<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2021v4.0" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-11-12T06:30:11-08:00</ReturnTs>
    <TaxPeriodEndDt>2022-05-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>061190201</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Peach &amp; McPherson CPA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>110 Washington Ave</AddressLine1Txt>
        <CityNm>North Haven</CityNm>
        <StateAbbreviationCd>CT</StateAbbreviationCd>
        <ZIPCd>06473</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>060653173</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>VNA Community Healthcare Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>VISI</BusinessNameControlTxt>
      <PhoneNum>2034584200</PhoneNum>
      <USAddress>
        <AddressLine1Txt>753 Boston Post Road Suite 200</AddressLine1Txt>
        <CityNm>Guilford</CityNm>
        <StateAbbreviationCd>CT</StateAbbreviationCd>
        <ZIPCd>06437</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>John MacDonald</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <SignatureDt>2022-11-10</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>John</PersonFirstNm>
        <PersonLastNm>MacDonald</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Raymond S Peach</PreparerPersonNm>
      <PTIN>P00156438</PTIN>
      <PhoneNum>2032349426</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
        <FederatedAssuranceLevelCd>FAL1</FederatedAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO BinaryAttachment.1" softwareId="21013475" softwareVersionNum="2021v4.0">
      <FinalReturnInd>X</FinalReturnInd>
      <PrincipalOfficerNm>Janine Fay</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>753 Boston Post Road Suite 200</AddressLine1Txt>
        <CityNm>Guilford</CityNm>
        <StateAbbreviationCd>CT</StateAbbreviationCd>
        <ZIPCd>06437</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>27568685</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>connecticuthomecare.com</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1922</FormationYr>
      <LegalDomicileStateCd>CT</LegalDomicileStateCd>
      <ActivityOrMissionDesc>It is the mission of the Organization to promote and preserve the health, safety, dignity and independence of individuals and families by providing therapeutic and preventive health care services to persons in their place of residence and in the community.</ActivityOrMissionDesc>
      <ContractTerminationInd>X</ContractTerminationInd>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>637</TotalEmployeeCnt>
      <TotalVolunteersCnt>53</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>5109130</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>324090</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>29822932</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>24653294</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>188559</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>517003</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>35120621</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>25494387</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>26026411</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>22627335</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>106388</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>5118544</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>4849280</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>31144955</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>27476615</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>3975666</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1982228</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>9784723</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>0</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3384216</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>0</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>6400507</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>0</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>It is the mission of the Organization to promote and preserve the health, safety, dignity and independence of individuals and families by providing therapeutic and preventive health care services to persons in their place of residence and in the community.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>21694686</ExpenseAmt>
      <RevenueAmt>24653294</RevenueAmt>
      <Desc>Health Services, including home health, hospice, homemaker/companion, school nursing and adult day care.</Desc>
      <TotalProgramServiceExpensesAmt>21694686</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd>false</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd>false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd>false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd>false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd referenceDocumentId="IRS990ScheduleN">true</TerminateOperationsInd>
      <PartialLiquidationInd referenceDocumentId="IRS990ScheduleN">false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="IRS990ScheduleR">true</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="IRS990ScheduleR">false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="IRS990ScheduleR">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="IRS990ScheduleR">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>25</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>637</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>true</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>John MacDonald</PersonNm>
        <PhoneNum>2034584200</PhoneNum>
        <USAddress>
          <AddressLine1Txt>753 Boston Post Road Suite 200</AddressLine1Txt>
          <CityNm>Guilford</CityNm>
          <StateAbbreviationCd>CT</StateAbbreviationCd>
          <ZIPCd>06437</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Janine Fay</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>259507</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33537</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John MacDonald</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>226939</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32936</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Donna Criscenzo</PersonNm>
        <TitleTxt>Medical Directot</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>206608</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4132</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jane Bonner</PersonNm>
        <TitleTxt>Psychiatric Nurse</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>154208</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30644</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James Limmer</PersonNm>
        <TitleTxt>Director of IT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>156401</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27560</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robyn Westerkamp</PersonNm>
        <TitleTxt>VP HR/Marketing</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>155470</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19777</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Guy Tommasi</PersonNm>
        <TitleTxt>Administrator LCH</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>139655</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31300</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lauren Janush</PersonNm>
        <TitleTxt>Psychiatric Nurse</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <ReportableCompFromOrgAmt>108308</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36896</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Cowan</PersonNm>
        <TitleTxt>Chairman</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Bradley Kronstat</PersonNm>
        <TitleTxt>Vice-Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Louise-Marie Dembry MD</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Brown</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Will Cushing PA-C</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Aaron Hershman Esq</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Gerald J Kerins MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christian McNamara</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Paolucci</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sally R Rinaldi RN MPH</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brian Sawchuk DDS</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Steven Supernaugh</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Diane Vorio RN MPH</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1407096</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>216782</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>36</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>207997</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>116093</AllOtherContributionsAmt>
      <TotalContributionsAmt>324090</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Health Services</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>24653294</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24653294</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>24653294</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>32412</TotalRevenueColumnAmt>
        <ExclusionAmt>32412</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2558889</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>2074298</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>484591</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>484591</TotalRevenueColumnAmt>
        <ExclusionAmt>484591</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>25494387</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24653294</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>517003</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>723874</TotalAmt>
        <ManagementAndGeneralAmt>723874</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>18340544</TotalAmt>
        <ProgramServicesAmt>16090339</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2164877</ManagementAndGeneralAmt>
        <FundraisingAmt>85328</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>355393</TotalAmt>
        <ProgramServicesAmt>298306</ProgramServicesAmt>
        <ManagementAndGeneralAmt>55449</ManagementAndGeneralAmt>
        <FundraisingAmt>1638</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1682787</TotalAmt>
        <ProgramServicesAmt>1412480</ProgramServicesAmt>
        <ManagementAndGeneralAmt>262552</ManagementAndGeneralAmt>
        <FundraisingAmt>7755</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1524737</TotalAmt>
        <ProgramServicesAmt>1279817</ProgramServicesAmt>
        <ManagementAndGeneralAmt>237893</ManagementAndGeneralAmt>
        <FundraisingAmt>7027</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>82307</TotalAmt>
        <ManagementAndGeneralAmt>82307</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>53335</TotalAmt>
        <ManagementAndGeneralAmt>53335</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1004872</TotalAmt>
        <ProgramServicesAmt>831572</ProgramServicesAmt>
        <ManagementAndGeneralAmt>172625</ManagementAndGeneralAmt>
        <FundraisingAmt>675</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>71814</TotalAmt>
        <ManagementAndGeneralAmt>71691</ManagementAndGeneralAmt>
        <FundraisingAmt>123</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1522219</TotalAmt>
        <ProgramServicesAmt>740219</ProgramServicesAmt>
        <ManagementAndGeneralAmt>780554</ManagementAndGeneralAmt>
        <FundraisingAmt>1446</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>5560</TotalAmt>
        <ManagementAndGeneralAmt>5560</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>561297</TotalAmt>
        <ManagementAndGeneralAmt>561297</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>389101</TotalAmt>
        <ProgramServicesAmt>370988</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18113</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>24530</TotalAmt>
        <ManagementAndGeneralAmt>24530</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>29902</TotalAmt>
        <ManagementAndGeneralAmt>29902</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>162484</TotalAmt>
        <ManagementAndGeneralAmt>162484</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>267467</TotalAmt>
        <ManagementAndGeneralAmt>267467</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debts</Desc>
        <TotalAmt>521139</TotalAmt>
        <ProgramServicesAmt>521139</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Health Promotion</Desc>
        <TotalAmt>123005</TotalAmt>
        <ProgramServicesAmt>119578</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1031</ManagementAndGeneralAmt>
        <FundraisingAmt>2396</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruitment</Desc>
        <TotalAmt>30248</TotalAmt>
        <ProgramServicesAmt>30248</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>27476615</TotalAmt>
        <ProgramServicesAmt>21694686</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5675541</ManagementAndGeneralAmt>
        <FundraisingAmt>106388</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>800</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1855713</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>167629</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>4131231</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>461300</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>482219</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>2672788</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>13043</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>9784723</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2408945</BOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>110669</BOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>60614</BOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>803988</BOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3384216</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>6400507</BOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>6400507</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>9784723</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1982228</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-733501</NetUnrlzdGainsLossesInvstAmt>
      <InvestmentExpenseAmt>-7637</InvestmentExpenseAmt>
      <OtherChangesInNetAssetsAmt>-3677141</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="21013475" softwareVersionNum="2021v4.0">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>168256</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>694600</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>208342</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5109130</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>324090</CurrentTaxYearAmt>
        <TotalAmt>6504418</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>31034001</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>29835662</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>29542438</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>29822932</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24653294</CurrentTaxYearAmt>
        <TotalAmt>144888327</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>31202257</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>30530262</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>29750780</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>34932062</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>24977384</CurrentTaxYearAmt>
        <TotalAmt>151392745</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <PublicSupportTotal509Amt>151392745</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>144236</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>196209</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>132872</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>188559</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>517003</CurrentTaxYearAmt>
        <TotalAmt>1178879</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>144236</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>196209</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>132872</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>188559</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>517003</CurrentTaxYearAmt>
        <TotalAmt>1178879</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>124</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1504</CurrentTaxYearMinus3YearsAmt>
        <TotalAmt>1628</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>31346617</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>30727975</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>29883652</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35120621</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>25494387</CurrentTaxYearAmt>
        <TotalAmt>152573252</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99230</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99550</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00770</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00440</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="21013475" softwareVersionNum="2021v4.0">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="21013475" softwareVersionNum="2021v4.0">
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Donna Criscenzo</PersonNm>
        <TitleTxt>Medical Directot</TitleTxt>
        <BaseCompensationFilingOrgAmt>206608</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4132</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>210740</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Guy Tommasi</PersonNm>
        <TitleTxt>Administrator LCH</TitleTxt>
        <BaseCompensationFilingOrgAmt>139655</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>2793</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28507</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>170955</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Limmer</PersonNm>
        <TitleTxt>Director of IT</TitleTxt>
        <BaseCompensationFilingOrgAmt>156401</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27560</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>183961</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jane Bonner</PersonNm>
        <TitleTxt>Psychiatric Nurse</TitleTxt>
        <BaseCompensationFilingOrgAmt>154208</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3084</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27560</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>184852</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Janine Fay</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>251507</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>8000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>5030</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28507</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>293044</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>John MacDonald</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>221939</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>5000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>4439</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>28497</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>259875</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robyn Westerkamp</PersonNm>
        <TitleTxt>VP HR/Marketing</TitleTxt>
        <BaseCompensationFilingOrgAmt>155470</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3109</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16668</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>175247</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleN documentId="IRS990ScheduleN" softwareId="21013475" softwareVersionNum="2021v4.0">
      <LiquidationOfAssetsTableGrp>
        <LiquidationOfAssetsDetail>
          <AssetsDistriOrExpnssPaidDesc>All Assets &amp; Liabilities (Net assets)</AssetsDistriOrExpnssPaidDesc>
          <DistributionDt>2022-05-22</DistributionDt>
          <FairMarketValueOfAssetAmt>3677141</FairMarketValueOfAssetAmt>
          <MethodOfFMVDeterminationTxt>Book Value</MethodOfFMVDeterminationTxt>
          <EIN>061044331</EIN>
          <USAddress>
            <AddressLine1Txt>309 Seaside Avenue</AddressLine1Txt>
            <CityNm>Milford</CityNm>
            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>06460</ZIPCd>
          </USAddress>
          <IRCSectionTxt>501(c)(3)</IRCSectionTxt>
        </LiquidationOfAssetsDetail>
      </LiquidationOfAssetsTableGrp>
      <DirectorOfSuccessorInd>false</DirectorOfSuccessorInd>
      <EmployeeOfSuccessorInd>false</EmployeeOfSuccessorInd>
      <OwnerOfSuccessorInd>false</OwnerOfSuccessorInd>
      <ReceiveCompensationInd>false</ReceiveCompensationInd>
      <AssetsDistributedInd>true</AssetsDistributedInd>
      <RequiredToNotifyAGInd>true</RequiredToNotifyAGInd>
      <AttorneyGeneralNotifiedInd>true</AttorneyGeneralNotifiedInd>
      <LiabilitiesPaidInd>true</LiabilitiesPaidInd>
      <BondsOutstandingInd>false</BondsOutstandingInd>
      <BondLiabilitiesDischargedInd>false</BondLiabilitiesDischargedInd>
    </IRS990ScheduleN>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="21013475" softwareVersionNum="2021v4.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors consists of community volunteers, who interact with each other in the normal course of business (i.e. banker, lawyer, accountant, etc.) unrelated to the activities of the Organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's audit firm prepares IRS Form 990 from information provided by the Organization. A draft copy is reviewed and approved by management. The draft copy is then forwarded to the Finance Committee for their review and input, if any. The draft is then presented to the complete Board of Directors for their review and input, if any. The final copy is then filed with the Internal Revenue Service.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually, all members of the Board of Directors are required to read the conflict of interest policy statement, disclose any conflicts of interest, and sign.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>The Chairperson of the Board of Directors reviews the President/CEO's performance and approves any compensation changes. If the Chairperson deems it necessary, he or she will also seek input from the Executive Committee of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>The President/CEO reviews the Chief Business Officer/CFO's performance and approves any compensation changes. Other top management's performance is reviewed by the President/CEO, who also approves any compensation changes for other top management.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's governing documents, conflict of interest policy and financial statements are available upon request. Information is maintained by the management of the Organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Distribution of Assets Due To Merger = -$3677141</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="21013475" softwareVersionNum="2021v4.0">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LifeTime Care at Home LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>753 Boston Post Road</AddressLine1Txt>
          <CityNm>Guilford</CityNm>
          <StateAbbreviationCd>CT</StateAbbreviationCd>
          <ZIPCd>06437</ZIPCd>
        </USAddress>
        <EIN>061587163</EIN>
        <PrimaryActivitiesTxt>Home Care Support Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CT</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Community Health Care Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LifeTime Helping Hands LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>753 Boston Post Road</AddressLine1Txt>
          <CityNm>Guilford</CityNm>
          <StateAbbreviationCd>CT</StateAbbreviationCd>
          <ZIPCd>06437</ZIPCd>
        </USAddress>
        <EIN>205301044</EIN>
        <PrimaryActivitiesTxt>Referral Source</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CT</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Community Health Care Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LifeTime Caregiver Placement Serv LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>753 Boston Post Road</AddressLine1Txt>
          <CityNm>Guilford</CityNm>
          <StateAbbreviationCd>CT</StateAbbreviationCd>
          <ZIPCd>06437</ZIPCd>
        </USAddress>
        <EIN>833573034</EIN>
        <PrimaryActivitiesTxt>Aide Placement Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CT</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Community Health Care Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
