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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>COLIN LEONARD</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <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>483635</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>140419</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JUNE CASTLE</PersonNm>
        <TitleTxt>CFO/CAO</TitleTxt>
        <AverageHoursPerWeekRt>15.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>25.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>256075</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24945</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BASIL ARIGLIO</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>16.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>24.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>261556</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36791</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA LAZAREK-LAQUAY</PersonNm>
        <TitleTxt>CCO</TitleTxt>
        <AverageHoursPerWeekRt>12.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>28.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>248638</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14674</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHERYL MANNA</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>16.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>24.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>240846</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18116</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY ANNE HANKINS 19-20</PersonNm>
        <TitleTxt>VP OF HR</TitleTxt>
        <AverageHoursPerWeekRt>15.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>25.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>154796</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>-14789</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH TWARDY</PersonNm>
        <TitleTxt>CTO (CH TRANSFORM OFF/EVP)</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>248019</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38102</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOEL AMIDON</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>24.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>16.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>162812</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20967</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JANET BILLINGTON</PersonNm>
        <TitleTxt>VP PERFORM EXCEL</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>154828</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17043</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GAIL CARMICHEL</PersonNm>
        <TitleTxt>CLINICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>145412</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18362</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT BLEHAR</PersonNm>
        <TitleTxt>DIR PROV RELATIONS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>139982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14088</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TAMMY LINDSAY</PersonNm>
        <TitleTxt>CHIEF OF STAFF</TitleTxt>
        <AverageHoursPerWeekRt>16.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>24.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>140625</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32390</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW FOGARTY</PersonNm>
        <TitleTxt>CORPORATE COUNSEL &amp; COMPLIANCE</TitleTxt>
        <AverageHoursPerWeekRt>16.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>24.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>137616</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16892</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>440222</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2334618</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>378000</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>12</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HOME AIDES OF CENTRAL NEW YORK INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1050 W GENESEE STREET</AddressLine1Txt>
            <CityNm>SYRACUSE</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13204</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LICENSED HOME CARE SERVICES</ServicesDesc>
        <CompensationAmt>2595543</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MEDITURE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>C/O TABULA RASA 228 STRAWBRIDGE DR</AddressLine1Txt>
            <CityNm>MOORESTOWN</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08057</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>265276</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TRHC OPCO INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>TABULA RASA 228 STRAWBRIDGE DR</AddressLine1Txt>
            <CityNm>MORRESTOWN</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08057</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>250403</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DAYMARCK LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6405 METCALF STE 108</AddressLine1Txt>
            <CityNm>OVERLAND PARK</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66202</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>236530</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HOMECARE HOMEBASE LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 678637</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75267</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AND PROGRAM CONSULTANTS</ServicesDesc>
        <CompensationAmt>213340</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>9</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>16338</GovernmentGrantsAmt>
      <TotalContributionsAmt>16338</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PREMIUM &amp; MEDICAID EXCESS REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>347685740</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>347685740</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>13489746</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13489746</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COVID TESTING-PRG SVC FEES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>829180</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>829180</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PRICE CONCESSION ADD BACK-OPT</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>575000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>575000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>BAD DEBT EXPENSE ADD BACK-VNA</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>-81011</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-81011</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>362498655</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1224397</TotalRevenueColumnAmt>
        <ExclusionAmt>1224397</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>9177848</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>8767403</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>410445</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>410445</TotalRevenueColumnAmt>
        <ExclusionAmt>410445</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>MGMT SVC FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1392495</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1392495</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FLSA</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>822296</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>822296</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>6540</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6540</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>358</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>358</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>2221689</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>366371524</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>364720344</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1634842</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>22268143</TotalAmt>
        <ProgramServicesAmt>16711170</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5539004</ManagementAndGeneralAmt>
        <FundraisingAmt>17969</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>691801</TotalAmt>
        <ProgramServicesAmt>514109</ProgramServicesAmt>
        <ManagementAndGeneralAmt>177692</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2410505</TotalAmt>
        <ProgramServicesAmt>1497777</ProgramServicesAmt>
        <ManagementAndGeneralAmt>904817</ManagementAndGeneralAmt>
        <FundraisingAmt>7911</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2397474</TotalAmt>
        <ProgramServicesAmt>1811600</ProgramServicesAmt>
        <ManagementAndGeneralAmt>585874</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>38994</TotalAmt>
        <ProgramServicesAmt>9892</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29102</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>232150</TotalAmt>
        <ProgramServicesAmt>136490</ProgramServicesAmt>
        <ManagementAndGeneralAmt>95660</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>205490</TotalAmt>
        <ManagementAndGeneralAmt>205490</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <OfficeExpensesGrp>
        <TotalAmt>6778610</TotalAmt>
        <ProgramServicesAmt>4849309</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1929301</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>452101</TotalAmt>
        <ProgramServicesAmt>173119</ProgramServicesAmt>
        <ManagementAndGeneralAmt>278982</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>953406</TotalAmt>
        <ProgramServicesAmt>888469</ProgramServicesAmt>
        <ManagementAndGeneralAmt>64937</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>427222</TotalAmt>
        <ProgramServicesAmt>97662</ProgramServicesAmt>
        <ManagementAndGeneralAmt>329560</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1986779</TotalAmt>
        <ProgramServicesAmt>1577447</ProgramServicesAmt>
        <ManagementAndGeneralAmt>409332</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>506338</TotalAmt>
        <ProgramServicesAmt>486777</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19561</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT CARE</Desc>
        <TotalAmt>307843616</TotalAmt>
        <ProgramServicesAmt>307843616</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER CONTRACT SERVICES</Desc>
        <TotalAmt>6193947</TotalAmt>
        <ProgramServicesAmt>3169150</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3024797</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROFESSIONAL SUPPLIES A</Desc>
        <TotalAmt>750793</TotalAmt>
        <ProgramServicesAmt>744407</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6386</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>UNCOLLECTIBLE ACCOUNTS</Desc>
        <TotalAmt>575000</TotalAmt>
        <ProgramServicesAmt>575000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>354712369</TotalAmt>
        <ProgramServicesAmt>341085994</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13600495</ManagementAndGeneralAmt>
        <FundraisingAmt>25880</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>12049906</BOYAmt>
        <EOYAmt>18439852</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>867381</BOYAmt>
        <EOYAmt>171108</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>10105331</BOYAmt>
        <EOYAmt>2153818</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1223995</BOYAmt>
        <EOYAmt>898840</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>18261991</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4158422</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>14701344</BOYAmt>
        <EOYAmt>14103569</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>25086294</BOYAmt>
        <EOYAmt>27901148</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>21748408</BOYAmt>
        <EOYAmt>22560758</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>85782659</BOYAmt>
        <EOYAmt>86229093</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>53079754</BOYAmt>
        <EOYAmt>17194961</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>7149580</BOYAmt>
        <EOYAmt>7006753</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>1488740</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>18513714</BOYAmt>
        <EOYAmt>38069009</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>80231788</BOYAmt>
        <EOYAmt>62270723</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>5550871</BOYAmt>
        <EOYAmt>23958370</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5550871</BOYAmt>
        <EOYAmt>23958370</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>85782659</BOYAmt>
        <EOYAmt>86229093</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
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        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>154508</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT BLEHAR</PersonNm>
        <TitleTxt>DIR PROV RELATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>139982</BaseCompensationFilingOrgAmt>
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        <PersonNm>MARY ANNE HANKINS 19-20</PersonNm>
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        <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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        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
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      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BROOKE D'AMICO</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CAO</RelationshipDescriptionTxt>
        <TransactionAmt>68187</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>THOMAS ARIGLIO</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SON OF CFO</RelationshipDescriptionTxt>
        <TransactionAmt>25772</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
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      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JAIME ROLF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
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        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
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        <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>
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      <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>
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      <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 -302,326. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -506,494. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -190,952. COVID-19 PPP REVENUE FORGIVENESS-REC'D IN 2021 5,493,063.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 12, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.</ExplanationTxt>
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    </IRS990ScheduleO>
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</Return>
