</Desc>
        <TotalAmt>115759467</TotalAmt>
        <ProgramServicesAmt>115759467</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER CONTRACT SERVICES</Desc>
        <TotalAmt>6851623</TotalAmt>
        <ProgramServicesAmt>3251206</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3600417</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>UNCOLLECTIBLE ACCOUNTS</Desc>
        <TotalAmt>855000</TotalAmt>
        <ProgramServicesAmt>855000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES AND ANCILLARY</Desc>
        <TotalAmt>852215</TotalAmt>
        <ProgramServicesAmt>304008</ProgramServicesAmt>
        <ManagementAndGeneralAmt>548207</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>516817</TotalAmt>
        <ProgramServicesAmt>15674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>501143</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>165803196</TotalAmt>
        <ProgramServicesAmt>148817707</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16967200</ManagementAndGeneralAmt>
        <FundraisingAmt>18289</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>19733222</BOYAmt>
        <EOYAmt>26023477</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1573431</BOYAmt>
        <EOYAmt>2082981</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1109928</BOYAmt>
        <EOYAmt>812109</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>29568286</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>6663790</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>18298565</BOYAmt>
        <EOYAmt>22904496</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>27578162</BOYAmt>
        <EOYAmt>20016774</EOYAmt>
      </InvestmentsPubTradedSecGrp>
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        <NontaxableBenefitsFilingOrgAmt>26788</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>224046</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RYAN BLEHAR</PersonNm>
        <TitleTxt>VP HR</TitleTxt>
        <BaseCompensationFilingOrgAmt>167177</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>18150</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7029</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24899</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>217255</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH CHEVRETTE</PersonNm>
        <TitleTxt>VP, INFORMATION TECHNOLOGY</TitleTxt>
        <BaseCompensationFilingOrgAmt>148923</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15200</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5874</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>178929</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KELLY BESAW</PersonNm>
        <TitleTxt>VP, HOUSING DEVELOPMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>164002</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>7500</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6935</DeferredCompensationFlngOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. IS THE EMPLOYER OF THE CEO. THE ORGANIZATION'S EXECUTIVE COMMITTEE IS THE COMPENSATION COMMITTEE AND THEY APPROVE THE COMPENSATION OF THE CEO. THE COMMITTEE USES THE ANNUAL BENCHMARK HOMECARE SALARY AND BENEFITS REPORT, AND ALSO LOOKS AT EXECUTIVE COMPENSATION OF SIMILAR SIZE ORGANIZATIONS AS WELL AND EVALUATES HER PERFORMANCE FOR THE YEAR. THE CEO USES THE SAME METHOD FOR THE COMPENSATION OF THE OTHER KEY EMPLOYEES.</ExplanationTxt>
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        <NameOfInterested>
          <PersonNm>JENNAFER ROLF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>84998</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BROOKE D'AMICO</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CAO</RelationshipDescriptionTxt>
        <TransactionAmt>75310</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>THOMAS ARIGLIO</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SON OF CFO</RelationshipDescriptionTxt>
        <TransactionAmt>55801</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JAIME ROLF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>26736</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BRIAN CAVANAGH</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BROTHER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>39212</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK, INC. IS NASCENTIA HEALTH, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. IS THE SOLE MEMBER OF VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK, INC. THE MEMBER RESERVES TO ITSELF ALL THE RIGHTS AND POWERS OF CORPORATE MEMBERSHIP CREATED BY THE LAWS OF THE STATE OF NEW YORK OR THE CERTIFICATE OF INCORPORATION OR THE BY-LAWS OF THE CORPORATION. SPECIFICALLY, THE MEMBER RESERVES THE AUTHORITY TO APPOINT DIRECTORS TO THE GOVERNING BODY, TO AMEND THE BY-LAWS OF THE CORPORATION, AND TO APPROVE THE SALE, TRANSFER, OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT REVIEWS FORM 990, THEN SENDS ENCRYPTED E-MAIL TO THE BOARD MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEM TO REVIEW PRIOR TO THE FILING OF THE FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE WRITTEN CONFLICT OF INTEREST POLICY IS REVIEWED ON AN ANNUAL BASIS. SIGNATURES FROM THE BOARD MEMBERS DISCLOSING CONFLICTS OF INTEREST ARE UPDATED ON AN ANNUAL BASIS AS WELL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S EXECUTIVE COMMITTEE IS THE COMPENSATION COMMITTEE AND THEY APPROVE THE COMPENSATION OF THE CEO. THE COMMITTEE USES THE ANNUAL BENCHMARK HOMECARE SALARY AND BENEFITS REPORT, AND ALSO LOOKS AT EXECUTIVE COMPENSATION OF SIMILAR SIZE ORGANIZATIONS AS WELL AND EVALUATES HER PERFORMANCE FOR THE YEAR. THE CEO USES THE SAME METHOD FOR THE COMPENSATION OF THE OTHER KEY EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>PENSION/POST RETIREMENT 94,078. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,028,755. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -516,767.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 12, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA HOMECARE OPTIONS LLC (DBA NASCENTIA HEALTH OPTIONS)</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1050 W GENESEE STREET</AddressLine1Txt>
          <CityNm>SYRACUSE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13204</ZIPCd>
        </USAddress>
        <EIN>455291202</EIN>
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        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NASCENTIA NEIGHBORHOOD AT THE BEECHES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1050 W GENESEE STREET</AddressLine1Txt>
          <CityNm>SYRACUSE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13204</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>HOUSING INITIATIVES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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          <CityNm>SYRACUSE</CityNm>
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        </USAddress>
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      <IdRelatedTaxExemptOrgGrp>
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        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>CCH HOME CARE &amp; PALLIATIVE SERVICES INC</BusinessNameLine1Txt>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
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        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HOME AIDES OF CNY (DBA NASCENTIA HOME AIDES)</BusinessNameLine1Txt>
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          <AddressLine1Txt>1050 WEST GENESEE STREET</AddressLine1Txt>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13204</ZIPCd>
        </USAddress>
        <EIN>160916474</EIN>
        <PrimaryActivitiesTxt>ENABLE AGING, ILL AND FRAIL INDIVIDUALS TO REMAIN AT HOME</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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      <IdRelatedOrgTxblCorpTrGrp>
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      <IdRelatedOrgTxblCorpTrGrp>
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      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
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      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>1</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
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      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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  </ReturnData>
</Return>
